The long-term association between bilateral oophorectomy and depression: a prospective cohort study

Elvira V Bräuner, Louise F Wilson, Trine Koch, Jane Christensen, Christian Dehlendorff, Anne Katrine Duun-Henriksen, Lærke Priskorn, Julie Abildgaard, Mette K Simonsen, Jeanette T Jørgensen, Youn-Hee Lim, Zorana J Andersen, Anders Juul, Martha Hickey

Abstract

OBJECTIVE: Depression is a leading cause of disability globally and affects more women than men. Ovarian sex steroids are thought to modify depression risk in women and interventions such as bilateral oophorectomy that permanently change the sex steroid milieu may increase the risk of depression. This study aimed to investigate the associations between unilateral and bilateral oophorectomy and depression over a 25-year period (1993-2018) and whether this varied by age at oophorectomy or use of menopausal hormone therapy. METHODS: Twenty-five thousand one hundred eighty-eight nurses aged ≥45 years from the Danish Nurse Cohort were included. Nurses with depression prior to baseline were excluded. Poisson regression models, with log-transformed person-years as offset, were used to assess the associations between oophorectomy and incident depression. Nurses who retained their ovaries were the reference group. RESULTS: Compared with nurses with retained ovaries, bilateral oophorectomy was associated with a slightly higher rate of depression (rate ratio [RR], 1.08; 95% confidence interval [CI], 0.95-1.23), but without statistical significance. However, when stratified by age at oophorectomy, compared with nurses with retained ovaries, bilateral oophorectomy at age ≥51 years was associated with higher rates of depression (RR 1.16; 95% CI, 1.00-1.34), but not bilateral oophorectomy at age <51 years (RR 0.86; 95% CI, 0.69-1.07); P value for difference in estimates = 0.02. No association between unilateral oophorectomy and depression was observed. CONCLUSIONS: In this cohort of Danish female nurses, bilateral oophorectomy at age ≥51 years, but not at younger ages, was associated with a slightly higher rate of depression compared with those who retained their ovaries.

Original languageEnglish
Article number0000000000001913
JournalMenopause (New York, N.Y.)
Volume29
Issue number3
Pages (from-to)276-283
Number of pages8
ISSN1072-3714
DOIs
Publication statusPublished - Mar 2022

Keywords

  • Cohort Studies
  • Depression/epidemiology
  • Female
  • Humans
  • Hysterectomy
  • Middle Aged
  • Ovariectomy/adverse effects
  • Prospective Studies
  • Risk Factors

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