Prophylactic oophorectomy is the medical term for removal of healthy ovaries to prevent the potential risk of developing ovarian cancer later in life. “Prophylactic oophorectomy is performed across the world on the basis of very limited evidence,” says lead review author Leonardo Orozco.
The reviewers excluded all studies where the women had gynecological cancer, were postmenopausal, or both. Of the 119 studies that the researchers identified, only one controlled clinical trial met the review’s inclusion criteria. “We were able to find only one clinical control trial of low-quality that has been used to justify such a high number of prophylactic oophorectomies every year,” Orozco says.
That single study included 362 women of 45 to 55 years. Of those, 217 underwent hysterectomy alone and 106 underwent hysterectomy plus oophorectomy. The study looked at the average changes in psychological well-being and sexuality, both before and one year following the surgery.
But many factors go into the decision to remove the ovaries: for example, “We know that women who undergo early menopause are at very high risk for cardiovascular disease and osteoporosis,” Mary Jane Minkin, a clinical professor at Yale University School of Medicine, says. “There is a reduction in risk of breast cancer, to be sure, but the other diseases are substantially increased.”
Orozco adds that it is important to consider the long-term implications of ovary removal, some of which remain unclear. For example, even after menopause, the ovaries produce significant amounts of certain hormones that other tissues convert to estrogen. “Therefore,” he says, “there could be underlying advantages of ovarian function.”
“The conclusions of this review are limited by the lack of data,” Orozco says. “However, it demonstrated that more research of higher methodological quality is needed in order to justify an intervention that we still don’t know is beneficial or harmful.”
MEDICA.de; Source: Health Behavior News Service