Removal of Ovaries During Hysterectomy for Benign Condition Carries Health Risks
Among women who have a hysterectomy for reasons other than cancer, those who also have their ovaries removed have a slightly higher overall risk of death from cancer and heart disease than those who do not have their ovaries removed. These results were published in Obstetrics and Gynecology.
Hysterectomy (surgical removal of the uterus) is a common procedure among women in the United States. Among women who undergo a hysterectomy for benign (non-cancerous) conditions, many also have their ovaries removed in order to reduce the risk of ovarian cancer. For premenopausal women, removal of the ovaries results in an abrupt drop in both estrogen and androgen production. Removal of the ovaries can also affect hormone levels in postmenopausal women because even after menopause the ovaries produce hormones that can be converted to estrogen in other tissues in the body.
To explore the health effects of bilateral oophorectomy (removal of both ovaries), researchers evaluated information from the Nurses’ Health Study. This study began in 1976 and enrolled 122,700 female registered nurses between the ages of 33 and 55. The study participants have provided updated health information every two years since the start of the study, allowing scientists to address a wide range of research questions.
The current analysis focused on the 29,380 women who had undergone a hysterectomy without a diagnosis of gynecologic cancer. Fifty-six percent of the women had a hysterectomy plus a bilateral oophorectomy (removal of both ovaries) and 44 percent of women had a hysterectomy without an oophorectomy.
More than 24 years of follow-up information was available.
- Compared with women who did not have their ovaries removed, women who did have their ovaries removed had a 28% increased risk of death from heart disease, a 17% increased risk of death from cancer, and a 12% increased risk of death from any cause.
- Although women who had their ovaries removed were less likely to develop breast or ovarian cancer, they were more likely to develop lung cancer and more like to die of cancer than women who did not have their ovaries removed.
The researchers conclude that removal of the ovaries at the time of hysterectomy for a benign condition reduces the risk of breast and ovarian cancer but increases the risk of all-cause mortality, fatal and non-fatal coronary heart disease, and lung cancer. Removal of the ovaries did not improve survival in any of the age groups evaluated.
It should be noted that these results do not apply to women who have a high risk of ovarian cancer as a result of a BRCA1 or BRCA2 mutation.
Reference: Parker WH, Broder MS, Chang E et al. Ovarian conservation at the time of hysterectomy and long-term health outcomes in the Nurses’ Health Study. Obstetrics and Gynecology. 2009;113:1027-37.
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