28 April 2009

Women Who Keep Ovaries Live Longer

Female internal reproductive anatomy.Image via Wikipedia

From Denny: The latest study in the May issue of the journal Obstetrics & Gynecology is quite dramatic. For decades now, every year there are hundreds of thousands of women who have undergone hysterectomies (removal of the uterus) along with removal of their ovaries that medical professionals believed would protect them from developing ovarian cancer, a rare cancer, usually only done on women with family histories of high risk. Now a new study reveals that the women who at least kept their ovaries were found to live longer and healthier.

Surpise Finding of Developing Heart Disease

The surprise finding was that the women who removed their ovaries were more likely to develop heart disease and a higher percentage to die during that 24-year follow-up. They were successful at developing fewer breast cancers and eliminated ovarian cancer but at what price? Looks like they traded eliminating ovarian cancer for heart disease and a shorter life.

35 Year Practice in Gynecology

This was a true long-term study of a 24-year follow-up and came from the famous Nurses' Health Study. This detailed study really raises questions about this widespread and 35-year practice. Right now the statistics are that about 300,000 women a year undergo hysterectomies and about half of them get their ovaries removed as well.

“This study shows that you’re more likely to die if you have your ovaries taken out, unless you’re among a group of women with a family history that places you at high risk for ovarian cancer or breast cancer,” said the lead author, Dr. William H. Parker of the John Wayne Cancer Institute in Santa Monica, Calif. Ovarian cancer is rare; it is also difficult to detect and because it is difficult to discover it is often deadly.

Harvard Nurses' Health Study & 24-Year Follow-Up

Thre were 29,380 women who participated in the Harvard Nurses’ Health Study. Of those only 34 died of ovarian cancer who had kept their ovaries. In the study there were 16,345 who had a hysterectomy and with both ovaries removed. There were 13,035 who had a hysterectomy but kept their ovaries.

Results of Group Who Had Ovaries Removed

What were the results for the first group of those who had a hysterectomy and with both ovaries removed?

* 895 cases of breast cancer, a 25% lower risk than those who kept their ovaries.

* 96% less risk of ovarian cancer (just 5 cases)

* 12% more likely to die during the follow-up period.

* 17% higher risk of heart disease than those with ovaries.

* 17% greater risk of dying of cancer.

* greater risk for lung cancer, a surprise finding.

* higher risks of heart disease and death was higher for women who had hysterectomies with ovaries removal before age 50 that did not take estrogen in comparison to women with hysterectomy before age 50 who kept their ovaries.

Controversial Estrogen Usage

The debate will rage on about the controversial use of estrogen and how it plays a role in heart disease among women. "Dr. Parker and other experts suggested that women who kept their ovaries lived longer because even though the ovaries make less estrogen after menopause, they produce androstenedione and testosterone, which are converted into estrogen by fat and muscle."

A Doctor's Opinion

Dr. Isaac Schiff, chief of obstetrics and gynecology at Massachusetts General Hospital and a professor at Harvard School of Medicine, said the study did not mean that women undergoing hysterectomies should never have their ovaries removed.

“A woman with a strong family history of ovarian cancer or breast cancer should still be given the option of having her ovaries removed,” said Dr. Schiff, who was not involved in the study. “The individual patient should be given the information, and decide what’s best for her.”

But that is a change from the past, he said, adding, “We used to just arbitrarily say, ‘If you’re over 45, have your ovaries taken out.’ ”

Taoism Teachings

I'm with the Taoists who figured out thousands of years ago it was not a good idea to take out inner organs if you could avoid it. I've argued with fellow women for years not to do this procedure as so many do it just because "everyone else is doing it" - no kidding, a peer pressure phenomenon. Many times women are poorly diagnosed and just want relief so they go ahead with the procedure, often used for everything but cancer prevention.

It took a while but my intuition proved right: keep some hormones in your body as you will live longer - just like that old Taoist spiritual adept taught me when I was an American high school kid in Taiwan. His advice proved invaluable to me all these years.

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