Take Them or Leave Them? The Ovaries

Women faced with a hysterectomy (aka surgical menopause) often have concern and should discuss the issue of taking or leaving the ovaries with this life changing surgery.  I do understand that sometimes there is just simply no choice in having a hysterectomy with prolonged issues of bleeding, pain, and cancer risk, but I also think women need to be aware of this information before going in for the surgery in situations where there might be an option to retain the ovaries.

William Parker MD and Cathleen Rivera MD reported that removing the ovaries is detrimental to overall health and results in increased mortality.  Now this is a big study and it's why I like to share it for purposes of this blog.  Here are the facts of the study found in the National Institutes of Health library:

Dr. Parker followed 30,000 women for 24 years after their hysterectomy.  Half had the ovaries removed and half did not. The group with the ovaries removed DID have lower rates of ovarian and breast cancer.  BUT, they also had a MARKED increase in death from heart disease and other cancers. :(  The group with the ovaries removed had a HIGHER ALL-cause morality rate.  

And another study:
Dr Rivera followed 1,000 premenopausal women (under 45 yo) after hysterectomy and found that the removal of the ovaries resulted in a disturbing 84% INCREASE IN DEATH from heart disease.  That word death should get somebody's attention.

I haven't even traveled down the trail of osteoporosis, thyroid disease, and Alzheimers Disease in this blog all which now show a strong association to hormone imbalance. 

Now sometimes there's not a choice to have the ovaries removed.  It is necessary in some cases. The experts would agree that if a woman has a high risk of ovarian or family breast cancer, and positive genetic markers, then it would make sense to remove the ovaries. 


"Real world" scenario here:
So, here's how the conversation might go in a physician/surgeons office (just using myself as mock patient here). 
"Sonja, you need to have a hysterectomy to remove these fibroids." Dr. X. 

"Will you need to remove my ovaries as well?" I reply. 

"If I take the ovaries it eliminates the chance of ovarian cancers, and you don't need them anyway." Dr. X  responds.

"Say what?" (yes that's exactly what I would say. smile)


Why would I respond that way? Because, I just shared the evidence of 30,000 women in a 24 year study.   What about my risk for other diseases (strong family history of heart disease), and what about the risk for other cancers?  It simply doesn't add up in my case.  Sorry Dr. X, I'm keeping my ovaries.   (BTW, I'm not facing a surgery and in the best of health.  This is strictly for example!) 


Now, what about those who HAVE to have the ovaries removed?  Well, there is a good ending to this post for those facing this surgery and if you've already had a hysterectomy with your ovaries removed, there is also hope for you.  Modern science and studies do prove that hormone replacement therapy can reduce the increased risks or heart disease associated with ovary removal with hysterectomy.  The bio-identical hormones are the best plan for patients (over synthetics) and can be customized to an individuals needs and hormone levels.  The testing is simple and I can work with your personal physician to provide the necessary hormones that you have lost due to a hysterectomy.  I just finished up two hysterectomy patient charts this morning with each showing varied hormone levels, varied family histories, varied physical attributes, varied concerns, etc. etc.  Each will receive a unique formulation to match their imbalance and symptoms.  It's great to be able to provide this option for women.  I also provide testing and individualized treatment for men.

Get tested and get treated! 

To your good health,
Dr. Sonja