Hysterectomies before the age of 35 quadruple the risk of congestive heart failure and double the risk of coronary artery disease, according to new research.
While the procedure to remove the uterus is a standard method to deal with uterine conditions – such as fibroids and endometriosis – there is scant concrete research looking at the long-term health risks.
Now a cohort study by the Mayo Clinic has found evidence that the common operation for pre-menopausal conditions could pave the way to severe post-menopausal health woes decades down the line.
Beyond worsening heart health, hysterectomies were also found to affect metabolism, increasing a woman’s obesity risk by 18 percent.
Lead author Dr Shannon Laughlin-Tommaso, an associate professor of gynecology at the center, said even she was surprised by the stark figures.
Hysterectomies are standard to treat uterine conditions, but a new study shows it has risks
She said she hopes the findings drive more healthcare professionals to seriously consider non-surgical alternatives before hysterectomies.
‘We know there are long-term health risks for an oophorectomy [removal of the ovaries],’ Dr Laughlin-Tommaso explained, ‘but recently there has been some thought that a hysterectomy could affect health risks as well.
‘We have the ideal study population to look at both pre-menopausal and post-menopausal women so we wanted to see whether there was a risk.’
The study analyzed data on 2,000 women who had a hysterectomy but kept their ovaries between 1980 and 2002, all from Olmsted County in Minnesota, where the Mayo Clinic is based.
All of the women were over the age of 18 at the time of their procedure, and had undergone the procedure to treat a benign disease.
Their data, which was drawn from the Rochester Epidemiology Project, a medical records database of all inpatient and outpatient records in Minnesota, was contrasted with women who had not undergone a hysterectomy.
Each woman was age-matched to one from the same county, to eliminate environmental or age factors.
After accounting for cardiovascular and metabolic conditions prior to surgery, the researchers looked for new signs of disease post-hysterectomy.
As expected, there was a correlation between the rates of cardiovascular or metabolic disease and hysterectomies.
But even still, Dr Laughlin-Tommaso insists, they were stunned by how clear that correlation was.
‘I was surprised at the high risk for women under 35 for coronary artery disease,’ Dr Laughlin-Tommaso said.
‘Any time you see an increase in disease risk 20 years after a procedure is surprising, no matter what your expectations were.’
They found that women under the age of 35 who’d had a hysterectomy without ovary removal had a 4.6-fold increased risk of congestive heart failure and a 2.5-fold increased risk of coronary artery disease.
In general – including women over 35 – the operation increased the risk of obesity by 18 percent, coronary artery disease by 33 percent, lipid abnormalities by 14 percent and high blood pressure by 13 percent.
The findings add weight to Dr Laughlin-Tommaso’s passion project: to offer alternatives for women with benign but chronic uterine conditions.
These conditions may include endometriosis, when a woman’s womb lining breaks off and attaches to other parts of the body, or fibroids, which are abnormal non-cancerous growths.
Before removing the uterus, Dr Laughlin-Tommaso says, patients can try medical therapy such as hormonal oral contraceptives of progestin and estrogen.
‘Hysterectomy is the second most common gynecologic surgery, and most are done for benign reasons, because most physicians believe that this surgery has minimal long-term risks,’ Dr Laughlin-Tommaso explained.
‘With the results of this study, we encourage people to consider nonsurgical alternative therapies for fibroids, endometriosis and prolapse, which are leading causes of hysterectomy.’