Women of childbearing age who undergo surgery to remove both ovaries—known as bilateral oophorectomy—may face a greater risk of developing heart failure later in life, according to new research.
Compared with those in the general population who retain their ovaries, women who underwent bilateral oophorectomy had a 1.5-fold increased risk of developing heart failure after adjusting for race, age, gender, diabetes, smoking status, and high cholesterol.
However, white women and those who had their ovaries removed at younger ages experienced an even higher, two-fold increased heart failure risk. This is estimated to be a six percent increase in absolute risk.
Study Findings Show Clear Connection
The new study, to be presented later this month at the American College of Cardiology’s Annual Scientific Session (ACC.25), reveals that this procedure, which suddenly halts the production of estrogen and other hormones, leads to early menopause and carries substantial cardiovascular risks.“Our study shows that there is an association between removing both ovaries and future development of heart failure, in particular,” he noted. “We believe this may be due to early menopause.”
Before menopause, estrogen, produced by the ovaries, plays a crucial role in maintaining healthy cholesterol levels, promoting blood vessel dilation, and enhancing blood flow, all of which contribute to a lower risk of cardiovascular disease.
Kulthamrongsri and team analyzed data from nearly 7,000 women from 2017 to 2023. Among these participants, women who underwent oophorectomy at an average age of 43.6 were typically diagnosed with heart failure by age 57. Since this was an observational study, there was no control group.
The findings revealed that women who had both ovaries removed faced a 50 percent higher risk of heart failure compared to those who retained their ovaries. This remained true even after researchers accounted for factors like race, age, diabetes, smoking, and high cholesterol.
White women and those who had their ovaries removed at younger ages experienced an even greater risk—a twofold increase in heart failure likelihood.
This graf from above describes the risk: The findings revealed that women who had both ovaries removed faced a 50 percent higher risk of heart failure compared to those who retained their ovaries. This remained true even after researchers accounted for factors like race, age, diabetes, smoking, and high cholesterol.
Why Bilateral Oophorectomy Is Performed
Removing both ovaries can be necessary for a number of conditions, including cancers and precancerous conditions of the reproductive organs, Dr. Greg Marchand, dual board-certified in OB/GYN and minimally invasive gynecologic surgery at Marchand Institute for Minimally Invasive Surgery, told The Epoch Times.He said that this procedure is also considered a “definitive treatment” for endometriosis, a painful condition in which tissue that should be inside the uterus grows outside of it, and is usually performed with a hysterectomy as a last resort to alleviate severe pain typically resulting in menopause symptoms such as hot flashes and night sweats.
Racial Disparities and Long-Term Health Effects
The study also revealed “surprising” racial differences, according to Kulthamrongsri. Unexpectedly, black women don’t have worse heart failure outcomes after early surgical menopause. Normally, they have higher heart failure risks from things like high blood pressure and diabetes.White women, who usually get heart failure from blocked arteries and lifestyle issues, might be more affected by the hormone changes from surgical menopause. This suggests that the way heart failure starts after early surgical menopause might be different and more related to hormone changes than usual risk factors, Kulthamrongsri noted.
Although the research relied on self-reported data and could not establish a specific timeframe for heart failure post-oophorectomy, Kulthamrongsri emphasized that it contributes to a growing recognition of the potential long-term cardiovascular consequences of surgically-induced early menopause.
“Women must do what is medically necessary in terms of oophorectomy, but our findings suggest they should have an informed discussion with their health care team about how to monitor their cardiovascular health,” he said.
Alternatives to Surgery
For women concerned about these risks, several alternatives to oophorectomy exist for conditions like endometriosis.Hormonal treatments such as birth control pills and related hormone treatments can help manage symptoms by reducing menstrual flow and hormone fluctuations, “which often exacerbate endometriosis pain,” Dr. Kecia Gaither, double board-certified in OB/GYN and director of perinatal services and maternal fetal medicine at NYC Health + Hospitals/Lincoln in the Bronx, told The Epoch Times.
Dr. Mary Greene with Manhattan Cardiology in New York told The Epoch Times that much of the previously believed increased risk for accelerated heart disease in women on hormone replacement therapy (HRT) “has been debunked,” and HRT does appear to be safe for many women.
“My recommendation for women on HRT is that they see their cardiologist annually for ongoing risk assessment and surveillance of cardiovascular disease,” she said.
In some cases, laparoscopic surgery can remove endometriosis without removing the ovaries.
Lifestyle choices—including eating a healthier diet, getting more exercise, and managing stress—may help some women manage their symptoms.
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