The History of Total Abdominal Hysterectomy-Bilateral Salpingo-oophorectomy (TAH-BSO) is not common in women with Parkinson's Disease
Total Abdominal Hysterectomy-Bilateral Salpingo-oophorectomy (TAH-BSO) and Parkinson's Disease
Objective: The estrogen in women is a protective factor against the Parkinson’s disease (PD). It was aimed to investigate the frequency of total abdominal hysterectomy-bilateral salpingo-oophorectomy (TAH-BSO) history causing withdrawal estrogen in patients with PD in this study.
Methods: The electronic records of the Movement Disorders Unit of the Neurology Department were reviewed. Female patients with PD were selected and compared with age-matched controls without movement disorders. The patients were divided into two groups (<45 years and ≥45 years) according to their age at TAH-BSO to investigate the effect of premature estrogen withdrawal. Characteristics of PD were evaluated in these two groups.
Results: 675 patients and 125 controls were included. The frequency of TAH+BSO was found higher in the patients with PD (15.3%) than controls (12%) but it was not significantly (p=0.34). Age of symptom onset, disease severity and daily levodopa dose were not different in patients (n=30) with age at TAH-BSO <45 years compared with the patients (n=73) with those ≥45 years at TAH-BSO. Risk of PD was found to be slightly increased in patients aged <40 years at the time of surgery (OR=1.94, 95% CI: 0.19-19.59, p=0.57) compared with those aged 40-44 years (OR=0.39, 95% CI: 0.10-1.49, p=0.17) and >45 years (OR=1.58, 95% CI: 0.32-7.80, p=0.57).
Conclusion: The frequency of TAH-BSO history in patients with PD is not common. Risk of PD may slightly increased in patients aged <40 years of TAH-BSO surgery. Age of TAH-BSO did not affect the analyzed clinical parameters of PD in this series.
1. Von Campenhausen S, Bornschein B, Wick R, Bötzel K, Sampaio C, Poewe W, et al. Prevalence and incidence of Parkinson’s disease in Europe. Eur Neuropsychopharmacol 2005;15(4):473–490.
2. Ascherio A, Schwarzschild MA. The epidemiology of Parkinson's disease: risk factors and prevention. Lancet Neurol. 2016;15(12):1257-1272.
3. Savica R, Grossardt BR, Bower JH, Ahlskog JE, Rocca WE. Risk factors for Parkinson's disease may differ in men and women: an exploratory study. Horm Behav. 2013;63(2):308-314.
4. Tysnes OB, Storstein A. Epidemiology of Parkinson's disease. J Neural Transm (Vienna). 2017;124(8):901-905.
5. Van Den Eeden SK, Tanner CM, Bernstein Al, Fross RD, Leimpeter A, Bloch DA, et al. Incidence of Parkinson’s disease: variation by age, gender, and race/ethnicity. Am J Epidemiol. 2003;157:1015–1022.
6. Picillo M, Nicoletti A, Fetoni V, Garavaglia B, Barone P, Pellecchia MT. The relevance of gender in Parkinson's disease: a review. J Neurol. 2017;264(8):1583-1607.
7. Liu B, Dluzen DE. Oestrogen and nigrostriatal dopaminergic neurodegeneration: animal models and clinical reports of Parkinson's disease. Clin Exp Pharmacol Physiol. 2007;34(7):555-565.
8. Benedetti MD, Maraganore DM, Bower JH, McDonnell SK, Peterson BJ, Ahlskog JE, et al. Hysterectomy, menopause, and estrogen use preceding Parkinson’s disease: an exploratory case-control study. Mov Disord 2001;16:830–837.
9. Litvan I, Bhatia KP, Burn DJ, Goetz CG, Lang AE, McKeith I, et al. Movement Disorders Society Scientific Issues Committee report: SIC Task Force appraisal of clinical diagnostic criteria for Parkinsonian disorders. Mov Disord 2003;18:467–486
10. North American Menopause Society. Menopause Practice: A Clinician's Guide. 3rd ed. Cleveland, OH: North American Menopause Society; 2007.
11. Simon KC, Chen H, Gao X, Schwarzschild MA, Ascherio A. Reproductive factors, exogenous estrogen use, and risk of Parkinson's disease. Mov Disord. 2009 15;24(9):1359-1365.
12. Marras C, Saunders-PR. The Complexities of Hormonal Influences and Risk of Parkinson’s Disease. Mov Disord. 2014; 29(7): 845–848.
13. Nitkowska M, Czyżyk M, Friedman A. Reproductive life characteristics in females affected with Parkinson's disease and in healthy control subjects - a comparative study on Polish population. Neurol Neurochir Pol. 2014;48(5):322-327.
14. Ragonese P, D’Amelio M, Salemi G, Aridon P, Gammino M, Epifano A, et al. Risk of Parkinson disease in women: effect of reproductive characteristics. Neurology 2004;62(11):2010–2014.
15. Redburn JC, Murphy MF. Hysterectomy prevalence and adjusted cervical and uterine cancer rates in England and Wales. BJOG 2001;108:388–395.
16. Phung, TK, Waltoft BL, Laursen TM, Settnes A, Kessing LV, Mortensen PB, et al. Hysterectomy, oophorectomy and risk of dementia: a nationwide historical cohort study. Dement Geriatr Cogn Disord. 2010;30(1):43-50.
17. Evans EC, Matteson KA, Orejuela FJ, Alperin M, Balk EM, Sherif E-N, et al. Society of Gynecologic Surgeons Systematic Review Group. Salpingo-oophorectomy at the Time of Benign Hysterectomy: A Systematic Review. Obstet Gynecol. 2016;128(3):476-485.
18. Lv M, Zhang Y, Chen GC, Li G, Rui Y, Qin L, et al. Reproductive factors and risk of Parkinson's disease in women: A meta-analysis of observational studies. Behav Brain Res. 2017;335:103-110.
19. Noyce AJ, Bestwick JP, Silveira-Moriyama L, Hawkes CH, Giovannoni G, Lees AJ, et al. Meta-analysis of early nonmotor features and risk factors for Parkinson disease. Ann Neurol. 2012;72(6):893-901.
20. Liu R, Baird D, Park Y, Freedman ND, Huang X, Hollenbeck A, et al. Female reproductive factors, menopausal hormone use, and Parkinson's disease. Mov Disord. 2014;29(7):889-896.
21. Emre SY, Balik KI, Bauthan O. Ovarian aging and premature ovarian failure. J Turk Ger Gynecol Assoc. 2014;15:190–196.
22. Fenton AJ. Premature ovarian insufficiency: Pathogenesis and management. J Midlife Health. 2015;6:147–153.