Wednesday, March 17, 2010 (Last Updated: 03/18/2010)
WEDNESDAY, March 17 (HealthDay News) -- The decision to perform prophylactic bilateral oophorectomy at the same time as hysterectomy should be made with caution, as it may do more harm than good, especially in women not at high risk for development of ovarian or breast cancers, according to a review published in the March issue of the Journal of Minimally Invasive Gynecology.
William H. Parker, M.D., of the John Wayne Cancer Institute at Saint John's Health Center in Santa Monica, Calif., reviewed observational studies of pre-menopausal and post-menopausal oophorectomy and found that the resulting estrogen deficiency is associated with higher risk of a range of diseases such as coronary artery disease, stroke, hip fracture, Parkinsonism, dementia, depression, anxiety, and cognitive impairment.
Unless women are at high risk for ovarian or breast cancer, prophylactic removal of the ovaries at the time of hysterectomy merits caution, Parker writes. Currently, bilateral oophorectomy is performed in 55 percent of all women in the United States having a hysterectomy, with 300,000 prophylactic oophorectomies performed annually.
"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 be the case," writes the author of an accompanying editorial. "It is incumbent on all gynecologists to know the data presented by Dr. Parker and to counsel their patients within the context of beneficence, non-maleficence, autonomy, and social justice."
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