If a gynecologist, like Rawtani Meera MD, has recommended a partial hysterectomy to treat your uterine fibroids, endometriosis, heavy or irregular periods, chronic pelvic pain or another non-cancerous condition, you may be wondering why a complete hysterectomy is not your doctor's preferred course of action. Many women in your position would just as soon have their entire reproductive system removed all at once to avert potential cancer later. This concern is perfectly understandable and may seem logical, but doctors are moving in the direction of sparing women's ovaries whenever possible. Keeping your ovaries may be more likely to extend your quality of life.
Different Types of Hysterectomy
There are various types of hysterectomy procedures that vary in which reproductive organs are surgically removed. Removal of the ovaries, or an oophorectomy, may or may not be recommended in addition to one of these procedures. A gynecologist makes a recommendation based upon which option addresses the medical condition to be treated.
- Subtotal, also called partial or supracervical, hysterectomy means that only the upper portion of your uterus will be removed, leaving the cervix in tact.
- A total hysterectomy removes the entire uterus and the cervix.
- A radical hysterectomy, typically reserved for patients in whom cancer is present, removes the entire uterus and surrounding tissues, the cervix and the upper portion of the vagina.
Why Not Be Proactive In Preventing Cancer?
If you have pondered this question, you are not alone. Cancer prevention can be a powerful motivator to want your ovaries removed during your hysterectomy. This was, in fact, commonly practiced for decades in women over the age of 45. That age has been bumped up to 65 in light of recent findings in a study conducted by Dr. William H. Parker of Saint John's Health Center. The study concluded that women who are under the age of 65 and have no known family history of ovarian cancer fare better long-term when their ovaries are left intact.
The Role of Your Ovaries After Menopause
When women enter menopause, their estrogen levels drop significantly, which raises the risk for several potentially devastating, and even fatal, health problems. These conditions include:
- Heart disease
Your ovaries continue to produce low levels of estrogen even for several years after menopause. They also continue to produce two additional hormones, testosterone and androstenedione, which your body's muscle cells convert into estrogen, thus bumping up estrogen levels and reducing the risk for osteoporosis, heart disease and stroke.
Weighing Your Risks and Benefits
Unless you have a family history of ovarian cancer, the risk for developing it is significantly lower than the risk for developing all of the above-mentioned conditions combined if you retain your ovaries. The younger a woman is at the time of her hysterectomy, the greater the risk for these conditions if her ovaries are removed.
If you are genetically predisposed to become afflicted with ovarian cancer, then the removal of your ovaries presents the greater benefit. Women who undergo oophorectomy may be placed on hormone replacement therapy, but such therapy is not without risks. Furthermore, hormone replacement therapy still has not been determined whether or not it offers the same level of protection as that provided by the ovaries.
Discuss Your Options
Do not be afraid to question your doctor's recommendations. A two-way discussion that allows you to discuss your concerns, family medical history and how each option will affect your well-being and quality of life into your post-menopausal years will empower you to make the best decision for your health.Share