Monthly Archives: February 2009

Mood and well-being after removal of both ovaries

The risk of depression after removal of both ovaries (also called bilateral oöphorectomy or surgical menopause) is a major factor for women to consider when they confront medical problems that require removal of the uterus (called a hysterectomy).  Many women are advised to consider having their ovaries removed when they are having the uterus removed.  Sometimes removal of the ovaries is required to fully treat the condition leading to surgery, but other times it is suggested as a precaution to reduce the risk of ovarian cancer.  Removal of both ovaries in a premenopausal woman results in an abrupt withdrawal of estrogen, progesterone, and testosterone.  Therefore removing both ovaries (rather than just one or neither ovary) may have significant effects on mood and well-being in women.

SSRIs in Pregnancy and Neonatal Distress Syndrome

Most obstetricians are now familiar with the potential for what has become known as neonatal distress syndrome (or "adaptation" syndrome) following third trimester exposure to SSRIs.  Some patients still worry about the possibility of their baby developing neonatal distress syndrome, especially if anything unusual happened during the post-delivery experience of an earlier pregnancy.  Women may be concerned about whether and to what degree the medication they were on played a role in their infant's distress and whether to continue that medication during a subsequent pregnancy.  The following case may help illustrate the decision-making dilemmas.

Severe Pregnancy Stress May Increase Schizophrenia Risk in Offspring

A study published in the Archives of General Psychiatry shows that children of women who experience the death of a close relative may have an increased risk of developing schizophrenia later in life.  This study was conducted with records of children born in Denmark between 1973 and 1995, which were then linked to the central registry containing inpatient and outpatient treatment records. It consisted of 1.38 million individuals, including 21,978 children whose mothers experienced death of a close relative during the pregnancy, and 14,206 children of mothers who experienced illness of a close relative during the pregnancy.