Oophorectomy as a risk factor for coronary heart disease

OBJECTIVE: The objective of the study was to examine the relationship between bilateral oophorectomy (BSO) and risk of coronary heart disease (CHD). STUDY DESIGN: We searched PubMed, EMBASE, meeting abstracts, and reference lists for studies that compared women with BSO at the time of hysterectomy with: (1) women with hysterectomy and ovarian conservation, (2) naturally menopausal women, (3) premenopausal women, or (4) women with no history of hysterectomy or BSO but unreported menopausal status. The primary outcome was fatal or nonfatal CHD. RESULTS: We reviewed 1956 citations. Seven observational studies met inclusion criteria. Heterogeneity among studies precluded formal metaanalysis. Four studies reported BSO increases risk for CHD but only in some subgroups of women or not in fully adjusted multivariate models. Three studies found no increased risk of CHD following BSO, but these studies had significant limitations. CONCLUSION: The existing evidence is inconclusive to determine the effect of BSO on risk of CHD.