The study, which has implications for women with endometriosis, was published in Menopause, the journal of the North America Menopause Society. Its title is “Cardiovascular and metabolic morbidity after hysterectomy with ovarian conservation.”
Doctors perform more than 400,000 hysterectomies, or surgical removal of the uterus, in the United Stated each year. Previous studies have suggested that hysterectomies that remove both ovaries increase the risk a woman will die or develop a cardiovascular or other disease. A metabolic disease is one that affects cells’ ability to convert food to energy.
Because of this, the rates of hysterectomies that spare ovaries have increased in the past few years. But doctors haven’t known the long-term risks associated with this procedure. So Mayo Clinic researchers decided to study the issue.
“Hysterectomy is the second most common gynecologic surgery, and most are done for benign reasons, because most physicians believe that this surgery has minimal long-term risks,” Dr. Shannon Laughlin-Tommaso, a Mayo Clinic gynecologist, said in a news release. “With the results of this study, we encourage people to consider nonsurgical alternative therapies for fibroids, endometriosis and prolapse, which are leading causes of hysterectomy,” said Laughlin-Tommaso, the author of the study.
A benign reason is one that does not involve a direct threat to a patient’s health.
The study covered 2,094 women who had an ovary-sparing hysterectomy for a benign reason between January 1980 and December 2002. Researchers used the Rochester Epidemiology Project to identify patients. The database includes the complete inpatient and outpatient records of all medical providers in Olmsted County, Minnesota.
To evaluate the risk of hysterectomies, the team compared the patients’ records with those of 2,094 age-matched women in the same county who had not had a hysterectomy or their ovaries removed.
Researchers discovered that women who had a hysterectomy that spared their ovaries were at 14 percent higher risk of developing fat abnormalities linked to heart disease and at 13 percent higher risk of developing high blood pressure than women who did not have the surgery.
In addition, women who had a hysterectomy had an 18 percent higher risk of becoming obese and a 33 percent higher risk of having a coronary artery disease.
The surgery-associated risks were particularly high in women who had a hysterectomy before the age of 35. Their risk of congestive heart failure was 4.6 times higher than those who had not had a hysterectomy, and their risk of coronary artery disease 2.5 times higher.
“This is the best data to date that shows women undergoing hysterectomy have a risk of long-term disease — even when both ovaries are conserved,” Laughlin-Tommaso said.
“Alternatives to hysterectomy should be considered to treat benign gynecologic conditions,” especially in women who have a hysterectomy before age 35, the researchers suggested.