Women who undergo removal of both ovaries before the age of 45 years have an increased risk of early mortality if they do not receive estrogen replacement treatment up to the age of 45 years, according to research conducted at the Mayo Clinic in Rochester, Minnesota.

Dr. Walter A. Rocca and his team followed women who underwent ovary removal, either for a benign condition or as preventative measure, before age 45 and before the onset of menopause.

The study included 1091 women who had both ovaries removed, 1274 who underwent removal of one ovary, and 2383 women from the general population. They were followed for an average of 30 years.

Overall, mortality rates were no higher among women who had both ovaries removed than among women in the other two groups, the investigators report in The Lancet Oncology medical journal. However, the risk of death was almost doubled for women who underwent double ovary removal for preventative reasons before age 45 and who did not receive estrogen replacement up to age 45.

Rocca’s group points out that, as a result of the widely publicized Women’s Health Initiative trial, hormone replacement therapy has been sharply curtailed among women of any age.

They propose that the Women’s Health Initiative trial findings, which linked hormone replacement among postmenopausal women to increased risks of breast cancer and stroke, may not apply to women with menopause before 50 years of age - so recommendations regarding hormone therapy for this group should be reconsidered.

SOURCE: Lancet Oncology, October 2006.