Q: I am having a hysterectomy as I have a prolapsed uterus and want to know if it is wise to have my ovaries removed?

By Kalispell OB/GYN | March 21, 2014

By Dr. Thomas deHoop / Kalispell OB/GYN

406 Magazine Hysterectomy

A:

The answer is dependent on a few factors such as age, family history, risk of heart disease and osteoporosis with age being the most significant. You have to balance the risks of removal (premature menopause) against therisks of leaving the ovaries in place. After ovarian removal, ovarian hormones levels diminish and fall to the levels found in a postmenopausal woman and this is considered surgically induced menopause.

This loss of ovarian hormones in the premenopausal woman will lead to hot flashes and vaginal dryness. More importantly, since ovarian estrogen helps prevent bone lost and has protective effects on the heart, premenopausal women who have their ovaries removed will have accelerated bone loss, increased risk of osteoporosis (weakened bones) and increased risk of heart disease.

Studies have shown that long-term survival is improved by keeping the ovaries at the time of hysterectomy in a premenopausal woman. Some studies even show benefit when the ovaries are preserved until 65 years of age. Therefore, ovarian preservation provides many benefits in the premenopausal woman. If the ovaries are removed in a postmenopausal woman,the reduction in hormones is less significant.

So what are the risks of ovarian preservation?
When ovaries are retained, the risk of ovarian cancer still exists. This is true for preand postmenopausal women. Although it is impossible to predict who will develop ovarian cancer, women with a strong family history of ovarian cancer or who have additional risk factors, should strongly consider ovarian removal at the time of hysterectomy. For premenopausal women, the risks of ovarian removal, such as osteoporosis, can be reducedby estrogen replacement therapy. Removal may also be recommended in women who have gynecologic conditions, such as endometriosis or pelvic pain from scarring which may worsen or recur with ovarian preservation and require future surgery. There is approximately a 2-3% lifetime risk of reoperation for other benign ovarian conditions such as ovarian cysts, pain or scarring in women who choose to retain their ovaries at the time of hysterectomy.
So it appears that postmenopausal women derive some benefits from ovarian preservation, while premenopausal women may benefit greatly if there are no additional risk factors. This decision should be made with your surgeon after careful consideration of your individual risks and benefits.
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DoctordeHoop072rDr. deHoop is a regular contributor to Health Care Answers for the  406 Woman Magazine.
This article  appears in the  June/July 2013 addition online and in print version around the Flathead Valley.

PLEASE NOTE: This information is not intended to be medical advice.  It is general health information and does not take into account your particular health status nor is it a substitute for personal medical care.  Kalispell OB/GYN shall not be liable for any damages arising out of the use of the content herein.

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