MedicalResearch.com Interview with:
Dr. Shannon Laughlin-Tommaso MD
Associate Professor of Obstetrics and Gynecology
Consultant, Division of Gynecology, Department of Obstetrics & Gynecology
Mayo Clinic, Rochester New York
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There are increasing data from a number of studies about the long term risks of hysterectomy both with and without removing the ovaries. We studied women who underwent hysterectomy with conservation of both ovaries to determine the long-term risk of cardiovascular disease using the Rochester Epidemiology Project (REP). The advantage of using the REP is that we were able to follow women for an average of 22 years, where previous studies had only been able to follow for 7-10 years and we were able to determine which women already had cardiovascular disease risk factors at the time of hysterectomy.
We found that women who undergo hysterectomy have a 33% increased risk of new onset coronary artery disease, a 13% increased risk of hypertension, a 14% increased risk in lipid abnormalities, and an 18% increased risk of obesity. For women who had a hysterectomy before age 35 years, these risks were even higher: 2.5-fold risk of coronary artery disease and 4.6-fold risk of congestive heart failure.
MedicalResearch.com: What should readers take away from your report?
Response: Hysterectomy is the 2nd most common gynecologic surgery and it can have significant long-term consequences, especially in women who undergo hysterectomy before age 35. Our study was not able to determine whether hysterectomy itself causes these changes or whether they are indirect. We believe it is likely an indirect effect through an effect on ovarian function since this has been seen in other studies. Many women seek alternatives to hysterectomy for abnormal uterine bleeding, fibroids, and pelvic pain, and this study gives them a reason to seek providers who support appropriate alternative options.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Because cardiovascular disease is the leading cause of death in women, we support any research that can reduce that risk. Thus, we should determine how hysterectomy affects the ovaries and if there is a technique that would lower those risks. We also need to study the long-term risks of the underlying gynecologic diseases and whether those are related directly to CVD. For instance, fibroids have been linked to hypertension – could there be a causal link there?
Funding/support: This study was supported by the Office of Research on
Women’s Health and the Eunice Kennedy Shriver National Institute of
Child Health and Human Development Building Interdisciplinary
Research Careers in Women’s Health (BIRCWH, K12 HD065987-2),
the National Institute on Aging (R01 AG034676 and P50 AG044170),
and the Eunice Kennedy Shriver National Institute of Child Health and
Human Development (R01 HD060503). WAR was partly supported by
other grants from the National Institutes of Health (R01 AG052425, U01
AG006786, and P01 AG004875). EAS is also partly supported by P50 HS023418.
Financial disclosure/conflicts of interest: EAS receives funding from
Bayer related to uterine fibroid research.
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