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A recent study found that women who undergo ovary removal before menopause may exhibit reduced white matter integrity in multiple brain regions later in life, as indicated by MRI findings.

Led by Michelle Mielke, Ph.D., from Wake Forest University, the research published in Alzheimer's & Dementia, uncovered that this effect is particularly notable in women who undergo premenopausal bilateral oophorectomy (PBO) before the age of 40.

"These results are important for [women] considering PBO for noncancerous conditions," Mielke and her colleagues noted, according to Auntminnie.com.

Past studies have highlighted that early removal of both ovaries can lead to sudden endocrine changes, heightening the risk of cognitive decline and dementia. However, there has been a dearth of neuroimaging research investigating the underlying mechanisms.

Using MRI diffusion tensor imaging (DTI), which tracks water molecule diffusion to map nerve fiber connections, Mielke and her colleagues examined 1,011 women between 2011 and 2020. Of these, 22 had PBO before age 40, with additional cohorts having the procedure between ages 40-45 and 46-49, while 907 women served as a reference group.

The findings revealed that women undergoing PBO before age 40 displayed significantly lower fractional anisotropy in key brain areas, including the anterior corona radiata, genu of the corpus callosum, and superior occipital white matter. Conversely, those undergoing PBO between ages 40-44 showed no marked differences compared to the reference group.

Moreover, women undergoing PBO between ages 45-49 exhibited lower frontal anisotropy and higher mean diffusivity in various white matter regions, despite over 80% using estrogen replacement therapy (ERT).

Mielke stressed the need for larger studies to validate these results and explore alternative forms of ERT that may better preserve brain white matter integrity.

Mielke and her team advocate for informed decision-making in women considering PBO and encourage further research into personalized therapies to safeguard brain health.