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Removal of ovaries with hysterectomy, post-menopause?

By August 16, 2009 - 10:32am
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I have a large, growing fibroid inside my uterus that needs removal. I am post-menopausal (late 50's). Should I have the ovaries removed too? Which is more important -- continuing to produce the small amount of hormones made in the ovaries post-menopause, or, eliminating the risk of ovarian cancer? There is a history of breast cancer in my family (aunts, sister,mother), but no ovarian cancer. I have never had cancer. Much thanks for your help.

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Yes. Thank you very much. I have always been reluctant to take any estrogen due to my family history of breast cancer. If I have my ovaries removed, do you still advise a low-dose estrogen patch, even in light of my family history? Much thanks.

Jane Ross

August 17, 2009 - 5:51pm

Hey janeellen, we asked the venerable Dr. Philip Sarrel your question. Here was his response ...

"Keeping your ovaries at the time of a hysterectomy is important to think about. If you were younger and had not yet reached your menopause, then the uterus could be easily removed, the ovaries examined and, if they appeared normal, could be saved.
However, at age 58 and having had your last menstrual flow, it is not likely the ovaries are producing very much hormone although the growth of your fibroid suggests your ovaries, despite your age, may be producing enough hormone to be stimulating growth of the fibroid.

For sure, with the growth of the fibroid, the problem should not be ignored and the uterus should be removed. While ovarian cancer is a relatively rare disease, it is a lethal one and removal of the ovaries will prevent that problem entirely.

You will be at an advantage for taking hormone replacement. Without a uterus, it should be easy to replicate the estrogen levels you have from your natural production. It's important, with removal of your ovaries, that steps be taken to protect you. I would go so far as to start an estrogen patch, at a low dose level, just prior to your surgery so that you do not have to experience withdrawal symptoms.

Having your estrogen level measured precisely just prior to the surgery will help your physician to determine the appropriate dose for you."

Does this information help you?

August 17, 2009 - 12:36pm

This is a good question: when is it indicated to have ovaries removed (if already undergoing surgery).

I will ask one of our experts to respond to your question, and hope you will hear an answer soon.

August 16, 2009 - 5:44pm
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