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Consequences of prophylactic bilateral oophorectomy

Definition of the Procedure

Bilateral oophorectomy is a surgical procedure which involves the sequential or simultaneous removal of both ovaries in a woman. There are different causes which may call for this type of surgery including the prophylaxis against cancer, an ovarian cyst, endometriosis, different types of benign diseases of the ovaries or cases of malignancies. In most patients, this type of surgical procedure is usually performed alongside with another type of surgical intervention called hysterectomy. Hysterectomy is a surgical intervention in which the woman’s uterus gets removed as well. There are a large number of women who suffer from a premature loss of ovarian function which occurs due to bilaterally oopherectomy performed before the natural menopause occurs.

Consequence of the Procedure

Even though bilateral oophorectomy is performed in order to take care of certain medical problems, it still may be associated with a wide array of different long term consequences and complications. Women who have to undergo oopherectomy before they reach their natural menopause are the ones which are most likely to have further medical complications. A large number of cases treated with bilateral oophrorectomy may lead to the development of cardiovascular diseases. The risk is much larger than in women who are premenopausal. Women who had bilateral oophorectomy sometimes use estrogen in order to reduce the risk of ischemic heart disease. On the other hand, bilateral oophorectomy may also be associated with a somewhat increased risk of coronary heart disease. The same can be said for increased risk of stroke as well. Some extreme cases may also be involved in an increased risk of premature cardiac death. It should be pointed out that bilateral oophorectomy in general may be involved with increased risk of different medical conditions such as impaired sexual functions, different sorts of psychiatric symptoms, fractures, osteoporosis, Parkinsonism, cognitive impairments, lung cancer, stroke and various types of mortality. On the other hand, bilateral oophorectomy significantly decreases the risk of breast cancer and ovarian cancer. Bilateral oophorectomy performed before the onset of natural menopause may be connected with a higher risk of dementia or cognitive impairment as well. The surgery may sometimes be held responsible for the onset of significant decrease in certain executive functions, procedural learning, verbal memory, verbal fluency and several other types of cognitive functions. When oophrectomy gets performed in women of younger age, it may additionally associated with worsened neurocognitive performance. Estrogen used in the treatment period may sometimes have certain harmful effects and trigger symptoms such as sleep disruption and some vasomotor symptoms. Bilateral oophorectomy performed before the onset of natural menopause carries risk of Parkinsonism and Parkinson’s disease. For those who do not know, Parkinsonism is a certain type of neurological syndrome which also includes Parkinson’s disease. Women who undergo bilateral oophorectomy before they get to experience the onset of their natural menopause are typically at higher risk of bone fractures and certain bone related medical conditions such as osteoporosis. In addition, the risk of osteoporosis is significantly increased in women who undergo the same procedure after the onset of natural menopause. Certain non-hormonal treatment options may be effective to a certain extent when it comes to preventing the onset of osteoporosis precipitated by bilateral oophorectomy. All in all, there are many negative effects bilateral oophorectomy brings along, most of which require additional treatment.

Mental Health and Sexual Function

Certain scientific studies have shown that hysterectomy performed in order to deal with certain types of benign diseases may also provide additional health benefits. Namely, it can be very efficient when it comes to improving the overall psychological well being of a person. It can also largely improve the quality of the patient’s life. Those same studies have also shown that hysterectomy combined with another surgical intervention known as bilateral oophorectomy may only have negative effects and a largely worsened state of a person’s overall psychological well being. Most women who undergo bilateral oophorectomy combined with hysterectomy before their natural menopause are often faced with higher risk of depression and anxiety. Those women also tend to be far less positive than those who only undergo hysterectomy. Fortunately, estrogen may be of great help in women who have oophorectomy performed before the onset of their natural menopause. As already mentioned, women who have had bilateral oophorectomy before the onset of natural menopause tend to suffer from a lot of problems related to their sexual function. Unfortunately, such problems with sexual function cannot be alleviated by using estrogen hormonal therapy. One of the most terrifying facts is the one that most women who tend to suffer from depression and anxiety induced by bilateral oophorectomy performed before the onset of natural menopause usually continue to experience such symptoms for many years after the surgery.  Libido, sexual arousal and orgasms get significantly affected as well by bilateral oophorectomy. 

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