Not infrequently we see women who ask about the possibility of oophorectomy (surgical removal of the ovaries) as a means of managing what appears to be a menstrually related mood disorder.  While this is an option rarely pursued, it appears that women with certain psychiatric conditions are more likely to undergo bilateral oophorectomy for non-malignant reasons.  

According to a recent study looking at 1,653 cases of oophorectomy and 1,653 age-matched controls, researchers observed that the following psychiatric disorders were associated with a greater risk of bilateral oophorectomy: somatoform disorders (OR = 3.65, 95% CI, 1.75-7.64), mood disorders (OR = 1.77; 95% CI, 1.51-2.09) and anxiety disorders (OR = 1.29; 95% CI, 1.04-1.59).  The link between oophorectomy and psychiatric illness was the strongest in women somatoform disorders under the age of 45 years (OR = 5.09; 95% CI, 1.75-14.86).  

In this type of study that analyzes medical records, it is easy to observe the associations but much more difficult to understand what they mean.  While some women with mood and anxiety disorders may experience premenstrual worsening of their symptoms and this may motivate the decision to surgically remove their ovaries, the strong association between somatoform disorders and oophorectomy suggests a more complicated relationship between psychiatric illness and oophorectomy.

Medically unexplained physical symptoms are common and can be quite challenging to manage.  This study underscores the importance of screening for underlying psychiatric illness in women seeking bilateral oophorectomy in order to make more informed decisions regarding treatment.    

Ruta Nonacs, MD PhD

 

Mental health conditions diagnosed before bilateral oophorectomy: a population-based case-control study.

Gazzuola Rocca L, Smith CY, Bobo WV, Grossardt BR, Stewart EA, Laughlin-Tommaso SK, Rocca WA.  Menopause. 2019 Aug 30.