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Life sciences · Journal article
Journal of the Endocrine Society · September 26, 2026
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Structured Abstract Background Women at risk of ovarian cancer due to BRCA1/2 pathogenic variants are advised to undergo bilateral risk-reducing salpingo-oophorectomy (RRSO) prior to natural menopause. Epidemiologic evidence suggests that surgical menopause increases cardiovascular disease risk, but prospective data is limited. It is also unknown how timing of RRSO impacts cardiovascular risk and whether this risk is mitigated by menopausal hormone therapy (MHT). We aimed to prospectively measure cardiometabolic risk factors 24-months after premenopausal RRSO compared to age-matched women who retained their ovaries. Methods Prospective observational study from baseline to 24-months in 104 RRSO women and 102 controls who retained their ovaries. At baseline and 24-months, blood pressure, body mass index (BMI), waist and hip circumference, fasting lipids, hs-CRP, glucose and insulin were measured, and HOMA-IR was calculated. Analyses were performed using generalized estimating equations, adjusting for baseline age, smoking status, vasomotor symptoms, and height (for BMI). Findings Baseline cardiometabolic phenotypes were similar between groups. At 24 months, there was no difference between groups in the rise in DBP of ≥5 mmHg (aOR 1.03 95%CI (0.48-2.18)). There was no evidence of a difference between groups in changes in BMI, waist circumference, HDL, non-HDL, LDL cholesterol, triglycerides, hs-CRP, or in markers of glucose metabolism at 24-months. After RRSO, 62% of women used MHT but there was no difference in any measured cardiometabolic marker between MHT users and non-users. Interpretation Surgical menopause did not clearly impact cardiometabolic status at 24-months. In those taking MHT, cardiometabolic risk markers did not appreciably differ from non-users.