Psychiatric Disorders May Up Risk for Bilateral Oophorectomy

Certain mental health conditions are associated with an increased risk for unnecessary bilateral oophorectomy for nonmalignant indications, according to a study published online in Menopause.

Liliana Gazzuola Rocca, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues used linked records from the Rochester Epidemiology Project to identify 1,653 premenopausal women who underwent bilateral oophorectomy for a nonmalignant indication (1988 to 2007). Each woman was age-matched to a population-based control who had not undergone bilateral oophorectomy.

The researchers found that preexisting mood disorders, anxiety disorders, and somatoform disorders were associated with an increased risk for bilateral oophorectomy. Similar associations were also seen for women ≤45 years of age at index date. Increased risk was only seen for personality disorders in unadjusted analyses, while adjustment disorders were only significant for women 46 to 49 years of age. There was significant variance in risk across strata by age at index date and by indication. In adjusted analysis, there was a linear trend of increasing odds ratios with more mental health conditions (1.55 for one mental health condition and 2.19 for at least three conditions).

"This study serves as an important reminder that mental health issues are common and can sometimes present with physical symptoms. It is incumbent on primary care providers, including gynecologists, to determine whether mental health conditions are playing a role in gynecologic complaints in order to provide patients with the most appropriate care," a coauthor said in a statement. "We know that there are significant long-term adverse health consequences associated with removing a woman's ovaries before the natural age of menopause, let alone the potential risks of an unnecessary surgical procedure."

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