- With Mayo Clinic internist
Sandhya Pruthi, M.D.
read biographyclose windowBiography of
Sandhya Pruthi, M.D.
Sandhya Pruthi, M.D.
Dr. Sandhya Pruthi, certified by the American Board of Family Practice, has been practicing medicine at Mayo Clinic since 1995 with special interests in breast diseases and women's health.
She is a consultant in the Department of Internal Medicine, Division of General Internal Medicine, and the Breast Diagnostic Clinic. She is an assistant professor of medicine at Mayo Clinic College of Medicine in Rochester, Minn.
The Winnipeg, Manitoba, native stresses education and patient-related research and has been active in both areas since joining Mayo Clinic. She is the primary investigator at Mayo Clinic of several clinical trials evaluating new agents for the prevention of breast cancer and identification of biomarkers for early detection of breast cancer. Her other research and clinical interests include managing the health of women who are at increased risk of breast cancer, breast pain and hot flashes, and developing patient education decision-making tools for breast-related concerns. She is director of the Breast Diagnostic Clinic and is a member of the Women's Health Executive Committee. Dr. Pruthi has been newly elected as a member to the board of directors for the American Society of Breast Disease. She has assisted with a variety of articles for MayoClinic.com.
"Having an opportunity to share information with my patients in the way that will help them to understand and be able to make educated decisions about their own health is very important to me," she says.
"The Web has become a major information site for people, and I want them to get the best and accurate information to be able to make informed choices for themselves, their family members and friends."
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Question
Oophorectomy (ovary removal): A risk factor for dementia?
If I have my ovaries removed before I'm 50, will I be more likely to have dementia when I get older?
Answer
from Sandhya Pruthi, M.D.
You might be, but you can cancel out this added risk by taking estrogen until you're 50.
Ovary removal (oophorectomy), usually done in conjunction with hysterectomy, has a dramatic effect on your body before menopause. The abrupt loss of your ovaries from an oophorectomy triggers all the changes of menopause.
Your ovaries produce most of your body's estrogen, a reproductive hormone that plays many roles beyond regulating your menstrual cycle. According to the latest research, estrogen may even protect your brain from age-related changes leading to cognitive impairment and dementia.
In one study, women who'd had their ovaries removed before menopause but had not received hormone replacement therapy (HRT) were found, overall, to have about a 50 percent increase in risk of dementia, as compared with women who retained their ovaries or took HRT after oophorectomy.
That observation suggests that exposure to estrogen — from a pill, a patch or your own ovaries — protects your brain as you get older. Estrogen depletion also leads to osteoporosis and increases your risk of heart disease.
The potential effect on your long-term mental function is just another factor to consider when weighing the pros and cons of HRT when you go through natural menopause. The decision has added urgency if your doctor recommends an oophorectomy before you reach menopause. The younger you are when your ovaries are removed, the more all the risks of estrogen depletion increase.
That's why it's important to talk at length with your doctor before you have an oophorectomy. Don't make a decision until you know:
- What condition the surgery is treating
- What other treatment options there are
- How extensive your surgery will be
- Whether you're close to menopause
- Whether you'll be a candidate for HRT
For some women, oophorectomy is worth the long-term risks. If you carry one of the genetic mutations that make you likely to develop breast and ovarian cancers, for example, this surgery may save your life — even if you don't take HRT.
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