Bilateral oophorectomy may do more harm than good
November 28, 2015
Premenopausal oophorectomy causes a rapid decline in circulating ovarian estrogens and androgens. Postmenopausal ovaries continue to produce significant amounts of the androgens testosterone and androstenedione, which are converted to estrogen. Estrogen deficiency has been associated with higher risks of coronary artery disease and hip fracture, and neurologic conditions. Although approximately 15,000 U.S. women die each year of ovarian cancer, 350,000 women die of coronary artery disease. Therefore reducing a woman's risk of ovarian cancer with oophorectomy may be outweighed by increased risks of coronary artery disease and neurologic conditions.
In an accompanying editorial, G. David Adamson, MD, FRCSC, FACOG, FACS, Director of Fertility Physicians of Northern California, Palo Alto and San Jose, CA, and past-president of both the American Society for Reproductive Medicine and the American Association of Gynecologic Laparoscopists, comments, "Dr. Parker has performed a valuable service to his fellow gynecologists and to women everywhere who have to make the difficult decision regarding ovarian conservation or removal at the time of hysterectomy. Oophorectomy is not necessarily the wrong decision for many women, but assessment of these data leads to the conclusion that more women are undergoing oophorectomy than should."
The article is "Bilateral Oophorectomy versus Ovarian Conservation: Effects on Long-term Women's Health" by William H. Parker, MD. The editorial is "Ovarian Conservation" by G. David Adamson, MD. Both appear in the Journal of Minimally Invasive Gynecology, Volume 17, Number 2 (March/April 2010) published by Elsevier.Source: Elsevier Health Sciences