Weighing Risks Of Removing Ovaries

(WebMD)  There is not enough evidence to justify the routine removal of the ovaries during hysterectomy - a common practice that may convey as many risks as benefits for premenopausal women, a new analysis suggests.

About half of the 600,000 hysterectomies performed in the U.S. each year include surgical removal of the ovaries along with the uterus. The most common reason cited for ovary removal is to prevent ovarian cancer .

But there is growing evidence that ovary removal may be associated with an increased risk for heart disease and stroke, and other age-related diseases, such as osteoporosis and even dementia .

The ovaries continue to produce hormones even after menopause that may be protective against such diseases, says ob-gyn Leonardo J. Orozco, MD, of the Women's Hospital, San Jose, Costa Rica.

In their newly published analysis, Orozco and colleagues were unable to find any high-quality controlled trials that examined the risks and benefits of routine ovary removal during hysterectomy in women with a low risk for ovarian cancer.

Ovary Removal Questioned

The analysis appears in the latest issue of The Cochrane Library, published by the medical research evaluation organization Cochrane Collaboration.

"Until more data becomes available, [ovary removal during hysterectomy] should be approached with great caution," Orozco tells WebMD. "Currently, the existing evidence does not support the high number of ovary removals in clinical practice."

The researchers concluded that there is an "urgent need" for appropriately designed trials to determine if ovary removal is justifiable for all women who have hysterectomies.

For women at high risk of ovarian cancer, including those with a strong family history of the disease and those with a genetic predisposition to get the cancer, the benefits of ovary removal are clear, says UCLA professor of obstetrics and gynecology William H. Parker, MD.

But for the vast majority of women who don't have these risks, removal of the ovaries during hysterectomy may not be justified, he says.

Parker's own 2005 study of hysterectomy patients between the ages of 40 and 80 with an average risk for ovarian cancer found no survival benefit associated with ovary removal at any age, and a survival disadvantage associated with the practice up until the age of 65.

Lower Risk of Heart Disease, Stroke

Women in the study who had their ovaries removed had a higher risk for heart disease and stroke. The younger the women were when their ovaries were removed, the higher their risk.

More recent studies from the Mayo Clinic suggest that ovary removal prior to menopause may be associated with an increased risk for Parkinsonism and dementia later in life.

"The evidence is mounting that there is no particular advantage [to ovary removal] for the patient with a low risk for ovarian cancer, and there might be a disadvantage," University of Wisconsin ob-gyn professor David Olive, MD, tells WebMD.

Premenopausal women who have their ovaries removed are often put on hormone therapy, but it isn't clear if hormone treatment is as beneficial as ovary retention, Olive says.

He adds that many women contemplating hysterectomy still aren't being told of the potential risks associated with ovary removal.

"Physicians tell patients that their risk of ovarian cancer can be removed by removing the ovaries," he says. "What they don't mention is that this may increase their risk for heart disease, which is much more common."


By Salynn Boyles
Reviewed by Louise Chang
©2005-2008 WebMD, LLC. All rights reserved

[blackyowe]

My Doctors were dead against taking my remaining ovary even 12 years ago. I had one removed because of a dermoid cyst that was enormous and grafted onto my ovary and it had to be done. Once one ovary is gone the other takes over and you still have a period every month. I was told by a doctor friend they can even leave a little part of an ovary and often it can do the job to produce the hormones us gals need.

[newlf4me]

I had my uterus and ovaries removed in 1996. It was the saddest day of my life. It wasn''t until later I found out the removal of the ovaries is called "female castration". I had no idea the hormones produced by this organ affect EVERY aspect of human life. These hormones not only affect *** drive but every kind of drive known to humankind. These hormones are responsible for our feelings of being in touch with the world around us, the ability to enjoy, to experience love, feelings of well-being, cognitive thinking, sleep, muscle strength, and so much more. And the loss of ovarian hormones sets a women up for a myriad of medical problems which only get worse through the years. It is sickening.

Removing only the uterus does not guarantee the ovaries will keep functioning. If they cease functioning (usually in about 2-3 years) it would be just like having the ovaries removed.

If a woman''s ovaries are removed before she reaches menopause, the loss is even more devastating. An intact woman''s ovaries function throughout her life, even after menopause. I could not believe a surgery could drastically ruin so many lives. Had I not been through it myself, I don''t think I could fathom it.

[bluestardad]

HEY MEDICAL FIELD!

CURE SOMETHING

ANYTHING!

QUIT MAKING MONEY OFF TREATING ILLNESS!

PROVE YOU ARE WORTH THE BILLIONS SPENT ON YOU EACH YEAR!

QUIT BEING A BUNCH OF MONEY GRUBBING PIMPS!

[godofredo29]

Sounds like the complete lack of concern with which they remove a guys testicle or testicles. Doctor thinks he/she feels a lump and off comes the testicle, just to test not even because they found cancer! Yet other procedures on the testicle(those related, say, to a epididymectomy) don''t result in its/their removal. Just try complaining about this and you get a "don''t worry, be happy" response. This, even though doctors are constantly saying they don''t know what the implications of long term testosterone replacement therapy are. No wonder that Olympic swimmer has elected to keep his until after the Games are over. Luckily you can transplant ovaries and testicles. I didn''t see that mentioned here in this article. But them we are talking about WebMD.

[nssherlock1]

HERSterectomy?????

[Marie Zarankevich]

Don''t you think it is time we lost the name Hysterectomy. -- It has been used to correct everything from mental illness to acne, and was named for the hysteria it seemed to fix. -- We now know that those women probably behaved better so they would not be disemboweled yet again. -- I know it would probably quiet me down! -- Please, somebody change that name. -- It is ugly, and inaccurate.

[jrandom321]

I wish I could have a hysterectomy with both ovaries removed. Then I'd never have a period again, and there'd be no chance of my ever having kids. Who cares about kids? I hate them anyway!

I don't care about losing my you-know-what drive because I don't ever plan on doing such things anyway. I am legally an adult, at 18, old enough to fight for my country, to vote, to smoke, to drive, to do 99% of things in the U.S. "land of the free," yet according to my doctors, too young to make medical decisions for myself and deal with the consequences if they occur.

They never give any medical reasons for not doing this besides I won't have children someday. I don't like them anyway, kids, and I wouldn't be a good parent anyway. I just want my periods and my childbearing capabilities to be gone for good. I get awful, crippling pains when I have my period, and the most horrible mood swings and temper flares -- PMDD. There is no real reason why I should keep my reproductive organs, because I have no plans to ever reproduce. I fervently believe there is a connection between mental illness and hormonal fluctuations, and I want these go-go ****** feminists to stop bashing people like me as being a traitor to some nonexistent "sisterhood."

Hysteria, or its modern name PMS/PMDD, is very real and should be treated as such. Plus, if you want to say "think of the children," well, think of the children who would benefit by not being born, genetically inheriting the madness of their mothers and to a good extent (no pun intended) their fathers, and being raised by "hysterical" banshees and violent drunks. This was my experience, and IMHO it's more people's experience than the sugarcoaters want you to believe! Call me a eugenicist, but I don't believe the mentally ill should have a right to have children, biologically or otherwise. All this does is bring more crazy, retarded mental deficients into the world!

[nssherlock1]

I say, just leave one. Kind of an off the shoulder number.....

[kenhamlett]

Finally!
I''ve been griping about this ovary removal issue for years. Even the single ovary removal does not seem justified without strong proof of the need. There may be hope for the medical community yet. Now if they would just divorce themselves from the scam artists they might one day appear respectable.
At least someone out there is thinking.