Researchers at the City of Hope National Medical Center in California studied over 130,000 women 45 years or older who had both ovaries removed. The study was published in the Journal of Fertility and Sterility 11/2011.
There has always been the question as to whether or not removal of both ovaries (a bilateral oophorectomy) would increase risk of death.
Interestingly, the researchers found that these women actually had a slightly lower chance of dying over the length of the study than similarly aged women who didn’t. The researchers also stated that women who had their ovaries removed before the age of 45 had no higher risk of death than women who didn’t.
Women who are advised to get a hysterectomy are also offered the option of removing there ovaries. This is done to reduce the risk of developing ovarian and breast cancer by eliminating the estrogen that is produced by the ovaries.
Removing the ovaries causes a woman to immediately commence menopause and until now it was not known what effect this would have on mortality.
Though smaller studies came to opposite conclusions, this current study contained by far the largest amount of patients.
“In some groups of women, such as those with a family history of breast or ovarian cancer, the benefit of early menopause is clear,” said Henderson in an email.
“However in most women it’s just not clear whether the downside associated with early menopause due to bilateral oophorectomy outweighs the benefits.”
In 2007, about 20,000 U.S. women were diagnosed with ovarian cancer, and almost 15,000 died from it, according to the Centers for Disease Control and Prevention.
According to Henderson’s study, about 600,000 women had hysterectomies every year between 2000 and 2004. More than half had their ovaries removed, too.
Over the past decade, a number of studies have produced conflicting answers to the question of whether ovary removal abruptly raises risks that tend to go up after natural menopause too, including death from heart disease, cancer and other causes.
Dr. William Parker of the John Wayne Cancer Institute at Saint John’s Health Center in Santa Monica, California who has published research linking ovary removal and increased risk of death said he notices younger doctors are more willing to accept that there might be a higher risk associated with the procedure than older doctors.
“It’s the gynecologist who sees the patient die of ovarian cancer,” said Parker.
“We are kind of operating with blinders on. We are very focused on this one condition.”
“You can’t make a definitive conclusion because the literature is so mixed,” said Dr. Vanessa Jacoby, an assistant professor of obstetrics and gynecology and reproductive science at the University of California, San Francisco.
Jacoby told Reuters Health that studying an association between the removal of ovaries and death from heart disease or cancer is hard for several reasons. One of the main reasons is that so much time has passed between the surgery and death.
“Women typically have an oophorectomy with their hysterectomy in their forties. Heart attacks don’t happen until much later, and so much time has passed. That is a very hard thing to study,” said Jacoby.
Another challenge is that no two studies are alike, Parker added.
“I don’t think you can start adding all the studies together that are out there, because they are all so different,” said Parker.
However, at the end of the day Parker said the decision needs to be made between the patient and her doctor.
“In the end it becomes a very personal decision, as it should be,” Parker said.
“As always have a frank and candid conversation with your doctor about your therapeutic choices,” said Henderson in an email.
“If you face the decision as to whether to undergo a bilateral oophorectomy, you must carefully weigh the risks and benefits to you as an individual.”
Fertility and Sterility, published online November 14, 2011.
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