Hysterectomies are the second most common surgeries among
American women, after cesarean section deliveries.  More than half
a million women, one in three, will undergo a hysterectomy before the
age of 60. In addition to removing the uterus, half of those women are
also advised to have an oophorectomy in which one or both ovaries are removed.
Thought to provide significant protection against breast and ovarian
cancer, the practice of oophorectomy may get a second look in light
of groundbreaking new research.  

In a study published in this month’s Obstetrics
& Gynecology, researchers found that women who had their ovaries
removed were at a much higher risk of death, heart disease and lung
cancer than the women whose ovaries were preserved. The risk was even
higher for women under the age of 50 at the time of their hysterectomy
and oophorectomy.
Because the ovaries continue to produce androgens which can be converted
to estrogen in the body, experts believe that estrogen may play a key
protective role against heart disease and this study adds to the evidence
to support that suggestion.   

The authors were quick to point out
that a woman with a strong family history of breast and/or ovarian cancers
should still take precautions and have her ovaries removed, but this
research suggests that women without a genetic predisposition for those
cancers will probably fare better keeping their ovaries.  

In light of this research, will gynecologists
change their practices?  Will women be informed that preserving
their ovaries may preserve their health?    

Looking at the bigger picture, according
to the National
Women’s Health Network,
up to 90% of hysterectomies are medically unnecessary and yet, women
are still having them. Why undergo major surgery with potential life-changing
side effects like depression and loss of sex drive if it’s not needed?
Are women being informed about the non-surgical alternatives to hysterectomies? 
Are women being told the whole story?   

Looking at the even bigger picture,
evidence is emerging that environmental contaminants and chemicals in
our everyday products may be contributing to a whole slew of female
reproductive disorders, including fibroids, the number one reason for a hysterectomy.
Protecting women against exposures to these chemicals could potentially
reduce their risk of developing reproductive disorders, including cancer,
and thus reduce the need for most elective hysterectomies.  

A growing body of medical professionals
have taken the concerns about environmental health and reproductive
health very seriously.  In September of last year, an editorial
was published in American Family Physician alerting doctors to
the risks of exposures to these chemicals and the need to educate patients.
Similarly, the Association
of Reproductive Health Professionals (ARHP)
has become a clearinghouse of environmental and reproductive health
information for physicians, including continuing medical education credits.
Progress is being made, but it is too soon to say when the mainstream
medical community will pick up these important connections and begin
offering clinical advice for patients.   

Until it becomes clear to on how doctors
will advise women to reduce their chemical risk for reproductive disorders,
this study further strengthens a recommendation from the National Women’s Health
Network for women to explore
non-surgical alternatives to hysterectomies.  At the very least,
women considering a hysterectomy should talk to their doctors about
preserving their ovaries.