ScienceDaily (July 20, 2008) — During hysterectomy operations, surgeons often remove a woman's ovaries as well as her uterus. Cochrane Researchers now say there is no evidence that removing the ovaries provides any additional benefit and warn surgeons to consider the procedure carefully.
"Until more reliable research is available, removal of the ovaries at the time of hysterectomy should be approached with caution," says lead researcher, Dr. Leonardo Orozco of the OBGYN Women's Hospital San José in Costa Rica.
Of those women who undergo hysterectomies aged 40 or above, around half also have their ovaries removed. This amounts to more than 300,000 women a year in the US alone. The reason most commonly given for carrying out an oophorectomy at the same time is that it prevents ovarian cancer. However the ovaries produce not only estrogen, but also important hormones such as androgens that may have important clinical effects which have yet to be identified.
The researchers say there is little evidence to support the idea that removing the ovaries during a hysterectomy provides an overall health benefit. They identified only one controlled trial, involving 362 women. This compared hysterectomies with oophorectomies to hysterectomies without oophorectomies. Although this trial showed a very slight positive effect on psychological well-being when oophorectomies were performed, the team say much more data is required before any conclusions can be drawn.
"There could be a real benefit or harm associated with oophorectomy, but it has not been identified, more research of higher methodological quality is needed." says Dr. Orozco.
Sunday, July 20, 2008
Removing Ovaries During Hysterectomy: Effects Remain Unknown
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For women to choose whether they will consent to removal of their ovaries they need to be informed about the functions of the ovaries and the consequences of their removal.
It is the responsibility of the doctor to inform women that their ovaries are their gonads, and that the medically correct word for removal of the ovaries is female castration.
There are two primary concerns about this discussion of whether the ovaries should be removed. First, the ovaries produce all of the hormones a woman needs all of her life. The ovaries produce a variety of hormones including several types of estrogens, progesterone and androgens, which are released into the general circulation in precise and constantly varying amounts in order to maintain the balance called normalcy. Neither pharmaceutical hormones nor medical/surgical procedures can replicate this normal balance of hormone production, circulation and continual spontaneous adjustment to the body''s needs.
Second, and equally important, it is of concern that because the focus of this is whether the ovaries should remain intact or be removed that women and men may feel that as long as the ovaries are not removed that removing the uterus is inconsequential.
The uterus is a hormone-responsive reproductive sex organ that provides support to the bladder and the bowel. When a hysterectomy is performed the vagina is shortened and made into a closed pocket. Women who experience uterine orgasm (most women are unaware that it is contractions of the uterus that they feel during intense, pulsating orgasm) cannot experience it ever again when the uterus is removed.
Every woman and man, needs to be fully informed about the functions of the female organs. The HERS Foundation''s website has a short educational video "Female Anatomy: the Functions of the Female Organs" that should be seen by every woman before she is told to sign a form consenting to a hysterectomy and/or castration.
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