Effect of prior oophorectomy on changes in bone mineral density and carotid artery intima media thickness in postmenopausal women

Capsule:
Secondary analysis of the Women’s Isoflavone Soy Health trial demonstrates that as menopausal onset increases in healthy postmenopausal women, oophorectomy is associated with faster rates of bone loss and carotid artery intima-media thickening.

Authors:
Sara J. Mucowski, M.D., Wendy Mack, Ph.D., Donna Shoupe, M.D., M.B.A., Naoko Kono, M.P.H., Richard Paulson, M.D., Howard N. Hodis, M.D.

Volume 101, Issue 4, Pages 1117-1122

Abstract:

Objective:
To determine the effect of prior oophorectomy in healthy postmenopausal women on the rate of loss of bone mineral density (BMD) and rate of increase in carotid artery intima-media thickness (CIMT).

Design:
Secondary analysis from a randomized controlled trial.

Setting:
University-based research clinic.

Patient(s):
Two hundred twenty-two healthy postmenopausal women in the Greater Los Angeles area.

Intervention(s):
Baseline and annual screening of BMD and assessment of CIMT every 6 months for a total of 3 years.

Main Outcome Measure(s):
Changes in BMD and CIMT during postmenopausal years.

Result(s):
Among women who were menopausal for more than 10 years, the rate of CIMT progression was statistically significantly less in women with intact ovaries compared with those in women with prior oophorectomy. In women 5–10 years postmenopause, there was a trend toward a slower loss of BMD in those who retained their ovaries, and in women more than 10 years postmenopause there was significantly less BMD loss in those who retained their ovaries.

Conclusion(s):
As time from menopausal transition increases, retained ovaries are associated with a slower rate of bone loss and a slower rate of thickening of the carotid artery wall compared with rates in menopausal women with oophorectomy.

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