Keeping both ovaries intact during a hysterectomy does not appear to protect women against cardiovascular disease (CVD) and metabolic conditions later in life, report Mayo Clinic researchers. Women who retained their ovaries during a hysterectomy still had a 14% increased risk of lipid abnormalities, a 13% increased risk of hypertension, a 33% increased risk of coronary artery disease (CAD), and an 18% increased risk of obesity, compared with age-matched controls.

Differences in risk depended on a woman's age at the time of hysterectomy. Women 35 years or younger had a 4.6-fold increased risk of congestive heart failure and a 2.5-fold increased risk of CAD. By contrast, women who underwent hysterectomy after age 50 were not at increased risk for CVD and metabolic conditions. The study included 2,094 women who had a hysterectomy between 1980 and 2002, but kept their ovaries. They were followed for about 20 years.

More than 400,000 hysterectomies, with or without ovarian preservation, are done yearly in the United States.

Impaired ovarian function after hysterectomy may be involved in the increased risks of CVD and metabolic disorders. "Further studies are needed to clarify the direct effects of hysterectomy on ovarian function and subsequent clinical outcomes," write the authors. Moreover, "uterine-preserving treatments for heavy menstrual bleeding and leiomyomas should be considered," and "for women who need to undergo a hysterectomy, hormonal treatment should be offered or clearly considered," they advise.-Carol Potera

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