Osteoporotic Hip Fractures
Estrogen deprivation states are well known to cause osteoporotic
hip fractures. The data regarding the effect of BSO on hip
fracture risk, however, is conflicting. In two separate analyses of
women enrolled in the Mayo Clinic’s cohort study on the effects
of oophorectomy on ageing, BSO was associated with a higher
than normal expected rate in the overall population.50,51 A
significant limitation of this study was the absence of a control
group: the referent risk was merely calculated from general
population statistics. In the prospective observational study of
almost 30,000women in the Nurses’Health Study, no difference
in hip fractures existed in either pre- or postmenopausal women
who had BSO.30 While not statistically significant, women with
BSO actually had a lower overall risk than ovarian conservation
(HR 0.89, 95% CI 0.71–1.12). Similarly, in a study of 6295 women
participating in the Study of Osteoporotic Fractures, postmenopausal
BSO was not associated with an increased risk of either
hip or vertebral fractures despite a lower serum testosterone
concentration in the BSO group.52 The Women’s Health Initiative
Observational Study also showed no increased risk of
fracture in women with BSO (HR 0.83, 95% CI 0.63–1.10).25