For many years, women who underwent hysterectomies also routinely had their ovaries removed, in order to prevent them from developing ovarian cancer in the future. A new study that will appear in the May 2009 issue of Obstetrics and Gynecology calls this practice into question.
The study, “Ovarian Conservation at the Time of Hysterectomy and Long-Term Health Outcomes in the Nurses’ Health Study,” examines the long-term survival rates of women of women who have had hysterectomies (removal of the uterus) because of non-cancerous reproductive disease. It compares the medical outcomes of women who had their uterus and ovaries removed with women who had only their uterus removed. The study used the database from the Nurses’ Health Study, which included 122,700 registered nurses in 1976 when it began.
The study found that women who had their ovaries removed had a higher risk of death from any cause, primarily from heart disease and lung cancer. Removing the ovaries at any age did not improve life-span for this group of women.
One of the studies lead authors, William Parker, MD, a clinical professor at the UCLA School of Medicine, has written a summary of the study and its findings that was published at Our Bodies Ourselves:
Women often have their healthy ovaries removed when they are having a hysterectomy in order to prevent ovarian cancer from developing in the future. About 50% of women who have a hysterectomy between ages 40-44 have their ovaries removed, and 78% of women between ages 45-64 undergoing a hysterectomy have their ovaries removed. All together, about 300,000 American women have their healthy ovaries removed every year.
If the ovaries are removed before menopause, a sudden decrease in the hormones made by the ovaries, including estrogen, testosterone and androstenedione, results. Even after a woman enters menopause, her ovaries continue to make considerable amounts of testosterone and androstenedione, which are then changed into estrogen by other cells in the body.
Some studies had already show that women who keep their ovaries have a lower risk of heart disease. While ovarian cancer accounts for 14,700 deaths per year in the U.S., heart disease causes 326,900 deaths, and stroke causes 86,900 deaths each year. If a woman is not at high risk for ovarian cancer, then keeping the ovaries might benefit her overall health and survival.
We designed a study to see whether it was better for women who needed a hysterectomy to keep their ovaries or have them removed during the surgery to remove the uterus.