HWN Suggests

The Crucial Decision That Can Protect Women’s Health as They Age

Though menopause and women’s health are getting more attention from doctors and researchers after being understudied for decades, the hysterectomy question remains particularly difficult. I did some research and here’s the bad news: Women under 50 whose hysterectomies involve removing both their uterus and ovaries—prompting surgical menopause—face increased risk for myriad health issues, including heart disease, stroke and dementia.

Now the good news: More women are preserving their ovaries after hysterectomies, reversing longstanding medical practice. But some doctors and researchers say it is likely that there are too many women undergoing removal of their ovaries when they don’t…

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Articles of Interest

Bilateral Salpingo Oophorectomy (BSO) - Risk-reducing surgery

If you are having a BSO, then your uterus (womb), cervix and vagina will not be removed. However, sometimes a BSO is done as part of a larger operation called a total hysterectomy, where the uterus and cervix are also removed. A total hysterectomy may be considered if a patient has other gynaecological problems, such as fibroids or endometriosis.

Effect of Bilateral Oophorectomy on Women's Long-Term Health

Bilateral oophorectomy at the time of hysterectomy for benign disease is commonly practiced in order to prevent the subsequent development of ovarian cancer or other ovarian pathology that might require additional surgery. At present, bilateral oophorectomy is performed in 78% of women aged between 45 and 64 years having a hysterectomy, and a total of approximately 300,000 prophylactic oophorectomies are performed in the USA every year. Estrogen deficiency resulting from pre- and post-menopausal oophorectomies has been associated with higher risks of coronary heart disease, stroke, hip fracture, Parkinsonism, dementia, cognitive impairment, depression and anxiety in many studies.

Oophorectomy vs Ovarian Conservation With Hysterectomy

In this large prospective cohort study, BSO decreased the risk of ovarian cancer compared with hysterectomy and ovarian conservation, but incident ovarian cancer was rare in both groups. Our findings suggest that BSO may not have an adverse effect on cardiovascular health, hip fracture, cancer, or total mortality compared with hysterectomy and ovarian conservation.

Oophorectomy: the debate between ovarian conservation and elective oophorectomy

Elective bilateral salpingectomy oophorectomy/remaining oophorectomy (EO) often occurs at the time of hysterectomy and occurs in almost half of all hysterectomies for benign reasons performed in the United States. However, a debate exists regarding risks and benefits of this elective procedure. The current recommendation by the American College of Obstetricians and Gynecologists (ACOG) on EO is that “strong consideration should be made for retaining normal ovaries in premenopausal women who are not at increased genetic risk of ovarian cancer

Removing organs “just in case”—is prophylactic removal of the ovaries a good thing?

Why is prophylactic oophorectomy undertaken at the time of hysterectomy? There are three possible reasons. Firstly, ovaries are often considered unimportant once a woman's reproductive life is over; secondly, ovaries are seen as associated with the possibility of causing recurrent gynaecological symptoms (sometimes described as the retained ovary or ovarian remnant syndrome13); and thirdly, there is insufficient evidence available on which to base a decision, because although some work has been done, a full evaluation of the risks, costs, and benefits of prophylactic oophorectomy in the absence of genetic markers and at the time of hysterectomy has not been undertaken.

Study: Removing ovaries before age 50 may increase the risk of chronic conditions for some women

Removal of ovaries and fallopian tubes prevents ovarian cancer, but it may come with other health risks. Experts recommend removal of ovaries and fallopian tubes in women at high risk for ovarian cancer due to inherited mutations in BRCA or other genes linked to ovarian cancer risk. For these high-risk women the benefit of ovarian cancer prevention outweighs the risk of long-term complications.

Was a Hysterectomy and Bilateral Salpingo-oophorectomy Necessary?

The gynecologist elected to proceed with a total abdominal hysterectomy and bilateral salpingo-oophorectomy (BSO) before the results of the frozen section returned, which revealed a benign serous cyst.

Resources

5 Things You Need To Know About Having Your Ovaries Removed

For some, it's done to minimize risk of ovarian cancer. For others, there's something already wrong with the ovaries, like cysts, pain, or even an emergency situation that involves twisting (you do not want to Google it; we promise). But no matter why you get the surgery, one thing's certain: Menopause comes on immediately, with all its bells and whistles, because the ovaries are the hormone hub of the reproductive system.