Mental Health Conditions May Lead to Unnecessary Oophorectomies

While undergoing a hysterectomy, especially in conjunction with an oophorectomy, in which one or both ovaries are removed, can have an impact on a woman’s mental health, the role of mental health may come into play before the procedure, according to a new study.

The study researchers, who examined 1600 premenopausal women who underwent bilateral oophorectomy between 1988 and 2007, found that psychiatric symptoms may lead a woman to undergo an oophorectomy, even after receiving a nonmalignant diagnosis.

“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,” Stephanie Faubion, MD, MBA, medical director of The North American Menopause Society, said in a statement.

“We know there are significant long-term adverse health consequences associated with removing a woman’s ovaries before natural age of menopause, let alone the potential risks of an unnecessary surgical procedure,” she added.

The team of researchers focused on 8 mental health conditions diagnosed prior to the women undergoing bilateral oophorectomy. What they found was pre-existing mood disorders, anxiety disorders, and somatoform disorders were associated with an increased likelihood of bilateral oophorectomy in overall analyses. Looking specifically at women who were aged under 45 years, these associations were still significant.

While mood and anxiety disorders were most frequently cited among the women, somatoform and personality disorders had the biggest impact.

Meanwhile, personality disorders were associated with an increased risk in overall analyses and adjustment disorders—a group of symptoms, such as stress, that can occur after a stressful life event—only increased the risk in women aged between 46 and 49 years.

Unsurprisingly, the presence of more than 1 mental health condition further increased the likelihood that a woman would undergo an oophorectomy.

Reflecting on the findings, the researchers suggested that awareness of these associations may guide women and physicians in future decision making and limit unnecessary bilateral oophorectomies.

Reference

Rocca L, Smith C, Bobo W, et al. Mental health conditions diagnosed before bilateral oophorectomy: a population-based case-control study [published online August 20, 2019]. Menopause. doi:10.1097/GME.0000000000001413.