Keeping ovaries at hysterectomy may boost survival

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For a woman who undergoes hysterectomy for benign disease such as Fibroids, leaving both ovaries in place has long-term survival benefits, at least if she is no older than 65 years and at average risk for Ovarian cancer, an analysis indicates.

Ovary removal is often recommended along with hysterectomy, on the thinking that it prevents the possibility of ovarian cancer developing, Dr. William H. Parker from the University of California, Los Angeles, and colleagues note in the medical journal Obstetrics and Gynecology.

Their analysis, however, shows that women who undergo ovary removal before age 55 are nearly 9 percent more likely to die before age 80. Those who have their ovaries removed before age 59 have a nearly 4 percent high risk.

"The important point,” Parker said, “is that gynecologists who have been looking at the issue of (ovary removal) have focused on one thing—Ovarian cancer. Women are living longer and the major killer of women is Heart disease, taking 25 times more women’s lives than ovarian cancer.”

The ovaries produce hormones for 30 years after menopause, he continued, “and these hormones are converted into estrogen, continuing the protection of the heart and bones. So, I think we need to look at the bigger picture.”

His group’s study shows that removing the ovaries “may be harmful if performed before age 65 and may be of no benefit at any age,” Parker said.

“These results, of course, do not apply to women at high risk of Ovarian cancer,” he emphasized.

SOURCE: Obstetrics and Gynecology, August 2005.

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