Surgical menopause doesn t elevate bone risk

Women who have undergone surgical menopause do not have a greater risk of bone fracture than women undergoing natural menopause, according to a new study in the journal Menopause. While women who have their ovaries surgically removed (typically to prevent ovarian cancer, or as part of a hysterectomy) experience a more abrupt decline in estrogen levels, this study found that the early menopause that they enter does not put them at a greater bone fracture risk than women who experience a natural onset of menopause.

In order to address the risks of bone fracture following surgically induced menopause, researchers analyzed data from more than 6,600 women aged 65 and older who had been followed for 14 years. Of these women, 1157 had undergone surgical menopause at an average age of 44. This group suffered fractures at a rate of 5.4 percent, which is quite close to the 5 percent rate among women who experienced natural menopause. Furthermore, the bone fracture risk was no greater in women who had opted against estrogen replacement after surgical menopause.

So what does this mean, in a larger context? It s good news for women who have to undergo surgical menopause, says ACSH s Dr. Gilbert Ross, since they re not at an increased risk of bone fracture compared to women who go through menopause naturally. On the other hand, Dr. Ross points out that the study results shouldn t deter menopausal women from beginning a course of hormone replacement therapy (HRT), which is typically prescribed to manage other menopausal symptoms, such as hot flashes and bone density loss. While this particular study may have found HRT to have a negligible effect on bone fracture in a specific group of patients." he says, "it s still debatable what the effect on bone density may be in the average menopausal woman."

Lead study author Dr. Kimberly K. Vesco of Kaiser Permanente advised that women who experience surgical menopause be guided by the same consideration of symptoms and risk factors as those who experience natural menopause. As we ve noted before in Dispatch, the benefits of HRT will outweigh the risks for most women with menopausal symptoms.