Should I Keep My Ovaries If I Have A Hysterectomy?

>> Thursday, September 29, 2011

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This has been an ongoing problem for gynecologists and women both. In all the newer studies they are finding that it may only be in cases of cancer or malignancy or severe endometriosis that the ovaries need to be removed. In the U.S. 78% of women 45-64 and 55% of women overall have their ovaries removed at the time of hysterectomy which tallies up to approximately 300,000 women a year undergoing hysterectomy w/removal of ovaries and tubes.

So why is this such a big deal? Well for one thing, once the ovaries are removed, it can take several months (up to a couple of years) for a woman’s hormones to re-balance and for her to feel good emotionally again. Not to mention the affects it has on the neurological system, affecting memory, sleep, sexual desire, mood, anxiety and depression. Once the ovaries are removed surgically the drop in estrogen and other hormones is very steep and quick and if no estrogen is replaced it can be a frightening event.

So it used to be that if a woman was over 40 years old and she needed a hysterectomy for non-cancerous reasons it was just automatic that a doctor would recommend that the ovaries be removed as it was considered the best way to prevent future ovarian cancer. Now because of the WHI and the Nurses Health Study and all we’ve learned over the years we know that is not true.

Only 15,000 women die a year from ovarian cancer and most of them were genetically predisposed to get it. The fact is that 327,000 women die every year of coronary heart disease (CHD) and 100,000-200,000 dementia cases and these both are directly related to the removal of both ovaries with no hormonal replacement used. The risk of this far outweighs any risk of ovarian cancer.

Women of all ages who keep their ovaries are more likely to have a better quality of life as the ovaries continue to produce a small amount of hormones even in menopause. During the 24 year follow-up on the Nurses Health Study, bilateral ovarian removal (BSO) was associated with an increase in death from strokes, CHD and an overall shortened lifespan.

NOTE: There is a group of women that we exclude and those are the ones that have the BRCA 1 and BRCA 2 gene mutations. 

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