Removing Ovaries During Hysterectomy Carries Higher Risks Than Benefits: Study

The drop in estrogen caused by removing ovaries during hysterectomies for younger women may increase their risk of cancer, heart disease and death.

The findings of a new study support current recommendations that doctors try to avoid removing ovaries for young women who have not yet gone through menopause, and do not face a high risk for ovarian cancer.

In a report published this month in the Annals of Internal Medicine, Danish researchers indicate that women who undergo a hysterectomy to have both ovaries removed face an increased risk of cancer and death within the 10 years after surgery.

As a result, the researchers conclude that current recommendations should remain unchanged, as the risk of removing ovaries during a hysterectomy may carry more risks than benefits for premenopausal women, and a more cautious approach should be taken with postmenopausal women.

The study involved a review of data on nearly 143,000 women in Denmark ages 20 years or older from 1977 to 2017 who underwent a hysterectomy, a surgical procedure to remove the uterus, for benign conditions, meaning they did not have cancer. This included conditions like prolapse of the uterus, pelvic pain, and heavy periods.

Ovary Removal Health Risks

According to the findings, women who had a hysterectomy with a full oophorectomy, which includes the removal of both ovaries, faced a higher risk of death within 10 years compared to women who did not have both ovaries removed. The data indicated the increased risk was only significant for those who had surgery between the ages of 45 and 54 years.

Women who had their ovaries removed had a lower risk of ovarian cancer compared to those who did not. But younger women who had a full oophorectomy also faced a higher 10-year risk for all other types of cancer.

In addition, the researchers found patients who had both ovaries removed and were younger than 45 also had an increased 10-year risk of being hospitalized for cardiovascular disease.

Researchers said the increased risk may be linked to the significant decline in sex hormone production, including estrogen and progesterone. Comparatively, when the ovaries are removed after menopause, it reduces androgen sex hormones only such as testosterone.

Estrogen has a protective effect on the cardiovascular system, including blood flow, cholesterol, and the health of blood vessels. Without that protective effect, the risks of heart disease and heart attack increase, especially among younger women, the researchers warned.

Researchers warn the risks of removing the ovaries during hysterectomy among young women outweigh the benefits. And the findings of the study support the current recommendations to not remove the ovaries during a hysterectomy among women who haven’t gone through menopause.

“The authors find that these results support current recommendations for conserving ovaries in premenopausal women without a high risk for ovarian cancer and suggest a cautious approach in postmenopausal women,” they concluded.