Time interval from castration in premenopausal women to development of excessive coronary atherosclerosis

The autopsy records of 80 patients who had a bilateral oophorectomy before age 50 were matched with 80 control patients. Castrated patients had an excess of coronary atherosclerotic blockage and myocardial infarcts, but this was directly related to the time interval from castration to “expected menopause” and the time interval from castration to death. Women castrated 0 to 9 years before age 50 did not have excessive coronary atherosclerosis. Those castrated 10 or more years before age 50 did have significantly more severe coronary artery disease. It took an average of about 14.4 ± 2.57 years after castration before excessive coronary atherosclerosis became apparent. Thus, women castrated before age 40 who are expected to survive more than 14 years are at high risk to developing coronary heart disease. These patients should receive estrogen replacement therapy.