pros and cons for keeping ovaries?

Can anyone tell me why I should keep my ovaries? My doc wants to remove. I am in menepause and have surgery April 4th. Do you need them after menepause? He says you don't and they could give you problems later on and have to do surgery again. Several woman I have spoken to said they didn't remove them and later had to. I am confused. I have to decide by Monday. Thanks.

Hi kept,

There a lot of good reasons to keep your ovaries if you are able. Even after menapause your ovaries produce small amounts of hormones and help the body's systems. You might want to take a look at Pre-Op Articles which you can find here. You will find a couple of articles about ovaries that may help you with your decision.

You can click on Resources, which is located at the top of each page and search ovaries for even more information like this: http://www.healthcentral.com/drdean/...ype=DeanTopics

Best wishes and I hope you find the answers you are looking for!

s

Deb

I hope you'll do some reading this weekend about ovaries and their role after menopause.

Menopause is just a phase in our lives where the ovaries downshift, the ovaries do not cease to function. They will continue to produce lower levels for decades to come.

Healthy ovaries are part of your overall endocrine system and work in concert with your pancreas, pituitary, thyroid, adrenals and hypothalamus to balance your levels of hormones that the body needs to control most of its functions. Ovaries produce estrogen, progesterone and androgens which contribute to healthy bones, teeth, bladder, cognition, vagina, sex drive and cardio-vascular system.

I'm a little concerned that your doctor wanted to remove your otherwise healthy ovaries when you're only just now menopausal and under the age of 50. The ACGOS no longer recommends removal of healthy ovaries to prevent "future problems". The current guidelines stress only removing healthy ovaries in younger women if there are strong ovarian cancer/breast cancer indicators.

While it's true that some women do have to have further surgery to remove troublesome ovaries, that number is about 5-10% of all women who keep their ovaries. Not to mention the fact that it might mean preserving your ovarian function for that much longer.

Here are a few recent threads:
Ovaries - To Keep or Not To Keep

Ovaries? Keep or not? Why or why not?

You also might want to read the Hormone Jungle as well, since you're already into menopause and on HRT to help you understand any changes that might occur after surgery (whatever decision you make).

I hope those help.

Take care.

The down side of keeping your ovaries is obviously the future problems you may or may not have.

I'm in the same position as you, but I told my doctor I want the ovaries out. Yes, they may continue to provide some hormones for me, after menopause (I'm 50). Nobody knows for sure for how long that will happen. And I'm sure there will be days when I'm sweating buckets I'll wonder why I did that! I've also known a few women who had a TAH/BSO years ago, and they've done very well.

However, having seen a friend die of ovarian cancer, knowing there are no appreciable symptoms until it's usually too late, I'll take the hot flashes. Sure, they say you may have 'some' problems with your ovaries and have to have them out later, and it's no big deal to do that. But who's to say what those problems might be? Toss the dice. Might be ovarian cysts, no big deal. Could be cancer.

Not a chance I'm willing to take.
Just my 2 cents worth of course.

HollyK

From someone on the other side -TAH & BSO on 3/10/05- you can't believe how I struggled with this decision.

My GYN/surgeon recommended them out due to possible problems later on. My concern was more on the cardio problems that could result from taking estrogen as opposed to ovarian cancer down the road. My family (and me) have cardiac concerns as opposed to no history of ovarian cancer.

I went from one day thinking I would keep them to the next day when they were definitely going!!! My surgeon had told me that I could let him know of my decision the day of surgery.

About a week before surgery I went to my cardiologist for surgery clearance. I had decided I would go with whatever recommendation he would make since he knew my cardio history
(high bp, mvp, previous a-fib) and would know the effects of estrogen on my body. Well, he surprised the heck out of me. Thought for sure he would say keep them, but he said definitely take them out. He gave me all the statistics for those on HRT (something like out of 10,000 women on HRT only 2 had minor heart attacks-no deaths) (don't quote me on these numbers!!!!) BUT he said he is seeing/hearing about alot of women in their 50's and 60's dying of ovarian cancer.

