Effects of Bilateral Oophorectomy Before Age 40 on Brain White Matter

A recent study published in Alzheimer’s & Dementia reveals significant findings regarding the long-term effects of premenopausal bilateral oophorectomy (PBO) before the age of 40 on brain white matter integrity in later life. Conducted by Michelle M. Mielke, Ph.D., and colleagues from Wake Forest University School of Medicine, the research investigated how PBO and the age at which it occurs impact white matter integrity using regional diffusion tensor imaging metrics.

The study included data from various groups: 22 participants who underwent PBO before age 40, 43 who had PBO between ages 40 to 45, 39 who underwent PBO between ages 46 to 49, and 907 referents without PBO under age 50. The researchers discovered that women who underwent PBO before age 40 exhibited lower fractional anisotropy (FA) and higher mean diffusivity (MD) in specific regions of white matter compared to referents. These affected regions included the anterior corona radiata, genu of the corpus callosum, inferior fronto-occipital fasciculus, superior occipital, and superior temporal white matter. Similar but less pronounced changes were also observed in women who had PBO between ages 45 to 49.

The study authors hypothesize that the abrupt decline in both estrogen and testosterone levels following PBO may contribute to these observed changes. Despite many women in the study using estrogen replacement therapy, which addresses estrogen deficiency post-PBO, the persistence of reduced white matter integrity suggests a potential role of testosterone loss in this outcome.

The implications of these findings are significant, highlighting the complex interactions between hormone levels and brain health. Further research is needed to fully understand the mechanisms behind these changes and to explore potential therapeutic interventions that could mitigate the impact of PBO on brain function and structure later in life.

It’s important to note that one of the study authors disclosed ties to the pharmaceutical industry, underscoring transparency in reporting potential conflicts of interest in medical research. These findings contribute valuable insights into the long-term neurological effects of surgical menopause, informing future healthcare strategies and patient counseling regarding reproductive health decisions.