Keeping Ovaries During Hysterectomy: Pros and Cons
By Paula Jewett, MD
A recent report in Obstetrics & Gynecology advises that many women who have a hysterectomy—surgical removal of the uterus—should keep their ovaries. The authors studied data from hysterectomy patients between the ages of 40 and 80 and found no “survival benefit” for women at average risk of ovarian cancer after removal of the ovaries during a hysterectomy. While the report isn’t definitive, an editorial in Obstetrics & Gynecology suggests that it should initiate “a more lively, informative and considered discussion” between women and their physicians.
Until recently, conventional wisdom said that after menopause, ovaries don’t do much and carry a risk of ovarian cancer. So, we used to encourage all women who were menopausal or nearly menopausal who were having a hysterectomy for another reason to have their ovaries removed as a precaution against future ovarian cancer.
However, the recent study suggests that while ovaries stop making estrogen once a woman reaches menopause, they continue to make other hormones that help protect the heart and bones. The study examined data on deaths related to hip fractures, heart disease and ovarian cancer.
The study concluded that until a woman reaches 65, there is a long-term survival advantage from keeping her ovaries after a hysterectomy, as long as she’s not at above-average risk of ovarian cancer. Those at increased risk of ovarian cancer have a family history of ovarian cancer, have never been pregnant, or are older than 50, since the risk of developing ovarian cancer increases with age. Women who have had children, who have breast-fed, or who use birth control pills are less likely to develop ovarian cancer.
The researchers also concluded that after age 65, the risks and benefits of ovary removal are about even.
One of the article’s authors, William H. Parker, MD, of the UCLA Medical School, explains that all in all, hysterectomy patients older than 40 with an average ovarian cancer risk don’t seem to have a survival advantage from having their ovaries removed.
At Women’s Care, we continuously read and study research related to women’s health. And while we take such research into consideration, we still firmly believe that each patient and her personal circumstances should be evaluated individually. We encourage and welcome thorough discussions with our patients to consider all the variables and options involved in medical treatment and care.
A recent report in Obstetrics & Gynecology advises that many women who have a hysterectomy—surgical removal of the uterus—should keep their ovaries. The authors studied data from hysterectomy patients between the ages of 40 and 80 and found no “survival benefit” for women at average risk of ovarian cancer after removal of the ovaries during a hysterectomy. While the report isn’t definitive, an editorial in Obstetrics & Gynecology suggests that it should initiate “a more lively, informative and considered discussion” between women and their physicians.
Until recently, conventional wisdom said that after menopause, ovaries don’t do much and carry a risk of ovarian cancer. So, we used to encourage all women who were menopausal or nearly menopausal who were having a hysterectomy for another reason to have their ovaries removed as a precaution against future ovarian cancer.
However, the recent study suggests that while ovaries stop making estrogen once a woman reaches menopause, they continue to make other hormones that help protect the heart and bones. The study examined data on deaths related to hip fractures, heart disease and ovarian cancer.
The study concluded that until a woman reaches 65, there is a long-term survival advantage from keeping her ovaries after a hysterectomy, as long as she’s not at above-average risk of ovarian cancer. Those at increased risk of ovarian cancer have a family history of ovarian cancer, have never been pregnant, or are older than 50, since the risk of developing ovarian cancer increases with age. Women who have had children, who have breast-fed, or who use birth control pills are less likely to develop ovarian cancer.
The researchers also concluded that after age 65, the risks and benefits of ovary removal are about even.
One of the article’s authors, William H. Parker, MD, of the UCLA Medical School, explains that all in all, hysterectomy patients older than 40 with an average ovarian cancer risk don’t seem to have a survival advantage from having their ovaries removed.
At Women’s Care, we continuously read and study research related to women’s health. And while we take such research into consideration, we still firmly believe that each patient and her personal circumstances should be evaluated individually. We encourage and welcome thorough discussions with our patients to consider all the variables and options involved in medical treatment and care.
