Divisions of Epidemiology.
Neurology, College of Medicine, Mayo Clinic, Rochester, MN.
Menopause. 2018 Nov;25(11):1275-1285. doi: 10.1097/GME.0000000000001229.
We studied the long-term risk of depressive and anxiety symptoms in women who underwent bilateral oophorectomy before menopause.
We conducted a cohort study among all women residing in Olmsted County, MN, who underwent bilateral oophorectomy before the onset of menopause for a noncancer indication from 1950 through 1987. Each member of the bilateral oophorectomy cohort was matched by age with a referent woman from the same population who had not undergone an oophorectomy. In total, we studied 666 women with bilateral oophorectomy and 673 referent women. Women were followed for a median of 24 years, and depressive and anxiety symptoms were assessed using a structured questionnaire via a direct or proxy telephone interview performed from 2001 through 2006.
Women who underwent bilateral oophorectomy before the onset of menopause had an increased risk of depressive symptoms diagnosed by a physician (hazard ratio = 1.54, 95% CI: 1.04-2.26, adjusted for age, education, and type of interview) and of anxiety symptoms (adjusted hazard ratio = 2.29, 95% CI: 1.33-3.95) compared with referent women. The findings remained consistent after excluding depressive or anxiety symptoms that first occurred within 10 years after oophorectomy. The associations were greater with younger age at oophorectomy but did not vary across indications for the oophorectomy. In addition, treatment with estrogen to age 50 years in women who underwent bilateral oophorectomy at younger ages did not modify the risk.
Bilateral oophorectomy performed before the onset of menopause is associated with an increased long-term risk of depressive and anxiety symptoms.
我们研究了绝经前双侧卵巢切除术的女性出现抑郁和焦虑症状的长期风险。
我们对明尼苏达州奥姆斯特德县的所有女性进行了队列研究，这些女性在绝经前因非癌症原因于 1950 年至 1987 年间接受了双侧卵巢切除术。每一位接受双侧卵巢切除术的队列成员都与同一人群中未接受卵巢切除术的年龄相匹配的参照女性相匹配。我们总共研究了 666 名接受双侧卵巢切除术的女性和 673 名参照女性。女性中位随访时间为 24 年，通过 2001 年至 2006 年期间直接或代理电话访谈使用结构化问卷评估抑郁和焦虑症状。
与参照女性相比，绝经前接受双侧卵巢切除术的女性发生经医生诊断的抑郁症状的风险增加（风险比=1.54，95%可信区间：1.04-2.26，调整年龄、教育和访谈类型后）和焦虑症状（调整后的风险比=2.29，95%可信区间：1.33-3.95）。排除卵巢切除术后 10 年内首次发生的抑郁或焦虑症状后，结果仍然一致。这些关联在卵巢切除术年龄较小的情况下更为显著，但与卵巢切除术的指征无关。此外，在年龄较小的女性中，接受双侧卵巢切除术并在 50 岁前接受雌激素治疗，并不会改变这种风险。
绝经前双侧卵巢切除术与长期抑郁和焦虑症状风险增加有关。
