Oophorectomy as a risk factor for coronary heart disease
Presented at the Women's Reproductive Health Research Symposium, Rochester, NY, June 1-3, 2008; and at the American Association of Gynecologic Laparoscopists Annual Meeting, Las Vegas, NV, Oct. 29-Nov. 1.
Received 26 January 2008; received in revised form 27 May 2008; accepted 20 August 2008. published online 19 November 2008.
Objective
The objective of the study was to examine the relationship between bilateral oophorectomy (BSO) and risk of coronary heart disease (CHD).
Study Design
We searched PubMed, EMBASE, meeting abstracts, and reference lists for studies that compared women with BSO at the time of hysterectomy with: (1) women with hysterectomy and ovarian conservation, (2) naturally menopausal women, (3) premenopausal women, or (4) women with no history of hysterectomy or BSO but unreported menopausal status. The primary outcome was fatal or nonfatal CHD.
Results
We reviewed 1956 citations. Seven observational studies met inclusion criteria. Heterogeneity among studies precluded formal metaanalysis. Four studies reported BSO increases risk for CHD but only in some subgroups of women or not in fully adjusted multivariate models. Three studies found no increased risk of CHD following BSO, but these studies had significant limitations.
Conclusion
The existing evidence is inconclusive to determine the effect of BSO on risk of CHD.
aDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, CA
bDepartment of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA
Reprints: Vanessa Jacoby, MD, MAS, University of California, San Francisco, Women's Health Clinical Research Center, 1635 Divisadero St, Suite 600, San Francisco, CA 94115
Cite this article as: Jacoby VL, Grady D, Sawaya GF, et al. Oophorectomy as a risk factor for coronary heart disease. Am J Obstet Gynecol 2009;200:140.e1-140.e9.
This study was supported in part by Grant K12 HD001262 from the Women's Reproductive Health Research Career Development Program (to V.L.J.).
ABSTRACT
Oophorectomy as a risk factor for coronary heart disease