Surgical menopause and cardiovascular risks

In Brief Objective and Design: To review the relevant literature on the effect of surgical menopause on cardiovascular disease (CVD). Results and Conclusions: Early menopause (before age 50) is associated with an increased risk of CVD. Bilateral oophorectomy around the time of menopause may impart either a small influence or no effect on increasing the risk of CVD; however, bilateral oophorectomy before menopause significantly increases the risk. Some data suggest a protective effect of estrogen therapy in this setting exist. The CVD risk is principally that of coronary heart disease and not cerebrovascular disease. Mortality rates may be increased in women with early menopause, either spontaneous or surgically induced. Hysterectomy per se, without bilateral oophorectomy, does not seem to increase CVD risk. It is clear that premature natural or surgical menopause, but particularly the latter, increases the risk of coronary disease. This effect probably does not relate to hysterectomy without oophorectomy.