Saturday, September 16, 2006

Youngish women should hang on to those ovaries!

The question usually arises when facing a hysterectomy about whether or not to remove the ovaries as well. Ovarian cancer is difficult to diagnose, so the removal rationale reasons that an ovary snatched is a deadly tumor ducked.

Scientists at the Mayo clinic compared a large group of women who underwent oopherectomy (removal of ovaries) at the time of hysterectomy with a group of women motoring into the future with ovaries intact. Those women under 45 who lost both ovaries to surgery had a 67% increased risk of dying from any cause in the years following surgery. More notably, most of the elevated mortality risk occurred in the group who both lost their ovaries and received no estrogen replacement. This sub-group had double the all-cause mortality risk!

One Mayo Clinic surgeon remarked, "For women with average risk for breast and ovarian cancer where we might have considered preventive ovariectomy, the discussion will have more of an emphasis on conserving the ovaries for protecting the health of the woman." Furthermore, study authors felt that women under 50 undergoing oopherectomy should receive estrogen if there are no specific health reasons why they should not.

In my experience in this post-WHI world, many women under 50 who've run out of estrogen due to surgical reasons are scared to use estrogen. Hopefully, this study will ease their fears about choosing hormonal therapy.


Anonymous said...

I knew I was doing the right thing! Had a vaginal hysterectomy in my early 40's keeping my healthy ovaries. Was determined NOT to go the estrogen route when menopause hit. Well did I ever change my mind quick ;-) Especially too since I'm quite small (101 lbs dripping wet)and have to worry about osteoporosis. Went on the lowest dose vivelle-dot and felt better almost immediately! Still can't get a straight answer from a Doctor how long I can stay on HRT? Have been taking it for a year and have NO plans of going off anytime soon.

Thanks for such an informative blog.

Femail doc said...

That is certainly a big question, how long to stay on estrogen therapy. I have some thoughts on that that I will post tomorrow.
Judy P.

tk said...

Wow. I'm glad I found your blog . . . Both of my ovaries were removed when I had my hysterectomy, and I never knew why--I wasn't given an option. I struggled with the HRT decision, and I'm glad I'm on it.

Femail doc said...

Hi tk,

Thanks for stopping by. There's a lot to estrogen therapy that isn't hitting the evening news.