"Association of Bilateral Salpingo-Oophorectomy Before Menopause Onset With Medial Temporal Lobe Neurodegeneration"
“Women who undergo bilateral salpingo-oophorectomy (BSO) before the onset of menopause have an accelerated accumulation of multimorbidity, with an increased risk of aging-associated neurological diseases, including dementia
Premenopausal oophorectomy–induced oestrogen deficiency is thought to be the primary cause of the increased risk of cognitive impairment or dementia in women with BSO before the onset of menopause. Alzheimer Disease (AD) biomarker abnormalities have been observed more frequently in women undergoing menopause compared with premenopausal women, after controlling for age.
In our study, 96% of the women with BSO were treated with estrogen (primarily oral conjugated equine estrogen), for a median of 10 years after BSO; however, this type and duration of hormonal treatment after BSO does not seem to be sufficient to prevent structural changes in the medial temporal lobe later in life.
In this study, women who underwent BSO before age 50 years and before reaching natural menopause had smaller amygdala volumes, thinner parahippocampal-entorhinal cortices, and lower entorhinal white matter fractional anisotropy values compared with control-participant women.
Abrupt hormonal changes because of BSO in premenopausal women may lead to medial temporal lobe structural abnormalities later in life. Because alterations in structural imaging biomarkers of neuro-degeneration in the medial temporal lobe precede clinical symptoms of dementia, enlargement and longitudinal follow-up of this cohort is needed ‘'.
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