Hysterectomy for benign, non cancerous, indications is one of the commonest surgical procedures in women, but the association between the procedure and the increase risk of cardiovascular disease (CVD), heart attack and stroke is not fully understood.

Hysterectomy has traditionally been considered the method of choice for treating a variety of benign, non-cancerous, gynecological disorders due to the low surgical complication rate and definite cure of these diseases. Incidence rates of hysterectomy in the USA and in western European countries have remained relatively stable despite recent years introduction of minimally invasive treatment options, such as endometrial ablation, for conditions, such as heavy periods and fibroids.

The majority of hysterectomies are preformed in women before menopause and the removal of ovaries after the age of 40 is common. The removal of ovaries is often recommended as a measure to reduce the risk of developing ovarian cancer. A number of studies have suggested that hysterectomy with the removal of ovaries prior to age 50 may increase the risk for heart attack and stroke. Given the fact that cardiovascular disease is the leading cause of death in women, and hysterectomy is such a common surgery, further investigation was warranted.

A recent European study published in the European Heart Journal has helped bring this issue to the forefront. This large study looked at 800,000 women under the age of 50. The authors conclusions were: “Hysterectomy in women aged 50 and younger substantially increases the risk for cardiovascular disease later in life and removal of ovaries further adds to the risk of both coronary heart disease and stroke.” Erik Ingelsson

J. Kyle Mathews, MD

Plano OB Gyn Associates

Plano Urogynecology Associates

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