Eye on Women’s Health: Ovary Conservation

By Hawthorne Haywood

 

 

Hundreds of thousands of women a year have elective bilateral oophorectomy, the removal of both ovaries. But a ground-breaking study published in the May 2009 issue of Obstetrics and Gynecology reversed prevailing wisdom and said healthy women should hang on to their ovaries–the benefits they provide outweigh the risks they pose.

Pre- and post-menopausal ovaries make important hormones that help you stay healthy and live longer. Women without their ovaries are at higher risk for heart disease, lung disease and osteoporosis than women who have them, notes study author Dr. William Parker, a staff gynecologist at Santa Monica-UCLA Medical Center in Los Angeles.

In his report, which incorporated 20 years of published data from various sources, he and his team found that, “Compared with ovarian conservation (keeping your ovaries), bilateral oophorectomy at the time of hysterectomy for benign disease is associated with a decreased risk of breast and ovarian cancer, but an increased risk of all-cause mortality, fatal and nonfatal coronary heart disease, and lung cancer.”

Dr. Paula A. Radon says the findings are beginning to change the course of women’s health, at least in her office at the The Comprehensive Gynecology Center, which is affiliated with Anne Arundel Medical Center in Annapolis.

For years, to prevent ovarian cancer—which affects 1 in 73 women a year—doctors have routinely removed the ovaries during a hysterectomy. “It was common in women past child bearing age, but now our thinking is changing,” explains Dr. Radon.

She notes that doctors now know that healthy ovaries continue to make small amounts of hormones for a woman’s entire life—especially testosterone—which can affect sexuality and well-being.

She points out that ovarian testosterone and androstenedione (both hormones) have been found in some women in their 80s. Muscle and fat cells turn testosterone into circulating estrogen, in turn protecting against heart disease and osteoporosis.

Dr. Radon agrees that for women who are carriers of the BRCA1 and BRCA2 gene mutations, ovary removal can reduce the risk of breast and ovarian cancer by around 80%.

However, for healthy women, the ovary is not dispensable and deserves protection. In his study, Dr. Parker concludes, “Preventive surgery should not be performed if it does not clearly benefit the patient; Given that approximately 300,000 U.S. women per year undergo elective oophorectomy, these findings have important public health implications.”

It is an exciting time, notes Dr. Radon, to practice women’s health, a specialty she chose because it allows her to care for her patients throughout their lives. Today, women’s health is burgeoning. The ovary is in the news and we look forward to future developments.

 

 

 

 

RESOURCES:

Dr. Paula Radon, The Comprehensive Gynecology Center,
compgyncenter.com

Ovarian Conservation at the Time of Hysterectomy and Long-Term Health Outcomes in the Nurses Health Study
Parker, William H. MD et al
journals.lww.com/greenjournal/Fulltext/2009/05000/Ovarian_Conservation_at_the_Time_of_Hysterectomy.11.asp