oophorectomy and osteoporosis

[jane2638]

Hello,

I've been reading the posts of ladies who have opted for oophorectomy. I'm wondering if osteoporosis has been a problem for you? I'm contemplating an oophorectomy myself so that I can avoid Tamoxifen and go to an AI.

Thanks,
Jane

[Jackie07]

Comp Med. 2012 Feb;62(1):8-13.
Long-term effects of ovariectomy on osteoporosis and obesity in estrogen-receptor-β-deleted mice.

Seidlova-Wuttke D, Nguyen BT, Wuttke W.
Source

Department of Endocrinology, University Medical Center Göttingen, Göttingen, Germany. ufkendo@med.uni-goettingen.de

Abstract

Untreated BERKO mice demonstrate few abnormalities in bone phenotype and recent ovariectomy has few effects on various bone characteristics in these mice. Long-term studies on the bone phenotype of intact and ovariectomized mice are unavailable. Using quantitative computed tomography (qCT), we determined various parameters of the metaphysis of the tibia in sham-ovariectomized (intact) and ovariectomized BERKO and wildtype mice. Body weight and estrogen-regulated fat were also measured. Mice underwent surgery (ovariectomy or sham) at 3 mo of age, and qCT analysis was performed every 2 to 4 mo until mice were 12 mo old. Ovariectomized wildtype mice gained body weight and their fat depot increased in size within 2 mo after ovariectomy. Obesity developed later in ovariectomized BERKO mice, which became significantly heavier than their wildtype counterparts. Ovariectomized wildtype mice lost trabecular density more rapidly than did ovariectomized BERKO mice, which did not show similar loss in trabecular density until at least 7 mo after ovariectomy. At the latest studied time point (9 mo after surgery), cortical area was significantly larger in ovariectomized BERKO mice than ovariectomized wildtype mice. The absence of ERβ in ovariectomized BERKO mice during the first 3 to 5 mo after ovariectomy had protective effects against obesity and trabecular rarification; this protective effect disappeared at later time points.

[Debbie L.]

Jane, I can't answer your question, but I'm curious why you want to avoid Tamoxifen.

You probably know that both oophorectomy and AIs increase risk of osteoporosis. I think AIs are the bigger culprit. I haven't seen anything to say that AIs in the absence of ovaries cause more osteoporosis than is seen in a naturally-menopausal woman (but that doesn't mean it's not out there).

Debbie Laxague

[Jackie07]

Jane,

I had requested and was approved for prophylactic hysterectomy/oophorectomy because of personal/family cancer history (possible HNPCC cluster) and genetic testing result (BRCA1 - VUS) Thought I'd be done with Tamoxifen (almost 5 years altogether) - but then my oncologist put me back on it 4, 5 months later (mid 2010), probably because of new reports on the benefit of Tamoxifen beyond 5 years (50% reduction on recurrence rate - something like from 4% reduced to 2%)

So I've been taking Tamoxifen for almost 7 years altogether. Besides the tiny cervical vertebrae degeneration (common for many middle-aged persons)that was detected 4, 5 years ago, I haven't noticed anything different. I've had chemopause since late 2003.

Please talk to your doctor about your concerns. Obviously there are a lot of factors to be considered.

[tricia keegan]

Hi Jane,

I had an ooph in '06 and have been taking Arimidex ever since and really have'nt noticed a difference although my last Dexa did show some bone loss. My Onc has approved a yearly iv of Zometa for this and I do tend to exercise a lot so hoping I can prevent it getting any worse, good luck with your decision.

[jane2638]

Dear Debbie, and others,

I'm wary of Tamoxifen because, as I wrote in an earlier thread (Tamoxifen, LHRH, AI, oophorectomy?), dated Feb. 13, there are a couple of studies suggesting that her2neu/PR- is predictive of Tamoxifen resistance. (I believe you responded to that thread.)

My onc says he would not want me to take Zoladex for more than a few months, as a "bridge" to surgery, if I opt for that route.

Thanks,
Jane

[rachelhmmd]

I took tamoxifen for five years prophylactically and was diagnosed with my first mammogram after finishing the course. I am Her 2 pos/ ER pos/PR neg. When I was choosing an anti-estrogen treatment, I was still premenopausal. My onc said I could either stick with tamoxifen ( though, clearly I had lost faith in that) vs go for chemical "castration" (lupron shots) or oopherectomy to put myself into menopause So I could take an AI. I had read some stuff about tamoxifen not working as well for her 2 pos women, so I went for the oopherectomy. I'm not crazy about my "supermenopause" but I feel like it was the safest course (at least in terms of my cancer). I did not know about the association between being PR- and tamoxifen resistant, but maybe I'm living proof of that theory.

[jane2638]

Thanks for all the responses! This may sound naive, but what happens after an oophorectomy? Have you noticed premature aging, significant weakening of bones, etc.?

Thanks,
Jane

[tricia keegan]

Jane I did'nt notice anything except some hot flashes for approx six weeks and they became fewer and fewer after that and I only get them now usually if I drink alcohol! This really was the only side effect I noticed and these days I get hot flashes very seldom!