There’s something about the female sex that seems to make medical practitioners itchy to remove organs, punch holes, and generally use surgical tools to reduce the amount of personhood. And so it is that new stories keep popping up revealing that some operation performed on massive numbers of women has turned out to be unnecessary, or dangerous, or way over-prescribed. Witness the cavalier over-prescription of complete hysterectomies, double mastectomies, and plastic surgery of many kinds in the past.
Now a new study tells us that there’s no evidence supporting the common practice of removing the ovaries during a hysterectomy (for those of you who still believe that all modern medicine is evidenced based). According to an article in Medical News Today, doctors routinely prescribe bilateral oophorectomy (removal of ovaries) in women over 55 who are undergoing hysterectomy but who are at low-risk for ovarian cancer. As it turns out, this was based on a “hunch” with no evidence to support it. And as it turns out, the hunch was wrong. After reviewing the literature, head researcher Leonardo Orozco of the Women’s Hospital in San Jose, Costa Rica, found only two studies looking at the impact of oophorectomy on low-risk women, and both studies focused only on sexual and emotional well-being. (It does seem rather interesting that a woman’s ability to perform sexually post-surgery was studied instead of looking at the health benefits and risks of the procedure.)
About half of the 600,000 hysterectomies performed in the US annually have an add-on oophorectomy in order to “prevent the possibility” of ovarian cancer developing. Guess the doctors figure that while they’re fishing around inside the women, they might as well empty the pond. And while it’s infuriating to discover all that cutting and chopping that’s been going on provides no benefit, it’s even more distressing to learn that it may actually cost the woman her long-term health. That’s right, not only is there no proven benefit, but removing the ovaries can have devastating long-term consequences because the ovaries produce hormones that supply some protection to several systems, including the cardiovascular, even after menopause.
That’s right, heart disease risk goes up when the ovaries go out. In fact, according to Dr. Mindy Minkin of the Yale University School of Medicine, oophorectomy may result in a seven-fold increased risk of cardiovascular disease in the absence of subsequent estrogen therapy, which of course carries its own risks. Removing the ovaries also raises the risk of stroke, osteoporosis, and dementia. A 2005 study at UCLA found that women between ages 40 and 80 with an average risk for ovarian cancer derived no survival benefit from losing their ovaries and in fact, experienced higher mortality rates up to age 65. The younger the women were, the higher the risk of developing heart disease. And last year, two studies at the Mayo Clinic found that removing the ovaries before menopause increased a woman’s risk of later developing dementia or Parkinson’s…twofold.
Dr. Orozco exercised restraint in summing up the findings. “Prophylactic oophorectomy is performed across the world on the basis of very limited evidence. Until more data becomes available, [it] should be approached with great caution. Currently, the existing evidence does not support the high number of ovary removals in clinical practice,” he said.
His colleague, Dr. David Olive of the Mayo Clinic, ratcheted it up a notch: “Physicians tell patients that their risk of ovarian cancer can be removed by removing the ovaries,” he says. “What they don’t mention is that this may increase their risk for heart disease, which is much more common.”
You can bet that physicians also don’t mention the fact that the procedure is recommended to women on the basis of guesswork and superstition, rather than on the basis of even a shred of solid evidence proving that the radical surgery will lead to any benefit. The bottom line is that there’s no more evidence supporting prophylactic oophorectomy than there was in the stone age practice of cutting a hole in the skull to release the evil spirits trapped inside.