Hysterectomy Can Impair Short Term Memory (at least in rats)

MedicalResearch.com Interview with:

Heather A. Bimonte-Nelson, Ph.D. Professor, Barrett Honors Faculty Department of Psychology Arizona State University

Dr. Bimonte-Nelson

Heather A. Bimonte-Nelson, Ph.D.
Professor, Barrett Honors Faculty
Department of Psychology
Arizona State University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The dogma in the field is that the nonpregnant uterus is dormant, and therefore it has not necessarily been of interest to study. Textbooks have described the nonpregnant uterus as “quiescent,” “dormant,” and “useless.” When I was in graduate school studying endocrinology, I read statements in books saying that the sole purpose of the uterus is for gestation.

However, all women aging into midlife will experience some type of menopause, and some of these women will undergo surgical menopause via removal of all, or a part of, their reproductive tracts. Research evaluating reproductive tract-brain connections has grown quite a bit in the last few decades. For example, the ovary-brain connection has been focused on quite a bit, and we now know that hormones coming from the ovaries (such as estrogens and progesterone) can affect more than reproduction, and can impact brain functioning. While the uterus-brain connection is not well understood, there is research indicating that the uterus and autonomic nervous system communicate directly.

We also know that hormones released from the ovaries impact the uterus. Therefore, there is a uterus-ovary-brain triad system. This uterus-ovary-brain triad has undergone little scientific investigation for functions outside of reproduction. Given that by age 60 one in three women experience hysterectomy, thereby interrupting this uterus-ovary-brain triad system, we believe it is important to understand the effects of variants of surgical menopause including hysterectomy.

This led to our current evaluation testing multiple variations in surgical menopause using a rat model, where we tested the effects of uterus removal alone (hysterectomy), ovarian removal alone, or uterus plus ovarian removal.

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Even With Preserved Ovaries Hysterectomy Linked To Increased Cardiac and Metabolic Risks

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

Dr. Laughlin-Tommaso

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.

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Alternatives To Hysterectomy May Be Underutilized

lauren coronaMedicalResearch.com Interview with:
Lauren Corona BS

Wayne State University School of Medicine
Detroit, MI

Medical Research: What is the background for this study? What are the main findings?

Response: Hysterectomy is the most commonly performed major gynecologic surgery in the United States. This study sought to examine how often alternative treatment is considered prior to hysterectomy for benign indications and how often pathology in the surgical specimen supports the need for hysterectomy. We utilized data from the Michigan Surgical Quality Collaborative, a statewide hospital collaborative, and limited the analysis to patients having a hysterectomy for uterine fibroids, abnormal uterine bleeding, endometriosis, and/or pelvic pain. Alternative treatment to hysterectomy was not documented prior to surgery in 38% (i.e. no documentation that the patient declined, was unable to tolerate, or failed any alternative treatment). A progesterone intrauterine device (IUD) was the least utilized form of alternative treatment, documented in only 12% of patients. In addition, nearly 1 in 5 (18.3%) had pathology reported that did not support the need for hysterectomy—i.e. the uterus was described as normal or unremarkable or only had minor amounts of pathology. Women <40 years had the highest rate of unsupportive pathology at 38%.

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What Is Risk of Cancer In Women Who Have Morcellation Hysterectomy?

Jason D. Wright, M.D. Levine Family Assistant Professor of Women's Health Florence Irving Assistant Professor of Obstetrics and Gynecology Division of Gynecologic Oncology Columbia University College of Physicians and Surgeons 161 Fort Washington Ave, 8th Floor New York, New York 10032MedicalResearch.com Interview with:
Jason D. Wright, M.D.
Levine Family Assistant Professor of Women’s Health
Florence Irving Assistant Professor of Obstetrics and Gynecology
Division of Gynecologic Oncology
Columbia University College of Physicians and Surgeons
161 Fort Washington Ave, New York, New York 10032

Medical Research: What are the main findings of the study?

Dr. Wright: This study is one of the first large scale studies to examine the risk of cancer specifically in women who underwent hysterectomy with electric power morcellation. Among 32,000 women treated at over 500 hospitals across the US we noted cancer in 27 per 10,000 women.
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Should the Ovaries be Removed at Time of Hysterectomy for Benign Disease?

MedicalResearch.com Interview with:

Catherine A. Matthews, MD
Associate Professor and Division Chief
Urogynecology and Reconstructive Pelvic Surgery
University of North Carolina, Chapel Hill

MedicalResearch.com: What are the main findings of the study?

Dr. Matthews: Women under 50 should try and preserve their ovaries at the time of hysterectomy for benign disease; however, women over 50 should consider elective ovarian removal as a way to reduce ovarian cancer. There is no adverse impact on cardiovascular, bone or sexual health in women over 50 who elect ovarian removal.
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