New research from Duke University published in this month’s issue of Obstetrics & Gynecology sheds some light on a topic that hasn’t been too closely studied – and confirms what many gynecologists have suspected.
Hysterectomy is the most performed gynecological surgical procedure with over 600,000 done annually in the U.S. In the most basic sense, a hysterectomy consists of the surgical removal of the uterus but may also include removal of the ovaries and fallopian tubes. Conditions like fibroids, uterine bleeding and cancer of the ovaries are some of the common conditions treated through a hysterectomy.
This intense surgical treatment is only done once other options have been exhausted. If the ovaries are removed, estrogen levels drop sharply. Besides no longer having your menstrual cycle, menopause is characterized by lower estrogen levels.
Results from this latest study though may give pause to some women considering the procedure.
Researchers at Duke enrolled 900 women ranging in ages from 30 to 47. Over half of the participants (465) were in the control group – meaning they had NOT undergone a hysterectomy. The other participants (406) had a hysterectomy that spared at least one ovary. Many surgeons prefer to leave the ovaries intact so estrogen hormone levels remain constant, which provides certain health benefits.
Blood tests and questionnaires of the study’s approximately 900 participants occurred over a 5 year period.
Patricia Moorman, PhD., MSPH is an associate professor in the Department of Community and Family Medicine at Duke and a lead researcher in the study. She says it’s been well known that early menopause – either from surgery or other factors that halt egg production – can lead to osteoporosis, heart disease and other conditions.
Although study participants did NOT have their ovaries removed, research found that 14.8% of women who had a hysterectomy started experiencing menopausal symptoms during the study. Only 8% of the control group reported menopausal symptoms during this time. Women who had one of their ovaries removed were at the highest risk of menopause.
According to the team’s analysis, women who had a hysterectomy started experiencing menopause approximately 2 years earlier than women who did not have the procedure.
Dr. Moorman says it isn’t really known why the ovaries in some women shut down after a hysterectomy.
“Some have hypothesized that surgery disrupts the blood flow to the ovaries, so the surgery leads to early ovarian failure,” she said. “Others have speculated it’s not the surgery, but the underlying condition preceding the surgery that causes it. Right now, it’s unresolved.”
Findings from this study can provide women and their doctors some concrete information on the effects of undergoing a hysterectomy. Knowing they may undergo menopause earlier, some women may try and find other treatment options before choosing the surgical procedure.
“Most women are very satisfied with the results of a hysterectomy. But this is a potential risk of the surgery that should be considered along with the benefit,” comments Moorman.