Battling Heart and Stroke

Cervical cancer is a cancer that affects the tissue of the cervix, the funnel-shaped organ located between the uterus and the vagina. According to estimates by the National Cancer Institute, about 11,000 new cases of cervical cancer have been diagnosed in the US in 2008, and 3,870 cases have resulted in death.

One of the most common forms of intervention for cervical cancer is hysterectomy which is the surgical removal of a woman’s uterus. According to MedicineNet, about 600,000 hysterectomies are performed in the US each year and about 50% of these also include bilateral oophorectomy, which is the removal of the 2 ovaries. The reason for removing the ovaries is to prevent the development of ovarian cancer.

The removal of a woman’s ovaries has drastic consequences, namely:

• A woman without ovaries, even at a young age, goes into premature menopause because the organs that produce the female hormones - the ovaries - are gone.
• A premenopausal woman will have to undergo hormone replacement therapy (HRT) to counteract menopausal symptoms. In recent years, HRT has been linked to many health problems in women, including cardiovascular disorder and breast cancer.
• A young woman without ovaries can no longer ovulate and produce eggs, thus ending the chances of a woman to produce an offspring. There have been many cases of women who had hysterectomy but with intact ovaries to have biological children through surrogate motherhood.

A recent study reviewed the database of clinical studies on hysterectomy and oophorectomy to answer the question whether performing an oophorectomy is necessary, especially in premenopausal women. The authors analysed data from studies conducted up to 2007. The results of the analysis were not conclusive but there is a tendency to point to the fact that oophorectomy may not be beneficial in the long run.

Leaving the ovaries in will mean a woman’s body can continue to produce female hormones that provide protection from a lot of age-related diseases including heart diseases, stroke osteoporosis and dementia.

There are of course, women who are at very high risk for developing cancer of the ovaries and in such cases, oophorectomy may be necessary, However, in many cases, especially when involving women of premenopausal age, the risk/benefit ratio of such an intervention should be carefully considered.

According to lead author Leonardo Orozco

“Until more data becomes available, [ovary removal during hysterectomy] should be approached with great caution…Currently, the existing evidence does not support the high number of ovary removals in clinical practice.”

Sources:

Cochrane Database Syst Rev. 2008 Jul 16;(3):CD005638

MedicineNet.com, 18 July 2008

Photo credit