Grand Rounds: Hysterectomy sans oophorectomy: The case for leaving a woman's ovaries alone

Article

If there's no cancer present, why remove a woman's ovaries during hysterectomy? Does the reduced risk of ovarian cancer outweigh the consequences of eliminating the protective hormones secreted by a healthy pair of ovaries? A team of researchers offers some thought-provoking conclusions.

The cumulative lifetime mortality rate for women from ovarian cancer after hysterectomy for benign disease is 0.47%, or fewer than one in 200. This is lower than the often-stated lifetime risk of one in 70, a number that includes women with BRCA1 or BRCA2 mutations or other high-risk germ-line mutations.

Despite these important health concerns, many women feel that they do not have enough information about long-term risks and benefits to help them make a decision regarding the prophylactic removal of ovaries when they are having a hysterectomy for benign disease.3 A recent decision analysis for women with inherited BRCA1/2 mutations and at high risk for ovarian cancer (and breast cancer) found that prophylactic oophorectomy was clearly beneficial after completion of childbearing.4 But a recommendation for women with average risk of ovarian cancer has not been established.

The ideal way to study this issue would be with a prospective, randomized trial. However, to be statistically valid and yield meaningful outcomes, such a study would require 8,000 women randomized to oophorectomy or ovarian conservation and then followed for 40 years. So it's unlikely that outcomes will ever be studied in this way.

Recent Videos
Baher Mankabady, MD, highlights safety of buprenorphine against OUD in pregnancy | Image Credit: linkedin.com.
Devon Ramaeker, MD
Elizabeth Gandee, APRN-CNP, highlights gaps in women's menopause knowledge | Image Credit: wexnermedical.osu.edu
Doula highlights how postpartum care is failing new mothers | Image Credit: linkedin.com
Nicky Herrick MD; and Anushree Agarwal, MD, MBBS, highlight their study on cardiac arrhythmias in pregnancy | Image Credit: © Igor Borodin - stock.adobe.com.
Lisa Becht, MD, FACOG, sheds light on fertility awareness | Image Credit: havingbabies.com.
First US national HPV conference highlights advances in cancer prevention | Image Credit: uchealth.com.
Mitchell Creinin, MD, reports estetrol pill eases menstrual symptoms | Image Credit: health.ucdavis.edu
1 expert is featured in this series.
Susanna Mitro, PhD, reveals ethnic disparities in uterine fibroid diagnosis | Image Credit: divisionofresearch.kaiserpermanente.org.
Related Content
© 2025 MJH Life Sciences

All rights reserved.