Hysterectomy, a very frequent surgery that aims to remove the uterus, is responsible for an increase in cardiovascular risk in women, even when it is associated with respect for the ovaries and their hormonal function. The risk is even greater if the uterus is removed before age 35.
Researchers at the Mayo Clinic show in a study carried out on the Olmsted County Cohort, which they have been watching closely for more than 50 years, that hysterectomy, the removal of the uterus, whatever the cause, and even if the ovaries are preserved, is associated with an increased risk of several cardiovascular and metabolic diseases. The results are published in the journal Menopause.
An increase in cardiovascular risks
The study shows that women who have had a hysterectomy without ovarian withdrawal have an increased risk of 14% cholesterol abnormalities, 13% risk of high blood pressure, 18% risk of obesity and 33% risk of coronary heart disease.
In addition, women under 35 are 4.6 times more likely to develop congestive heart failure and 2.5 times more likely to develop coronary heart disease.
"Hysterectomy is the second most common surgical procedure in gynecology, and most are done for benign reasons, because doctors think this surgery has minimal long-term inconvenience," says Dr. Laughlin-Tommaso . The ovaries are preserved during hysterectomy since studies have shown increased risk of illness and death in the event of suppression, but it was unknown if hysterectomy changed this risk
A large register of well followed women
The women in this study were identified using the "Rochester Epidemiology Project," a medical database that includes comprehensive medical records of inpatients and outpatients from all medical centers in Olmsted County, Minnesota. .
The researchers identified 2,094 women residents of Olmsted County who had a hysterectomy with ovarian conservation for benign disease. Each woman was compared to a woman of the same age living in the same county who had no hysterectomy or removal of the ovaries.
The best data to identify this risk
"The best evidence to date is that women who have had a hysterectomy have a long-term risk of disease, even when the ovaries are preserved," says Shannon Laughlin-Tommaso, MD, author of the study. Mayo Clinic OB-GYN. "While women are increasingly aware that ovarian removal poses health risks, this study suggests that" interadnexal hysterectomy ", that is, without touching the ovaries, also risks, especially for women who undergo a hysterectomy before the age of 35 ".
A very frequent operation
Hysterectomy is one of the most common surgeries in the world. Hysterectomy may be necessary to treat genital hemorrhage, fibroma, endometriosis of the uterus (adenomyosis), prolapse (or organ descent), cancer (15 to 20% of hysterectomies) or a serious bleeding complication childbirth.
Each year in France, approximately 70,000 hysterectomies are performed (Source CNAMTS). Yet France is one of the countries where the hysterectomy rate is among the lowest. In Europe, it is 5 to 15%, in the United States, it reaches 36% and in Australia 40%.
"With the results of this study, we encourage physicians to systematically consider non-surgical alternatives for the treatment of fibroids, endometriosis, and prolapse, which are the leading causes of hysterectomy."