One in three women in the U.S. has undergone a hysterectomy at age 60, becoming the second most common surgery among women of reproductive age. It is believed that the best treatment for the condition of many women's health, including severe fibroids, vaginal bleeding or chronic pelvic pain, endometriosis and uterine prolapse. It is also often treated aggressively to treat cancer of the uterus, ovaries and cervix. About half of all hysterectomies involve removal of both ovaries along with the uterus. However, new discoveries are beginning to question the efficacy and safety of this radical practice.Too Hysterectomy with bilateral oophorectomy (removal of both ovaries) is often performed to treat ovarian disease or simply to reduce the risk of ovarian cancer. However, in the 2009 May issue of Obstetrics and Gynecology, a major study concluded that while removal of both ovaries lowers the risk of ovarian and breast cancer in patients with noncancer hysterectomy, those who kept their ovaries lived more than those who have chosen them removed. The researchers conducted followup and 24 years found that women undergoing hysterectomy with bilateral oophorectomy had a 17% higher risk of heart disease. This effect was especially dramatic in women under 45 years of age who had a 26% greater risk of cardiac events. Furthermore, its rate of allcause mortality was 12% higher than those of women undergoing hysterectomy ovary intact. Despite a lower risk of cancer, the researchers note that, even in the ovary containing group, the risk of ovarian cancer remains low, at 0.26%. While cancer patients and those with a family history of ovarian cancer may reasonably consider ovary removal, patients without cancer, 90% of cases of hysterectomy, should know that prophylactic removal of the ovaries does not improve the survival at any age. In fact, leaving the ovaries in place may improve longterm health and survival. Indeed, in a review conducted by the Mayo Clinic last year, women with surgically induced menopause poorer performance on cognitive tests than those who undergo natural menopause. The first group was also more likely to parkinsonism, depression, anxiety, sexual dissatisfaction, and osteoporosis. In some cases, younger patients experienced greater oophorectomy declines.For some conditions, there are newer treatment options that do not involve any type of hysterectomy. For heavy periods, bioidentical hormones, endometrial ablation, can significantly decrease menstrual flow, such as devices IUD containing progesterone only. ExAblate is another procedure that uses beams of ultrasound with MRI guidance may be used against fibroids. With some of these options, there is often no pain and the patient can return to work the next day. Talk to your healthcare provider about some of the alternatives, along with their pros and Holthouse MD cons.Mark br br