I had them out, was put on Vivelle Dot .05 and feel great so far. I have read a lot of horror stories about adjusting hormones. Don't personally know about that unless my current dosage situation will come to a crashing end!!

Good luck with whatever decision you make - it is a tough one.

BarbNJ
TAH BSO and cervix 3/10/05 47 years old

I was 54 when I had my surgery. All three doc's I consulted with told me I should have them out. I think when you are certain age they always recommend it. Ovarian cancer did come up. And I also had been diagnosed with PCOS as a teen.
I was NOT in menopause-still having monthly periods that lasted a week.

I also had painful cysts on the right one-like being shot in the hip most of the time. I really wanted that one out.

I haven't had any problems with the Vivelle Dot, although my libido has gone on holiday!

In hindsight, I wish I would have kept one, just to see if it helped with libido. I am trying different doses of testosterone cream without a whole lot of success. It might not be related, but since it was fine before surgery and is not now, it could be related.

I am sure that confused you more, I still don't know if I made the right decision, but I was in so much pain in the months before surgery I was willing to do anything to make it go away.

BarbNJ - Although there is general agreement that the WHI studies are somewhat flawed because of the limited age groups that participated, it has definitely been shown that HRT does increase risk of heart attack much more than ERT (estrogen alone), however both have skyrocketing risks for stroke. And the risks are higher for both HRT and ERT for women with active heart disease, and therefore are not usually recommended for this group. It was for these reasons the studies were terminated prematurely - the study group mortality could not be justified. (Barb, see my Journal, you'll see why I have paid attention to this)

hollyk - Although ovarian cancer is a terrible disease and anyone would fear it, unless your tests or your personal or family history cause your doctor to recommend their removal, the risks are generally very small. Please consider the heart history of your family, which as you can see from the numbers below, is a much higher risk. (and keeping your healthy ovaries will reduce your heart risk)

Check out these 2001 stats for the leading causes of death in women:

361,000 - heart disease
100,000 - stroke
66,000 - lung cancer
63,000 - copd (a pulmonary disease)
41,000 - breast cancer
13,900 - ovarian cancer

Is anyone else starting to wonder why our doctors are putting the fear of G** into us over the risk of ovarian cancer?!?!? (and of COURSE they are going to see women coming back later for oophorectomy - that's what they DO for a living!)


joano

TAH at 54/kept Ov's

Kept, Like you I looked for answers prior to my surgery and the only articles I found related to oophorectomy and premenopausal women. As a result I was swayed by my doctor and allowed the removal of my ovaries. I was 52 and 8-9 months past my last period. I would not do this again and urge caution. I did not expect an increase in my symptoms and experienced a sharp increase in all of them with the addition of severe anxiety, depression, and feeling that my heart was pounding in my chest.

I found this article after my surgery. Donna Shoup also discusses the implications for women who are menopausal. That alone makes this article very different. Rational for Conservation of Ovaries by Donna Shoupe MD

I have also read that the farther you are into menopause and the more stable your symptoms are, the less you will notice the loss of your ovaries. Also, if you are already on HRT you will probably not feel the loss. Whether or not you feel the loss, your natural unsupplemented hormone levels will be lower than a menopausal lady who has her ovaries. The implications or mechanism are not fully understood. This is a fairly new area of research and more needs to be done. We have yet to understand or get FDA approval of testosterone for women.

My symptoms are all under control now. I am on ERT, I was not prior to my surgery.

I hope you are able to come to a decision that you feel comfortable with.

The protocol on ovary removal according to the ABOG is if you are pre-menopause (under the age of 45) that they want to leave in your ovaries if they are healthy to preserve your homones and to keep you from going into early menopause. If you are over 45, the protocal is for removal because that is usually the age where hormone levels drop in the ovaries and the onset of menopause begins. I f you have any research you want to do further, my doctor always refers me to WEBMD. It is the ultimate medical resource.
Good luck on Monday. My surgery is on Monday as well. My doctor will leave in my ovaries if and only if they are healthy.

Mcpiant

Mcpaint, The references are all over the map here. Some resources use age 50 as the cutoff. However this doesn't take into consideration some of the newer areas of research that may influence an individual woman's decision.