Removal of the ovaries (bilateral oophorectomy) while performing a hysterectomy is common practice to prevent the subsequent development of ovarian cancer. This prophylactic procedure is performed in 55% of all U.S. women having a hysterectomy, or approximately 300,000 times each year. An article in the March/April issue of The Journal of Minimally Invasive Gynecology suggests that this procedure may do more harm than good.
William H. Parker, MD, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, provides a comprehensive analysis of the medical literature relating to the benefit of oophorectomy at the time of hysterectomy. His investigation includes studies of post-hysterectomy cancer incidence, all cause mortality, cardiovascular disease, osteoporosis and hip fractures, coronary artery disease, and a number of other conditions. He concludes that, on balance, removal of the ovaries is not generally warranted for all women undergoing hysterectomy. In women not at high risk for development of ovarian or breast cancer, removing the ovaries at the time of hysterectomy should be approached with caution.
Dr. Parker states, "Presently, observational studies suggest that bilateral oophorectomy may do more harm than good. Given that 300 000 U.S. women a year undergo elective oophorectomy, the findings of increased long-term risks have important public health implications…Prudence suggests that a detailed informed consent process covering the risks and benefits of oophorectomy and ovarian conservation should be conducted with women faced with this important decision."
Premenopausal oophorectomy causes a rapid decline in circulating ovarian estrogens and androgens. Postmenopausal ovaries continue to produce significant amounts of the androgens testosterone and androstenedione, which are converted to estrogen. Estrogen deficiency has been associated with higher risks of coronary artery disease and hip fracture, and neurologic conditions. Although approximately 15,000 U.S. women die each year of ovarian cancer, 350,000 women die of coronary artery disease. Therefore reducing a woman's risk of ovarian cancer with oophorectomy may be outweighed by increased risks of coronary artery disease and neurologic conditions.
In an accompanying editorial, G. David Adamson, MD, FRCSC, FACOG, FACS, Director of Fertility Physicians of Northern California, Palo Alto and San Jose, CA, and past-president of both the American Society for Reproductive Medicine and the American Association of Gynecologic Laparoscopists, comments, "Dr. Parker has performed a valuable service to his fellow gynecologists and to women everywhere who have to make the difficult decision regarding ovarian conservation or removal at the time of hysterectomy. Oophorectomy is not necessarily the wrong decision for many women, but assessment of these data leads to the conclusion that more women are undergoing oophorectomy than should."
The article is "Bilateral Oophorectomy versus Ovarian Conservation: Effects on Long-term Women's Health" by William H. Parker, MD. The editorial is "Ovarian Conservation" by G. David Adamson, MD. Both appear in the Journal of Minimally Invasive Gynecology, Volume 17, Number 2 (March/April 2010) published by Elsevier.
Andrea Boccelli | EurekAlert!
Disarray in the brain
18.12.2017 | Universität zu Lübeck
Amputees can learn to control a robotic arm with their minds
28.11.2017 | University of Chicago Medical Center
A study carried out by an international team of researchers and published in the journal Physical Review X shows that ion-trap technologies available today are suitable for building large-scale quantum computers. The scientists introduce trapped-ion quantum error correction protocols that detect and correct processing errors.
In order to reach their full potential, today’s quantum computer prototypes have to meet specific criteria: First, they have to be made bigger, which means...
Since 2016, German and Spanish researchers, among them scientists from the University of Göttingen, have been hunting for exoplanets with the “Carmenes”...
DNA molecules that follow specific instructions could offer more precise molecular control of synthetic chemical systems, a discovery that opens the door for engineers to create molecular machines with new and complex behaviors.
Researchers have created chemical amplifiers and a chemical oscillator using a systematic method that has the potential to embed sophisticated circuit...
MPQ scientists achieve long storage times for photonic quantum bits which break the lower bound for direct teleportation in a global quantum network.
Concerning the development of quantum memories for the realization of global quantum networks, scientists of the Quantum Dynamics Division led by Professor...
Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...
11.12.2017 | Event News
08.12.2017 | Event News
07.12.2017 | Event News
18.12.2017 | Information Technology
18.12.2017 | Physics and Astronomy
18.12.2017 | Agricultural and Forestry Science