Effects of Bilateral Oophorectomy on Physical and Cognitive Aging
The Mayo Clinic SCORE on Sex Differences research team is testing the hypothesis that significant endocrine disruption caused by the removal of both ovaries and fallopian tubes (bilateral salpingo-oophorectomy, or BSO) before natural menopause contributes to accelerated aging, including a greater decline in both physical and cognitive function and to higher plasma levels of senescence-associated secretory phenotype (SASP) proteins.
Approximately 1 in 8 women has both ovaries removed before reaching natural menopause. The removal of both ovaries prior to natural menopause for noncancer reasons is associated with a significant reduction of ovarian and breast cancers. However, this surgical procedure may be associated with increased mortality, dementia, cardiovascular disease, skin aging and sexual dysfunction.
Ovaries are both endocrine and reproductive organs. They secrete hormones before menopause — primarily estrogen, progesterone and testosterone. And they secrete hormones after menopause — primarily testosterone, androstenedione and dehydroepiandrosterone. These hormones have important nonreproductive functions that are carried out via receptors spread throughout most tissues and organs of the body, including the brain, muscles, bones, blood vessels, heart and gastrointestinal tract.
Thus, reduced ovarian function, especially as caused by the removal of ovaries, can impact multiple systems throughout the life span. There is an urgent need to understand the long-term physical and cognitive consequences of the BSO procedure to empower women to make more-informed decisions.
The specific goals of the SCORE's project on the effects of BSO on physical and cognitive aging are to:
- Determine whether a history of premenopausal BSO is associated with worse scores on the frailty index and with decreased performance on specific measures of physical function, such as participants' six-minute walk distance, balance, hand grip strength and lower limb muscle strength
- Resolve whether a history of premenopausal BSO is associated with a decrease in global and domain-specific cognition
- Determine whether a history of premenopausal BSO is associated with elevated SASP protein levels
- Michelle M. Mielke, Ph.D.