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Spare the Ovaries! What Women Should Ask Before a Hysterectomy

ByCOMMENTARYBy MARIE SAVARD, M.D.ABC News Medical Contributor
May 22, 2009, 10:16 PM

May 24, 2009— -- Far too many women, even young women, have their perfectly healthy ovaries removed at the time of a hysterectomy.

Doctors long recommended this to prevent ovarian cancer later in life. Although many doctors claim that this practice rarely happens today, the statistics say otherwise.

Of the 600,000 hysterectomies each year for non-cancerous causes, half of all women have their ovaries removed at the same time -- and many of these women have many years to go before menopause.

So, it seems that the practice of removing healthy ovaries at the time of hysterectomy has continued, despite years of evidence suggesting that ovaries are complicated hormone powerhouses, even in the time approaching and during menopause.

Our ovaries influence all aspects of our health and sense of well-being. Unfortunately, too many doctors feel that taking estrogen pills or an estrogen patch will work just fine, and there is really no big loss to having the ovaries removed.

However, taking estrogen as a substitute for young healthy ovaries hardly takes the place of what our healthy ovaries produce.

I remember the stories of many young -- and even not-so-young -- women describing how awful they felt following surgery when their ovaries were removed and how difficult it was to get the right balance of hormones. They all complained of low energy, reduced libido and not feeling quite right.

Even when I came up with a regimen that helped relieve many of their symptoms, they complained that they still were not feeling themselves.

Ovarian cancer is fairly uncommon, accounting for about 3 percent of all cancers and only 1 percent of all deaths in women. But it is difficult to detect and treat, so understandably, many women go along with their doctors and agree to have their healthy ovaries removed. What women don't consider are the potential health risks to having their ovaries removed.

A study published in the May 2009 issue of the journal Obstetrics & Gynecology, from the famous Nurses' Health Study, found what research has long shown us: Surgical removal of perfectly healthy ovaries is associated with a number of health risks, especially for young women.

But the increased risk of death found by the researchers surprised me. The overall risk of death was increased by 40 percent, and the risk of heart attack and stroke increased by 50 percent in women with removal of ovaries before age 50, especially if they didn't take hormones after surgery. In this study, all women, even older women, benefited from keeping their ovaries.

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