Hysterectomy, the surgical removal of uterus, may not be significantly associated with any heart trouble in middle-aged folks any more than women who have not been through the procedure. At least not any time soon!
Hysterectomy, the second most common surgery among U.S. women, after cesarean-section deliveries, can involve the removal of the ovaries as well. Young women undergo hysterectomy usually to remove or prevent cancer. However, the surgery can also be used to treat painful benign growths in the uterine wall known as fibroids or to stop heavy bleeding. The evidence until now linked the removal of ovaries, which are the main source of estrogen in a woman, to the increased risk of cardiovascular disease risk by inducing premature menopause.
Given the association between the gradual decline of estrogen following natural menopause and women's increased heart risks, researchers have investigated whether hysterectomy raises those risks.
A study involving more than 3,000 women over a period of 11 years, now suggests that elective hysterectomy did not significantly increase any risk factors for heart disease such as cholesterol, markers of inflammation and blood pressure in women.
"I think it's encouraging to women and clinicians that this is not something they have to worry about if they're considering hysterectomy (in) midlife," said Karen Matthews, the study's lead author from the University of Pittsburgh, in a Reuters Health news report.
Matthews and her colleagues used data from the Study of Women's Health Across the Nation, which followed a large, multiethnic group of 1,952 women aged between 42 and 52 years, for more than a decade from 1996 through 2008, to understand the experience of American women during and after menopause.
The women were not yet in menopause at the beginning of the study. The women received annual health checkups specifically for markers for heart and cardiovascular disease. The markers included various components of cholesterol, blood pressure, blood clotting factors and molecules that are signals of inflammation. The women were also monitored for any surgeries and whether or not they had started menopause.
The findings reported in the Journal of the American College of Cardiology indicated that none of those markers in the 183 women who chose to have their uterus removed (with or without their ovaries) were significantly worse, compared to the 1,769 women who went through natural menopause. The findings are pertinent to women in their forties, past their child bearing years, and are contemplating a hysterectomy to address excessive bleeding or other factors associated with a quality of life problem.
On the other hand, the results are not applicable to women who need to have their uterus and ovaries removed due to cancer.
"Our study really couldn't examine that question because we had too few women who had gynecological cancers, and the equation changes when you have gynecological cancer," said Matthews.
However, other experts do not seem so sure, in light of past studies that revealed heart health risks 10 to 15 years down the road following hysterectomy. "Atherosclerosis takes a while to develop...," according to Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital in Boston, in an interview with Reuters Health. The transition to menopause from hysterectomy may not happen in the time period of the study. "This isn't totally surprising that there wasn't a difference in risk factors during the follow up period," Manson said.
