Removal of Ovaries and Fallopian Tubes Linked To Increased Risk of Death For Younger Women: Study

Young women who undergo a full hysterectomy, including removing the ovaries and fallopian tubes, face an increased risk of dying at an earlier age, compared to older women who undergo the same surgery, according to the findings of a new study.

Undergoing a hysterectomy at a young age, before menopause, increases the risk of death posed to women who have the surgery, according to research published this month in the medical journal The BMJ.

University of Toronto researchers studied more than 200,000 women who underwent non-malignant hysterectomy in Ontario, Canada, from 1996 to 2015. Researchers compared women of various ages who underwent bilateral salpingo-oopherectomy, a hysterectomy surgery that removes the uterus, fallopian tubes and ovaries. A traditional hysterectomy only removes the uterus.

Among the women who had a bilateral salpingo-oopherectomy, 19% of women were under the age of 45, 41% were between the ages of 45 and 49, 69% were between the ages of 50 and 54, and 81% were over 55 years old.

According to the findings, there was an increased risk of all cause death, non-cancer related, among women under the age of 45 who had the procedure, and women between the ages of 45 to 49. However, the risk of all cause death was not found among women over the age of 50.

Younger women often opt to get a full hysterectomy when they face an increased risk of ovarian cancer. The surgery is done to prevent the risk of ovarian cancer later in life, but until now, doctors had little research to indicate if there was a risk associated with doing so.

The increased risk of death is not an arbitrary number of 40 or 45 years old. It’s not as if a woman reaches 50 and no longer faces the increased risk of death. Instead, it is the incidence of menopause that typically occurs around the age of 50 that lowers the risk of death for older women, the researchers determined.

Removing the ovaries increased the risk of death, but not from cancer, when done at an early age. Researchers believe the reason the risks are higher among younger women is because removing the ovaries prematurely stops all ovarian hormone production, including estrogen production, early which puts women into sudden menopause.

The loss of estrogen may increase the risk of other serious health problems, including early death, as the production of estrogen affects multiple organs throughout the body. This is done quickly and dramatically, instead of over time as the natural progression of menopause. The same side effects are not expected in postmenopausal women whose ovaries stopped producing estrogen before having surgery.

“While caution is warranted when considering bilateral salpingo-oophorectomy in premenopausal women without indication, this strategy for ovarian cancer risk reduction does not appear to be detrimental to survival in postmenopausal women,” the researchers concluded.

They indicated doctors should be aware of the increased risk, but among women with a high risk of ovarian cancer, the benefits and risks should be weighed before a decision is made.