Results of study re osteoporosis and arthritis in those with pre-45 y/o ovary removal

snowbird_11

thought this might be good heads-up for those who must deal with early age ovary removal...

Early Oophorectomy Linked to Osteoporosis, Arthritis
Elsevier Global Medical News. 2011 Dec 12, B Jancin

SAN ANTONIO (EGMN) - Bilateral oophorectomy in women younger than age 45 is associated with a subsequent doubled prevalence of osteoporosis and a similarly elevated rate of arthritis, compared with women with intact ovaries.

These findings from a new analysis of the Third National Health and Nutrition Examination Survey (NHANES III) had a further twist: The likelihood of having low bone mineral density and/or arthritis was even greater in the subgroup of women not on hormone replacement therapy following their surgically-induced abrupt menopause, Anne Marie McCarthy said at the San Antonio Breast Cancer Symposium.

"The implication of our findings is that women who've had their ovaries removed at a young age can now be informed about their risk for bone loss over the long term. However, additional studies are needed to determine the frequency of monitoring for osteoporosis and the appropriateness of various preventive strategies in women who've had their ovaries removed," according to Ms. McCarthy, a doctoral candidate in epidemiology at Johns Hopkins University, Baltimore.

The bone mineral density analysis included 3,660 women who underwent femoral neck bone density measurement by dual energy x-ray as part of their participation in NHANES III, which was conducted in a U.S. nationally representative sample in 1988-1994.

The age-standardized mean femoral neck bone density was significantly lower in women with oophorectomy before age 45 than in those with intact ovaries: 0.711 compared with 0.743 g/m² (P = .017). Moreover, in a multivariate logistic regression analysis, women with early oophorectomy had an adjusted 1.78-fold increased likelihood of having osteoporosis, compared with women with intact ovaries. Upon exclusion of hormone replacement therapy users, the odds climbed even higher so that oophorectomy before age 45 was associated with a 2.92-fold increased likelihood of osteoporosis, she reported.

The Johns Hopkins investigators are now in the midst of a study in which they're measuring bone mineral density before and after prophylactic oophorectomy in women who carry high-risk BRCA mutations.

The arthritis analysis included 4,039 women. Those who had undergone oophorectomy were significantly more likely to report having been informed by a physician that they have arthritis, by a margin of 45.4% to 32.1% (P less than .001). Among the subset of women with oophorectomy before age 45, the prevalence of arthritis was even higher at 47.7%. In a multivariate analysis, women with oophorectomy when they were younger than 45 had a 1.78-fold increased odds of arthritis compared with those with intact ovaries. If they didn't use hormone replacement therapy, however, those odds rose to 1.99-fold.

Because the investigators didn't study the NHANES III participants' actual medical records, they were unable to say what specific forms of arthritis were more prevalent in the early oophorectomy group. Also, since to Ms. McCarthy's knowledge this is the first-ever study linking oophorectomy to arthritis, this association needs confirmation by others. There are animal data supporting such a link, she noted.

"One possible mechanism is that we think estrogen is important for the health of cartilage, so losing estrogen can lead to inflammation and damage of cartilage, perhaps," Ms. McCarthy speculated.

Prophylactic bilateral oophorectomy is a widely accepted procedure to reduce the risks of breast and ovarian cancer in BRCA mutation carriers. But this indication actually accounts for only a small fraction of oophorectomies performed in this country. About 600,000 women per year undergo hysterectomy for indications including fibroids, abnormal bleeding, endometriosis, and uterine prolapse, according to the Centers for Disease Control and Prevention, and about half of them have both ovaries removed at that time to prevent ovarian cancer.

NHANES III was conducted by the CDC. Ms. McCarthy said she had no relevant financial disclosures.

Copyright © 2011 International Medical News Group

Military wife

Thank you!
Thank you so very much for sharing this! I've been suffering from pelvic pain, knee pain and now it's started in my hands and shoulder. My docs were saying it had no relation to my treatments or surgery, but finally sent me to a rheumatologist after a year of high dose Motrin during the day and Percocet at night.

The X-rays ordered by the rheumatologist showed mild arthritis in all these ares, but he said I was too young to feel anything and it was probably all tightened muscles from radiation. After three months of weekly PT, I still had the pain, but was indeed more limber. I kept explaining these pains were arthritis and showed all the sounds including classics like weather change related increased stiffness and pain. Still, nothing. I'm still currently on Percocet and Motrin. I don't know if this will change anything, but maybe they will take me a bit more seriously and look at my issues more as something than before. I'm only 38 and I had a radical hysterectomy at 36 followed by six rounds of chemo and 33 of radiation.

Do a lot of you have this problem?

jazzy1

Military wife said:

Thank you!
Thank you so very much for sharing this! I've been suffering from pelvic pain, knee pain and now it's started in my hands and shoulder. My docs were saying it had no relation to my treatments or surgery, but finally sent me to a rheumatologist after a year of high dose Motrin during the day and Percocet at night.

The X-rays ordered by the rheumatologist showed mild arthritis in all these ares, but he said I was too young to feel anything and it was probably all tightened muscles from radiation. After three months of weekly PT, I still had the pain, but was indeed more limber. I kept explaining these pains were arthritis and showed all the sounds including classics like weather change related increased stiffness and pain. Still, nothing. I'm still currently on Percocet and Motrin. I don't know if this will change anything, but maybe they will take me a bit more seriously and look at my issues more as something than before. I'm only 38 and I had a radical hysterectomy at 36 followed by six rounds of chemo and 33 of radiation.

Do a lot of you have this problem?

Military Wife
Your situation sounds so similar to mine....pain in hip to start after my treatments (same as yours), doc told me it's not cancer, but you're getting older....probably arthritis. I stopped running and turned to low-impact type exercises and lots of yoga classes. All was well for almost 2 years and now it's a bit worse. Do have sciatica issues, which are helped via my chiropractor.

Funny this subject should come up, as the joint pain is a bit worse and per hubbie, change of seasons and more moisture in air from rain/snow affect arthritis. I'm fine with Aleve or some over the counter. Have you tried glucosamine and chondroitin...helps joint pain???? It has helped me quite a lot.

You might want to check out another part of this site...think it's called LONG TERM SURVIVORS and another is LONG TERM SIDE AFFECTS? You'll see many people with different forms of cancer having long term affects from treatments. Quite a few with debilitating pain and taking pain meds to help.

Do you by chance have MMMMT cancer -- it's a form of uterine? BTW I'm 55 years and my orthopedic told me we can start building arthritis symptoms in our early 40's and yes it's genetic.

I'd chalk all this up to long term affects from treatments. Now how do we help ourselves???

Jan