HYSTERECTOMY: LEAVE THE OVARIES

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Gabe Mirkin, M.D.

Doctors used to recommend that a women have her ovaries removed along with her uterus because ovaries cannot become cancerous in a jar. They don't do that much any more. Removing the ovaries deprives a woman of her male hormones as well as her female ones.

After removal of her ovaries, a woman's cholesterol, particularly the bad LDL cholesterol, rises (1) and she is at increased risk for suffering a heart attack (6). Other side effects include depression (2), osteoporosis (3),and the drop in male hormones causes loss of assertiveness, muscle strength and interest in making love (2). Furthermore, a recent study in the British Journal of Obstetrics and Gynecology shows that removing a uterus markedly reduces a woman's chances of getting ovarian cancer, even though the ovaries are left in place (4).

Estrogen prevents osteoporosis, heart attacks and vaginal dryness. When doctors prescribe estrogen, they usually prescribe the second female hormone, progesterone, only to women with a uterus to prevent uterine cancer. However, recent data show that giving both estrogen and progesterone is especially beneficial in strengthening bones and does not reduce the benefits from estrogen in preventing heart attacks (5).

1) Y Suda, H Ohta, K Makita, K Takamatsu, F Horiguchi, S Nozawa. Influence of bilateral oophorectomy upon lipid metabolism. Maturitas 29:

2 (JUN 3 1998):147-154. 2) S Carranzalira, A Murillouribe, NM Trejo, J Santosgonzalez. Changes in symptomatology, hormones, lipids, and bone density after hysterectomy. International Journal of Fertility and Womens Medicine. 42: 1 (JAN-FEB 1997):43-47. It was observed that hysterectomy does not have a deleterious effect on hormone or lipid levels, nor on bone density, but depression was a frequent finding in hysterectomized women.

3) A Yildiz, I Sahin, K Gol, Z Taner, A Uluturk, K Biberoglu. Bone loss rate in the lumbar spine: A comparison between natural and surgically induced menopause. International Journal of Gynecology & Obstetrics 55: 2(NOV 1996):153-159 Conclusions: Oopherectomized women seemed to suffer a relatively higher bone loss rate compared with natural menopause.

4) A Loft, O Lidegaard, A Tabor. Incidence of ovarian cancer after hysterectomy: a nationwide controlled follow up. British Journal of Obstetrics and Gynaecology 104: 11(NOV 1997):1296-1301.

5) Randomised comparison of oestrogen versus oestrogen plus progestogen hormone replacement therapy in women with hysterectomy. British Medical Journal 312: 7029 (FEB 24 1996):473-478.

6) S Rako. Testosterone deficiency: A key factor in the increased cardiovascular risk to women following hysterectomy or with natural aging? Journal of Womens Health 7: 7 (SEP 1998):825-829.

Checked 9/5/05