Removal of Ovaries During Hysterectomy Might Increase Risk of Heart Disease, Premature Death, Study Says

More than half of the approximately 615,000 women who undergo hysterectomy each year in the US also have their ovaries removed in order to eliminate their risk of developing ovarian cancer, but a study published in the Aug 1 issue of... Obstetrics & Gynecology suggests that the negative side effects of oophorectomy before age 65 might outweigh the benefits, the AP/Long Island Newsday reports (Stengle, AP/Long Island Newsday, 8/1). William Parker, a clinical professor at the University of California-Los Angeles David Geffen School of Medicine, and colleagues analyzed previously published data on the absolute and relative risk of ovarian cancer, coronary heart disease, hip fracture, breast cancer and stroke for women who had undergone hysterectomy with and without oophorectomy. The researchers then developed a model to predict the optimal course of action for maximizing the survival of women at average risk of developing ovarian cancer (Parker et al., Obstetrics & Gynecology, 8/1). According to the model, prophylactic removal of the ovaries -- which continue to produce small amounts of hormones even after a woman experiences menopause -- does not provide a health benefit, regardless of a woman's age at surgery. In addition, women who have their ovaries removed before age 65 could be at increased risk of heart disease because of the lack of estrogen in the body, Parker said (AP/Long Island Newsday, 8/1). Overall, the younger a woman is when she has her ovaries removed, the more substantial the negative impact on her health and her chances of living to age 80. The researchers conclude that patients and their doctors should weigh the benefits and drawbacks of oophorectomy before deciding to go ahead with the procedure (Goldberg, Boston Globe, 8/1). In an accompanying Obstetrics & Gynecology editorial, reproductive endocrinologist David Olive writes that although the study is not definitive in resolving the value of prophylactic oophorectomy, the findings are "sure to provide significant impact upon clinical practice." The percentage of hysterectomies performed with prophylactic oophorectomies has more than doubled from 25% in 1965 to 55% in 1999, according to national statistics (Rabin, Long Island Newsday, 8/2).


"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.