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parkinson’s disease risk goes up with the removal of ovaries

researchers have long suspected that sex- or gender-related issues play a role in parkinson’s because the disease manifests twice as frequently in women as in men.

100,000 canadians live with parkinson's disease
ovaries are usually removed in cases of a cyst or endometriosis. getty

a new study has found that removing a woman’s ovaries may increase her risk of developing parkinson’s disease and calls for the use of estrogen therapy for those with few other options.

the research, published in jama network open , relied on health data from the rochester epidemiology project and included 2,750 women who had surgery to remove both ovaries and 2,749 who did not. surgery was usually performed to address a non-cancerous condition, such as a cyst or endometriosis , or in an attempt to prevent cancer.

the team discovered that for every 48 women who were younger than the age of 43 at the time they had their ovaries removed, one additional woman went on to develop parkinson’s disease compared to the group that did not have them removed.

parkinson’s disease is a brain disorder that occurs  when clusters of nerve cells (or neurons) controlling the body’s movement die or malfunction, resulting in a decrease in the production of dopamine. the death of these cells leads to motor control issues that can have a debilitating effect on patients. tremors may be the most commonly known symptom but patients can also experience dementia, sleep disorders and bowel and bladder problems. parkinsonism is an umbrella term for any disorder that includes slowing movement, stiffness, tremors or loss of balance.

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there are more than 100,000 canadians   living with parkinson’s today and roughly 6,600 new diagnoses made every year. the associated costs of managing the incurable disease are more than $1.2-billion per year canada.

estrogen therapy is important for women who have had their ovaries removed

researchers have long suspected that sex- or gender-related issues play a role in parkinson’s because the disease manifests twice as frequently in women as in men. because ovaries are the main source of estrogen in women, their removal prior to menopause leads to an absence of helpful hormones that prevent endocrine dysfunction.

the study’s findings, which align with a 2008 study linking ovary removal in young patients to an increased risk of parkinson’s and parkinsonism, support current guidelines that recommend against the removal of both ovaries in patients with an average risk of cancer. women who carry a high-risk genetic variant for ovarian cancer can still have the procedure performed but they should be given estrogen therapy up until the age of 51, the approximate age of the natural arrival of menopause, according to walter rocca, first author of the study and a mayo clinic neurologist and epidemiologist.

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“as of today, it is not recommended to use estrogen therapy for the prevention of dementia or parkinsonism after spontaneous menopause in women who are age 46 to 55,” rocca said. “but this study and previous studies suggest that estrogen therapy is important in women whose ovaries were surgically removed younger than age 46. particularly vulnerable are women who underwent this surgically induced menopause before age 40.”

dave yasvinski is a writer with  healthing.ca

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