Ovarian cancer protection

Currently ACOG recommends “strong consideration should be made for retaining normal ovaries in premenopausal women who are not at increased genetic risk of ovarian cancer. [However,] given the risk of ovarian cancer in postmenopausal women, ovarian removal at the time of hysterectomy should be considered for these women.”

Elective oophorectomy or ovarian conservation at the time of benign hysterectomy?

Hysterectomy is the second most common surgery performed in US after cesarean section.  According to CDC data approximately 600,000 hysterectomies are performed each year. A nationwide study further reported that unilateral or bilateral oophorectomy was performed in 68 percent of women at the time of abdominal hysterectomy, 60 percent at laparoscopic hysterectomy, and 26 percent at vaginal hysterectomy.

Women have an option of undergoing elective oophorectomy (EO) along with benign hysterectomy to reduce the risk of ovarian cancer, thereby reducing a chance of second surgery coupled with decreased perceived   anxiety of breast and ovarian cancer subsequently. But there are negative side effects of this surgical induced menopause such as death, total cancer mortality, osteoporosis, cognitive decline, decreased sexual drive and increased cardiac mishap support conservation of ovarian function.

There is considerable debated going on between EO and ovarian conservation, with strong statements are put forward in favour of each. Currently ACOG recommends “strong consideration should be made for retaining normal ovaries in premenopausal women who are not at increased genetic risk of ovarian cancer. [However,] given the risk of ovarian cancer in postmenopausal women, ovarian removal at the time of hysterectomy should be considered for these women.”