Our Summary

This study looks at the relationship between women who had their ovaries removed before menopause (a procedure called bilateral salpingo-oophorectomy, or BSO) and the development of cognitive impairment or dementia. The study specifically investigates changes in the structure of a part of the brain called the medial temporal lobe, the presence of a brain lesion, and the build-up of a protein called β-amyloid, which is associated with Alzheimer’s disease.

The research involved women who had undergone BSO between 1988 and 2007 and a control group of women who had not had this surgery. Both groups underwent a range of scans and tests to measure the factors being investigated.

The results showed that women who had undergone BSO had smaller amygdala volumes and thinner parahippocampal-entorhinal cortex (parts of the brain) than the control group. In addition, women in the BSO group had lower entorhinal white matter fractional anisotropy, a measure of the health of the brain’s white matter.

The study concludes that the sudden hormonal changes caused by BSO in premenopausal women could lead to structural changes in the brain later in life. However, more research is needed to see if this leads to cognitive decline.

FAQs

  1. What is the relationship between bilateral salpingo-oophorectomy and cognitive impairment or dementia?
  2. What differences were found in the brain structures of women who underwent BSO compared to those who didn’t?
  3. Can the hormonal changes caused by BSO in premenopausal women lead to structural changes in the brain later in life?

Doctor’s Tip

One tip a doctor might give to a patient considering salpingo-oophorectomy is to discuss the potential risks and benefits with their healthcare provider. It is important to weigh the potential impact on hormonal balance and brain health, as well as the potential benefits of reducing the risk of ovarian cancer or other conditions. Additionally, patients should consider alternative options and explore other ways to manage their health concerns before undergoing this procedure.

Suitable For

Patients who are typically recommended for salpingo-oophorectomy include those who have a high risk of developing ovarian cancer or have a family history of ovarian or breast cancer, those with certain genetic mutations such as BRCA1 or BRCA2, and those with certain gynecologic conditions such as endometriosis or ovarian cysts. Additionally, women who have completed childbearing and wish to reduce their risk of ovarian cancer may also be recommended for this procedure.

Timeline

In summary, before a salpingo-oophorectomy, a patient may experience symptoms such as pelvic pain, abnormal bleeding, or a family history of ovarian or breast cancer. They may undergo diagnostic tests such as ultrasound, MRI, or blood tests to confirm the need for surgery.

After the surgery, the patient will likely experience some discomfort and pain, which can be managed with medication. They may also have restrictions on physical activity for a certain period of time. Depending on the reason for the surgery, the patient may need hormone replacement therapy to manage menopausal symptoms.

In the long term, a patient who has undergone salpingo-oophorectomy may be at higher risk for certain health issues, such as osteoporosis or heart disease, due to hormonal changes. Regular follow-up appointments with a healthcare provider are important to monitor any potential complications or changes in health.

What to Ask Your Doctor

  1. What are the reasons for considering a salpingo-oophorectomy?

  2. What are the potential risks and complications associated with this procedure?

  3. How will the removal of my ovaries affect my hormonal balance and overall health?

  4. What are the potential long-term consequences of having a salpingo-oophorectomy, such as the development of cognitive impairment or dementia?

  5. Are there any alternative treatments or procedures that could achieve the same goal without removing my ovaries?

  6. How will the removal of my ovaries impact my fertility and menopausal symptoms?

  7. Is there a possibility of hormone replacement therapy after the procedure to mitigate any negative effects on my health?

  8. What follow-up care or monitoring will be necessary after the surgery?

  9. Are there any lifestyle changes or precautions I should take after undergoing a salpingo-oophorectomy?

  10. Can you provide more information on the specific findings of this study and how they may apply to my individual situation?

Reference

Authors: Zeydan B, Tosakulwong N, Schwarz CG, Senjem ML, Gunter JL, Reid RI, Gazzuola Rocca L, Lesnick TG, Smith CY, Bailey KR, Lowe VJ, Roberts RO, Jack CR Jr, Petersen RC, Miller VM, Mielke MM, Rocca WA, Kantarci K. Journal: JAMA Neurol. 2019 Jan 1;76(1):95-100. doi: 10.1001/jamaneurol.2018.3057. PMID: 30326011