Cardiovascular risk factors at 24 months after risk-reducing salpingo-oophorectomy: a prospective controlled study from WHAM

BRCA1/2

Surgical menopause induced by risk-reducing salpingo-oophorectomy and its cardiometabolic effects

Women carrying BRCA1/2 pathogenic variants are advised to undergo risk-reducing salpingo-oophorectomy (RRSO) before natural menopause, while surgical menopause is suspected to increase cardiovascular risk on mainly epidemiological grounds. This prospective controlled study measured cardiometabolic risk factors at baseline and 24 months in 104 women who underwent premenopausal RRSO and 102 age-matched controls who retained their ovaries. At 24 months, there was no difference between groups in a diastolic blood pressure rise of at least 5 mm Hg (adjusted OR 1.03; 95% CI 0.48-2.18), nor in BMI, waist circumference, lipids, high-sensitivity CRP or glucose metabolism markers. After RRSO, 62% of women used menopausal hormone therapy, with no difference in any marker between users and non-users.

Synthesis written by Geno'X. For the full original abstract, please refer to the source publication.

A reassuring result for counselling on the timing of salpingo-oophorectomy, but 24 months of follow-up on intermediate markers says nothing about cardiovascular events, which develop over decades. With 104 operated women, absence of difference is not proof of absence of risk, and the study provides no specific argument for hormone therapy on these markers.

Analysis by Dr Thibaut Benquey