Investigators presented data at the American College of Cardiology's Annual Scientific Session (ACC.25) which showed that women who undergo bilateral oophorectomy may face a significantly increased risk of developing heart failure later in life, with White women and those who had the procedure at younger ages demonstrating the highest risk profiles.

Researchers analyzing data from the National Health and Nutrition Examination Survey (NHANES) found that, compared to women with intact ovaries, those who underwent bilateral oophorectomy had a 1.5-fold increased risk of developing heart failure after adjusting for race, age, sex, diabetes, smoking status, and high cholesterol; for White women and those who had their ovaries removed at younger ages, this risk doubled.

"We know that sex hormones, including estrogen and progesterone levels, play a crucial role in cardiovascular risk. Our study shows that there is an association between removing both ovaries and future development of heart failure in particular," said Narathorn Kulthamrongsri, MD, a first-year internal medicine resident at the University of Hawaii in Honolulu. "We believe this may be due to early menopause. However, in this case, early menopause results from the planned surgical removal of the ovaries, which differs from other causes such as occult infections, autoimmune diseases, or unexpected genetic disorders. Understanding this allows us to anticipate and manage potential complications, particularly cardiovascular disease."

The study examined data from 6,814 female patients who participated in the NHANES between 2017 and 2023. The average age of women undergoing oophorectomy was 43.6 years. According to researchers, the timing of ovary removal appeared to impact the onset of heart failure.

"The age at which a woman has her ovaries removed appears to impact her heart failure risk," Dr. Kulthamrongsri said. "We found that as the age at which a woman has her ovaries removed goes up by 1 year, the development of heart failure happens about 0.6 years later."

The racial disparity in outcomes was unexpected, according to the investigators. "This racial disparity is surprising, as previous research shows that Black individuals have a higher prevalence of worse outcomes in heart failure due to greater risks of hypertension, diabetes, and obesity. In contrast, White individuals more often develop heart failure from ischemic heart disease and tend to have more lifestyle-related risk factors, such as smoking, poor diet, and physical inactivity," Dr. Kulthamrongsri noted.

The researchers suggested that these findings underscore the need for cardiovascular risk discussions and closer heart monitoring for women considering oophorectomy before natural menopause, which typically occurs around age 51.

The researchers acknowledged study limitations, including reliance on self-reported data and the inability to determine whether oophorectomy is more likely to lead to heart failure within a specific timeframe after the procedure.

Nevertheless, Dr. Kulthamrongsri emphasized that these findings contribute to growing evidence that early surgical menopause may have long-term cardiovascular consequences, particularly increased heart failure risk. The team recommended additional studies using larger global datasets to validate these findings and exploring potential preventive measures, including cardiovascular screening recommendations and prophylactic heart medications.

Reference:
American College of Cardiology. Ovary removal increases heart failure risk. https://www.acc.org/About-ACC/Press-Releases/2025/03/20/09/58/Ovary-Removal-Increases-Heart-Failure-Risk.