NEW YORK (Reuters Health) – Women who undergo surgical
removal of both ovaries, a procedure called bilateral
oophorectomy — and who do not received hormone replacement
therapy – have a significantly increased risk of experiencing
moderate to severe hot flashes compared with women who have
natural menopause, according to new report published in the
journal Fertility and Sterility.
Dr. Jodi A. Flaws, of the University of Maryland,
Baltimore, and colleagues examined the association between type
of menopause and hot flashes after accounting for patterns of
hormone replacement therapy use. Three types of menopause were
considered: natural menopause, hysterectomy (removal of the
uterus), and hysterectomy with bilateral oophorectomy.
Four hundred seventy-five postmenopausal women between the
ages of 40 and 60 years completed a mailed survey on their
history of hot flashes and use of hormone replacement therapy.
Two hundred sixty-three women (55 percent) had natural
menopause, 142 (30 percent) had a hysterectomy with at least
one ovary left intact, and 70 (15 percent) had bilateral
oophorectomy.
Hormone replacement therapy use was more common among women
who underwent bilateral oophorectomy than among those who
underwent only hysterectomy or natural menopause. Women who
underwent bilateral oophorectomy were also more likely to have
used hormone replacement therapy for longer periods of time.
Women who had either type of surgical menopause had a lower
risk of experiencing any hot flashes.
However, among the women who did not receive hormone
replacement therapy, those who underwent bilateral oophorectomy
had an increased risk of moderate or severe hot flashes
compared with women who had natural menopause.
“Researchers have hypothesized that the increase in risk of
hot flashes among women who undergo bilateral oophorectomy
compared with postmenopausal women who do not undergo bilateral
oophorectomy is caused by the abrupt decline in the gonadal
hormone levels, including the estrogens that have been shown to
be negatively associated with hot flashes in midlife women,”
Dr. Flaws and colleagues explain.
Those who experience natural menopausal or who undergo
hysterectomy only have lower estrogen levels than premenopausal
women. However, the “conservation of one or both ovaries
provides some level of estrogen production and, therefore, a
lower likelihood of experiencing hot flashes,” the researchers
conclude.
SOURCE: Fertility and Sterility, May 2006.
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