Heart disease is a leading cause of death for both men and women. For a woman who needs a hysterectomy, an additional risk factor related to heart disease may be whether she chooses to have both ovaries removed (bilateral oophorectomy) in addition to her uterus.
The uterus, which is also called the womb, is a pear-shaped organ located in the abdomen which is part of a woman’s reproductive system. The ovaries are organs that are also part of a woman’s reproductive system which are located on either side of the uterus. Each month during a woman’s childbearing years, the ovaries release an egg which travels through a fallopian tube into the uterus. If the egg is fertilized, it implants in the wall of the uterus and grows into a baby. If it is not fertilized, it is flushed out of the body along with the lining of the uterus during her monthly period. In addition to providing eggs, the ovaries also produce hormones which are chemical messengers that help regulate a woman’s monthly cycle.
During a hysterectomy, a surgeon removes all or part of the woman’s uterus. This type of surgery is often used to treat cancer of the uterus and similar diseases. In some cases, there is a medical reason why the ovaries need to be removed along with the uterus. But in other cases, removing healthy ovaries is optional. For many years, doctors often recommended removing the ovaries to eliminate the risk of ovarian cancer. In recent years, several research studies have been done trying to determine if there are additional risks to women who have their ovaries removed to prevent future illness rather than to treat an existing condition.
The Women’s Health Initiative study gathered data on over 25,000 women ages 50 to 79 who had already gone through menopause and who had a hysterectomy. Approximately 56 percent of the group had their ovaries removed at the time of their hysterectomy. Seventy-nine percent of the women used some type of hormone replacement therapy following surgery. Researchers followed-up with the women for 8 years and concluded that removing the ovaries provided a lower risk of ovarian cancer and did not create a greater risk of heart disease or several other diseases in the women who had participated.
Another study known as the Nurses’ Health Study tracked the results of younger women with an average age of 51 years for 24 years following their hysterectomies. This study concluded that women who chose to have their healthy ovaries removed during hysterectomy had an increased risk of heart disease than women who kept their ovaries.
The difference in these studies seems to suggest that women over age 50 may benefit more from having their ovaries removed due to the decreased risk of ovarian and breast cancer without an increase in other risk factors. On the other hand, for women under age 50, the risk of stroke and heart disease may be doubled if they have healthy ovaries removed. This increased risk may outweigh the other benefits of ovary removal for women in this age group. The overall recommendation is for each woman to discuss all options and risks with her health care provider in order to make the best individual decision for her personal health.
Medscape: Conserve the Ovaries?
Medscape: Hysterectomy and Risk of Cardiovascular Disease
National Women’s Health Information Center
National Institutes of Health: Medline Plus
Los Angeles Times
Reviewed June 14, 2011
Edited by Alison Stanton