Women who undergo a common yet invasive surgery before hitting menopause could be at an increased risk of dementia and a general decline in cognitive function, according to new research. It's well known that dementia is more prevalent in women, with twice as many cases of Alzheimer's disease compared to men.
This fresh study could provide scientists with a better understanding of the underlying risk factors that make women more susceptible to these neurodegenerative diseases. The research looked at the brains of women who had their ovaries removed before menopause and discovered a significant decrease in their brain health.
A reduction in your brain's white matter can lead to cognitive decline and is closely linked to the effects of dementia. After analysing the MRI results of over 1000 women, researchers from Wake Forest University identified a connection between this brain-wasting disease and women who had undergone a Bilateral Salpingo Oophorectomy (BSO).
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This procedure, which involves the removal of the ovaries, is typically carried out pre-menopause to reduce the future risk of ovarian cancer, a disease that claims the lives of more than 4000 Brits annually. Other reasons for the surgery can include endometriosis and ovarian cysts.
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However, this new research suggests that this routine procedure could have a detrimental impact on your brain health years down the line, reports Gloucestershire Live.
When a woman undergoes an operation to remove her ovaries, it alters the hormone cycle in her body, a change that typically doesn't occur until menopause. Professor Michelle Mielke at WFU was intrigued to investigate if this observed connection between hormone production and cognitive decline could also be evident in women who have had BSO.
So, what does this all mean?
Women who have a Bilateral Salpingo Oophorectomy could be at higher risk of dementia (Getty)Your brain is made up of two types of matter: grey and white. In simple terms, your grey matter largely controls your movement and other brain functions, including memory, while your white matter transmits information and signals throughout your brain and to your nervous system.
Both these components of your brain are known to diminish with age, but can be severely impacted if you develop a form of dementia. Some forms, like Alzheimer's disease, primarily affect the grey areas of your brain, while others can cause your white matter to significantly shrink - leading to a decrease in your cognitive abilities.
The research discovered a strong association between ovary removal and the onset of white matter shrinkage. Undergoing a BSO results in an "abrupt endocrine dysfunction. as a result of removing the ovaries" - a phenomenon that study lead Professor Mielke was keen to delve into further.
Out of the 1011 MRIs analysed, patients were categorised by age group and whether they had undergone ovary removal surgery. The majority (907) had not had a BSO, while 22 had the procedure under the age of 40, another 43 women between 40 and 45, and 39 aged between 46 and 49 had their ovaries removed.
Cross-referencing with the extensive dataset of MRIs, Mielke discovered that those women who had a BSO before the age of 40 experienced a more significant decline in white matter. The professor stated: "Females who had BSO before the age of 40 had significantly reduced white matter integrity in multiple regions of the brain."
However, older women who underwent the procedure were less likely to see this decline in white matter, which, while not the only indicator of diseases like dementia, is a crucial factor in a doctor's diagnostic process.
Dr Verna Porter shed light on why this surgery can lead to a decrease in brain matter. Speaking to Medical News Today about the role of oestrogen and testosterone, they said: "Both hormones contribute to overall brain health, influencing mood, cognition, and neuroprotection.
"Oestrogen therapy, particularly when started soon after oophorectomy and within certain therapeutic windows, may help preserve white matter integrity and cognitive function.
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"Women who had their ovaries removed before age 40 showed reduced white matter integrity, which suggests an increased risk for cognitive impairment and dementia. This emphasises the critical role of ovarian hormone regulation in maintaining brain structure/ function, particularly in preserving white matter integrity."
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