Women who underwent bilateral oophorectomy at higher risk of carpal tunnel syndrome: Study
Rochester, MN: The risk of severe carpal tunnel syndrome (CTS) increases in women who underwent bilateral oophorectomy (removal of both ovaries) before menopause, finds a recent study. Estrogen therapy didn't provide a protective effect.
The findings of the study are published in Menopause, the journal of The North American Menopause Society (NAMS).
Carpal tunnel syndrome causes tingling and numbness in the arm and hand caused by a pinched nerve in the wrist. It more commonly affects women than men and peaks around the age of menopuase.
Carpal tunnel syndrome is the most common nerve disorder in the upper body. Although predominately idiopathic in nature, an association with sex hormones has been suggested because of a higher incidence in women compared with men of all ages. The peak frequency for women is around the age of menopause, which is 50 to 59 years, but for men, the peak is 70 to 79 years. In addition, estrogen therapy has been shown in other clinical trials to reduce the risk of CTS in postmenopausal women.
In this study, 1,653 premenopausal women who underwent bilateral oophorectomy between 1988 and 2007 were compared with a sample of 1,653 age-matched women who did not undergo the same surgery. Both groups were assessed for CTS in subsequent years using diagnostic codes.
This study is one of the first to demonstrate an increased long-term risk of de novo severe CTS in women who underwent bilateral oophorectomy before menopause. The risk was greater in women with lower body mass index, women who had never given birth to a child or carried a pregnancy, and in those with a benign ovarian indication for oophorectomy. The study did not find a protective effect of estrogen therapy after the surgery.
It remains unclear whether oophorectomy increases the risk of CTS because it causes abrupt estrogen deficiency because of another endocrine disruption or because of some confounding mechanism such as shared risk factors or a lower threshold to pain.
"This study highlights yet another risk associated with bilateral oophorectomy before natural menopause. Together, the findings of this study and others showing increased risk for disease outcomes, such as heart disease and dementia, should prompt a reassessment of bilateral oophorectomy before menopause in women who are not at high risk for ovarian cancer," says Dr. Stephanie Faubion, NAMS medical director.
The study titled, "Risk of de novo severe carpal tunnel syndrome after bilateral oophorectomy," is published in the journal Menopause.