Should Women Keep Their Ovaries When They Have Hysterectomies?

by Cindy Gray

When considering a hysterectomy, talk to your health care provider about the risk-benefit ratio of removal of the ovaries.More than 600,000 hysterectomies are performed in the United States each year. By age 60, one in three women will have had a hysterectomy to remove all or part of the womb and the surgery may also involve extraction of the ovaries. In recent years there has been much debate regarding what percentage of hysterectomies are medically necessary and also whether or not the ovaries should be removed as part of the procedure. 

Almost one-third of all hysterectomies are performed to treat uterine fibroids to relieve symptoms such as pain and excessive bleeding. A recent survey found that fewer than half of the women who have fibroids are told by their doctors that there are minimally invasive alternatives to surgery.  Approximately 10 percent of all hysterectomies are legitimately needed to treat gynecological cancers. The other 90 percent of hysterectomies could possibly be avoided and symptoms treated with medications and other techniques.

One of the major decisions facing women having hysterectomies is whether or not to have their ovaries removed as part of the procedure. While it used to be common practice to remove the ovaries, a study published in the journal Obstetrics and Gynecology challenged the practice.

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Doctors cite ovarian cancer prevention as the reason to remove the ovaries. While ovarian cancer is rare, it is serious and is often difficult to detect in its early stages. But removing the ovaries puts women at significantly increased risk for other, more common and potentially serious health conditions such as heart disease.  The average woman is 30 times more likely to die from heart disease than from ovarian cancer.

The only women who should consider have their ovaries removed during a hysterectomy are those with certain gene mutations or those who have a strong family history of ovarian cancer.

The ovaries and adrenal glands produce estrone (a lower potency estrogen) and the liver produces estriol (another weak form of estrogen). These substances provide support for heart, bone, breast and vaginal health. 

When considering a hysterectomy, talk to your health care provider about alternatives to surgery. Also, do not agree to have your ovaries removed without giving serious consideration to the risk-benefit ratio. 

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