Hysterectomies may raise heart risks even if eggs kept

Women who undergo hysterectomy before age 35 may face significantly higher long-term heart risks, even if their ovaries are preserved, a study has found.

The research by experts at the Mayo Clinic focused on more than 2,000 U.S. women who had their uterus removed but left their ovaries intact — widely considered the most desirable option if possible because it prevents a woman from entering early menopause. Compared to women in the same area of Minnesota who did not have hysterectomies, the study found those who did faced a greater risk of obesity, clogged arteries, high blood pressure and high cholesterol in the 20-plus years after surgery. The elevated risks ranged from 13 percent more for high blood pressure to 33 percent more for coronary artery disease.

For women under age 35, the risks were particularly acute — a 4.6-fold increased risk of congestive heart failure and a 2.5-fold greater risk of coronary artery disease, when the arteries become hard and narrow, blocking blood flow.

“This is the best data to date that shows women undergoing hysterectomy have a risk of long-term disease — even when both ovaries are conserved,” said lead author Shannon Laughlin-Tommaso, an obstetrician-gynecologist at the Mayo Clinic. “Hysterectomy is the second most common gynecologic surgery, and most are done for benign reasons, because most physicians believe that this surgery has minimal long-term risks.”

About 400,000 operations to remove the uterus are performed each year in the United States. Most are not due to life-threatening conditions like cancer, but rather because of painful fibroids, menstrual disorders or uterine prolapse, when the uterus begins to sag into the vagina, according to the study.

In cases of cancer or high genetic risks, doctors may remove the uterus, fallopian tubes and ovaries. In other cases, just the uterus is taken out, rendering a woman unable to become pregnant but preserving her hormonal function through the ovaries, thereby postponing menopause. This became more popular after research showed that ovary removal along with the uterus can raise the risk of early death and chronic disease. But experts say the effects of ovary-preserving hysterectomies have not been well studied until now.