Hello bede-ga,
I have found the following studies published in the medical literature
on the relationship (positive and negative) between life expectancy
and hysterectomy, with and without removal of ovaries. The answer
appears to be that it depends on the individual woman and her risk
factors, the condition for which she is being treated, her age, and,
especially in the case of younger women, also on whether she sticks to
an HRT regimen. Where there is an overall increase in average life
expectancy, this is very small, only a fraction of a year, however, at
the level of the individual woman it can add nearly 15 more years of
life.
1. Concurrent hysterectomy at bilateral salpingo-oophorectomy:
benefits, risks, and costs.
Grover CM, Kuppermann M, Kahn JG, Washington AE.
Department of Obstetrics, Gynecology, and Reproductive Sciences,
School of Medicine, University of California, San Francisco, USA.
Published in Obstetrics and Gynecology, 1996, Volume 88: pp. 907-913
This was a study in women being treated for non-cancerous ovarian
disease. It applied known data to theoretical calculations, and found
that hysterectomy with ovary removal would increase the average life
expectancy of a 45-year-old woman by 0.071 years, while at age 55,
life expectancy would be increased by 0.026 years.
From the summary: “To evaluate the medical and economic consequences
of concurrent hysterectomy at the time of bilateral
salpingo-oophorectomy (BSO) for benign ovarian disease in peri- and
postmenopausal women…. Decision analysis was used to compare the
health outcomes and economic costs of performing BSO with concurrent
hysterectomy versus BSO alone in theoretic cohorts of 10,000 women
undergoing surgery for benign adnexal disease…. Performing concurrent
hysterectomy in a cohort of 10,000 45-year-old women would prevent
approximately 71 future deaths from gynecologic disease at a cost of
five immediate deaths from the surgery. However, short-term
complications are much more frequent in women undergoing hysterectomy.
On average, hysterectomy at age 45 adds approximately 0.071 years of
life expectancy; at age 55, it adds 0.026 years”.
The full summary is available at:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8942826&dopt=Abstract
There is also a link to the full-text article, but the cost to obtain
it is US $ 30.00.
2. A risk-benefit analysis of elective bilateral oophorectomy: effect
of changes in compliance with estrogen therapy on outcome.
Speroff T, Dawson NV, Speroff L, Haber RJ.
Department of Epidemiology and Biostatistics, Case Western Reserve
University, MetroHealth Medical Center, Cleveland, Ohio.
Published in American Journal of Obstetrics and Gynecology, 1991,
Volume 164:pp 165-174
This study showed that removing the ovaries at the time of
hysterectomy will increase life expectancy, provided that the woman
faithfully follows her program of hormone replacement therapy (HRT).
However, the situation in real life is that women do not follow an HRT
program very well, and in these real life cases life expectancy is
longer if the ovaries are not removed.
The full summary is available at:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1986605&dopt=Abstract
3. Elective hysterectomy. Benefits, risks, and costs.
Sandberg SI, Barnes BA, Weinstein MC, Braun P.
Published in Medical Care, 1985, Volume 23: pp.1067-1085
Again, this study showed that compliance with HRT is important when
the ovaries are removed. In women aged under 35, hysterectomy and
removal of the ovaries would decrease life expectancy if no HRT was
given. In older women, hysterectomy increases life expectancy in those
who have hysterectomy for conditions such as benign growths, menstrual
disorders, cervical disease and endometriosis. However, life
expectancy is decreased in women who have few risk factors for cancer
and those in whom surgery is more risky.
From the summary:
“… it was found that gains in life expectancy and quality of life can
be expected when women ages 30-60 undergo hysterectomy for benign
neoplasm, disorders of menstruation, acquired abnormal anatomy,
cervical disease, or endometriosis, owing primarily to prevention of
reproductive tract cancers, which outweighs the impact of operative
mortality. However, women who have relatively high operative risk or
low expected cancer risks, beyond thresholds estimated in sensitivity
analyses, suffer losses in life expectancy. Women younger than 35 not
treated with replacement estrogens following hysterectomy and
oophorectomy can expect net losses in life expectancy with surgical
intervention due to increased risks of heart disease and
osteoporosis.”
The full summary is available at:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3928987&dopt=Abstract
4. Elective hysterectomy.
Cole P, Berlin J.
Published in American Journal of Obstetrics and Gynecology, 1977,
Volume 129: pp.117-123
These authors looked at hysterectomy alone. They concluded that the
average gain in life expectancy following this procedure in
35-year-old women is 0.2 years. They say, “This is due to the saving
of 1.3 per cent of women who would have died from cancer of the cervix
or endometrium; they gained 14.3 years of life. In addition, 3 per
cent of women are spared the development of and treatment for these
two conditions. All women operated upon would be relieved of some
undesirable aspects of the menopausal years such as irregular uterine
bleeding.”
The full summary is available at:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=409291&dopt=Abstract
Search strategy: I searched the Medline database of medical and
biomedical literature, using the Pubmed service of the National
Library of Medicine http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
My search terms were: hysterectomy, life expectancy |
