OOPHORECTOMY STATUS AND BONE-DENSITY IN OLDER, HYSTERECTOMIZED WOMEN

Introduction: This study examined the long-term effects of hysterectom y, with and without bilateral oophorectomy, and treatment with estroge n replacement on bone mineral density in older hysterectomized women. Methods: Subjects were 346 women 60-89 years of age, who were particip ants in the Rancho Bernardo Study and attended a follow-up clinic visi t in 1988-1991. Bone density was measured at the ultradistal wrist, mi dshaft radius, lumbar spine and hip. Results: Of these women, 182 had a hysterectomy with conservation of one or both ovaries sad 164 had a hysterectomy with bilateral oophorectomy. Current estrogen users had t he highest bone densities; those who never used estrogen replacement h ad the lowest. Only 9.1% of oophorectomized women, compared to 19.2% o f those with ovarian conservation had never used estrogen (P <.01). Af ter adjustment for covariates including estrogen replacement therapy, hysterectomized women with ovarian conservation had marginally higher bone densities at the wrist (P <.09) and spine (P <.06) than oophorect omized women. We found significant differences only among women curren tly using estrogen (P<.05 for wrist and P <.01 for spine densities, re spectively). Bone density did not differ at any site by oophorectomy s tatus among past or never users of estrogen. Conclusions: Hysterectomi zed women who use estrogen replacement therapy have better bone densit y, regardless of a bilateral oophorectomy. In addition, bilateral ooph orectomy may not have a long-term negative effect on bone density; hys terectomized women who do nor use estrogen appear to have equivalent b one density whether or not they had a bilateral oophorectomy. Medical Subject Headings (MeSH): bone density, estrogen replacement therapy, h ysterectomy, oophorectomy, postmenopause, women, menopause.