Ovary Removal Linked to Increased Heart Disease

Researchers at the University of Warwick and the NHS Foundation Trust, University Hospitals Birmingham conducted a nationwide retrospective study of the English Hospital Episode Statistics database to look for associations between removal of all ovarian tissue, versus conservation of at least one ovary at the time of hysterectomy with important health outcomes, such as ischemic heart disease, cancer, and all-cause mortality. The study included 113,679 women aged 35-45 who had had a hysterectomy for benign conditions between April 2004 and March 2014.

The results showed that patients in the ovarian conservation group were less likely to be admitted for ischemic heart disease after hysterectomy, and they were also less likely to have a cancer related post-hysterectomy admission. A significant difference in mortality was also seen; 0.6% in those with ovarian conservation, compared to 1.01% in patients with bilateral removal. In addition, fewer deaths were related specifically to heart disease and to cancer. The study was published on February 6, 2017, in BMJ.

“The combination of biological plausibility and the massive 'effect size' make a compelling case that women can be advised that their risk of ovarian cancer is greatly reduced by surgical removal of both ovaries,” said lead author Professor Richard Lilford, MD, of the University ofWarwick Medical School. “However, the lifetime risk of developing ovarian cancer is one in 52 in the UK, and the removal of a metabolically active organ such as the ovary may have harmful effects in the long term.”

Hysterectomy, or surgical removal of the uterus, is one of the most common surgical procedures for women. It may be total--removal of the body, fundus, and cervix of the uterus--or supracervical, involving the removal of the uterine body while leaving the cervix intact. Over 600,000 hysterectomies are performed annually in the United States alone, 90% of which for benign conditions. Such rates (the highest in the industrialized world), have led to a controversy claiming that hysterectomies are being largely performed for unwarranted and unnecessary reasons.