Fertil Steril. 2016 Oct 25. pii: S0015-0282(16)62838-8. doi: 10.1016/j.fertnstert.2016.09.018. [Epub ahead of print]

Sarrel PM¹, Sullivan SD², Nelson LM³.

Author information

• ¹Departments of Obstetrics, Gynecology and Reproductive Sciences and PsychiatryYale University, New Haven, Connecticut.
• ²U.S. Food and Drug Administration, Silver Spring, Maryland.
• ³CAPT US Public Health Service, Intramural Research Program, The Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland. Electronic address: Lawrence_Nelson@nih.gov.

Abstract

Bilateral oophorectomy performed in women before they are menopausal induces surgical primary ovarian insufficiency, an acute and chronic deficiency of the hormones normally produced by the ovaries. Without hormone replacement therapy (HRT) most of these women develop severe symptoms of estrogen (E) deficiency and are at increased risk for osteoporosis, cardiovascular disease, cognitive decline, dementia, and the associated increases in morbidity and mortality. In cases in which a hysterectomy has been performed at the time of bilateral oophorectomy transdermal or transvaginal E₂ replacement therapy without cyclic progestin replacement is the optimum hormonal management for these women. There is substantial evidence this approach even reduces the risk for breast cancer. Unfortunately, unwarranted fear of all menopausal HRTs has become widespread following the reports of the Women's Health Initiative studies. This fear has led to a steep decline in use of E therapy, even in women in whom HRT is clearly indicated. Discussion of possible ovarian conservation in women who are premenopausal is an integral part of the preoperative planning for any women undergoing hysterectomy. Timely and effective HRT for women who will experience surgical primary ovarian insufficiency is clearly indicated.

Published by Elsevier Inc.

KEYWORDS:

Premenopausal oophorectomy; estrogen therapy; ovarian insufficiency; surgical menopause

資料來源：PubMed

 連結網址：https://www.ncbi.nlm.nih.gov/pubmed/27793381