I am very excited about a new study that was just reported at the American Association for Cancer Research meeting about the removal of healthy ovaries during a hysterectomy.
When I was trained as a surgeon many, many years ago, we were told that you should always remove a womanâ€™s ovaries if she was finished having children because they were useless and would only get cancer if left behind. We did not have very sensitive blood tests for hormones and thought that the ovaries stopped working at menopause and so were, in essence, dispensable. I had always suspected that this was not true, and would counsel patients and friends to fight for their ovaries.
Now that we have more sensitive hormone tests, we know that in postmenopausal women the ovaries produce low levels of estrogen. They also produce testosterone and androstenedione, two hormones that are converted into estrogen in a womanâ€™s bones, brain, breasts, muscles, fat, and other organs. Even so, doctors have typically believed that removing the uterus should always include removing the ovaries, unless there was a good reason not to do so.
Dr. William Parker, a clinical professor at the University of California, Los Angeles, and his colleagues, reported on their study that used the Nurseâ€™s Health Study database to evaluate the health affects of a hysterectomy. The study showed that the women who had their ovaries removed when they had a hysterectomy had a higher risk of death from all causes than did women who kept their ovaries. This was true even if the women took estrogen after their ovaries were removed.
It is true that the women who had their ovaries removed were less likely to get ovarian cancer or breast cancer. But that did not outweigh the increased risk of heart disease, lung cancer, and stroke that was seen in the group of women who had had their ovaries removed.
The message is clear: Just because the medical profession has not yet figured out why an organ is still there, doesnâ€™t mean we should remove it!