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Ovary Removal May Up Parkinson's Disease Risk

Wednesday, April 13, 2005

By Charlene Laino
                	
Estrogen loss during childbearing years may increase a woman's risk for
Parkinson's disease.

Mayo Clinic researchers report that women who have had their ovaries
surgically removed are at increased risk for developing Parkinson's disease
later in life.

"The risk is higher — about double — for women with both ovaries removed.
However, even removing one ovary may increase the risk of Parkinson's
disease," says researcher Walter Rocca, MD, professor of neurology and
epidemiology.

The younger a woman is at the time of the surgery, the higher her risk of
the neurological disorder, he tells WebMD. Parkinson's disease is marked by
tremors, rigidity, and trouble with balance and coordination.

The study involved nearly 2,500 women. Half of them previously had one ovary
removed, while the others had both removed. For comparison, the researchers
also evaluated the risk of Parkinson's disease in a group of 2,387 women of
the same age who had not undergone ovarian surgery.

The study was presented today at the annual meeting of the American Academy
of Neurology.

The increased risk of Parkinson's disease is not due to the surgery itself,
Rocca says, but the subsequent drop in estrogen levels.

"There is biological evidence from animal studies that estrogen is
protective for the specific part of the brain that is involved in
controlling movements," he says. "Damage to this part results in Parkinson's
disease."

The Estrogen Connection

Removal of the ovaries is the major cause of reduced estrogen.

"The new study is the first to directly link ovary removal and Parkinson's
disease," he says. "And ovary removal is the most direct surrogate for low
estrogen stores."

Women who underwent removal of both ovaries had twice the risk of
Parkinson's disease compared with women who did not undergo surgery. Women
with one ovary removed experienced a 40% increased risk of developing
Parkinson's disease.

Rocca's previous study suggests that the younger a woman's age during the
natural menopausal transition, the higher the risk of Parkinson's disease.

Stanley Fahn, MD, professor of neurology at Columbia University in New York
and past president of the American Academy of Neurology, says the estrogen
connection is intriguing.

"The study fits with indirect evidence that estrogen might be protective
against Parkinson's disease," he tells WebMD.

Weighing the Risks and Benefits of Ovary Removal

Many women who are having one ovary removed because of cancer or a benign
cyst decide to have the other ovary removed as a preventive measure at the
same time, Rocca says. Likewise, some women undergoing a hysterectomy — the
surgical removal of the uterus — also opt to have one or two ovaries removed.

He advises women who are thinking about preventive removal of the ovaries to
weigh the new findings when making their decision.

"Our data suggest that this is not a good idea, at least in terms of your
brain," Rocca says. "Pros [of ovary removal] include cancer prevention, but
cons are your bone and brain health. The decision has to be made on a
case-by-case basis."

For those women having cancer-ridden ovaries removed, the decision is
unambiguous, he adds. "If you have cancer in the ovary, you want to cut it
out."


By Charlene Laino, reviewed by Brunilda Nazario, MD

SOURCES: American Academy of Neurology 57th Annual Meeting, Miami Beach,
Fla., April 9-16, 2005. Walter Rocca, MD, professor of neurology and
epidemiology, Mayo Clinic, Rochester, Minn.

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