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Menopause: Making Peace With Change

Sunday, November 29, 2015

When It Comes To Ovaries, Which is Your Good Side and Which Would You Keep If Just Keeping One

Removal of the ovaries at the time of hysterectomy for a woman who is still ovulating puts a woman at risk for certain diseases, while reducing the risk of ovarian cancer by about 98%. It has now been shown that losing both ovaries will  have various negative neurological consequences including increased risk of Parkinson's disease, increase her risk of declining cognitive function and increase her risk of fatal coronary artery disease, decrease her quality of life, and increase her risk of all-cause mortality. . It is true that the risks of these conditions can be reduced by restoring natural estrogen use with the use of estrogen supplementation. But the fears about the risks of estrogen have driven many women away from appropriate estrogen supplementation after premenopausal ovarian removal.  As with other surgical decisions, women need to discuss with their providers their overall health, when making those final decisions regarding whether to elect to remove ovaries at the time of a hysterectomy.Dr Douglas Brown from Mass General Hospital, published in Menopause Vol 21, 2014, has proposed the idea of keeping just one ovary instead of two at the time of hysterectomy. The questions are many, we don't usually discuss whether a woman will need hormones after keeping just one ovary, and we don't discuss whether one ovary is superior to the other, or whether one ovary is more likely to get cancer than the other ovary. We may not know. In the new study he discusses, it showed that the right ovary is just a bit more likely to get ovarian cancer, but endometriosis is a bit more likely in the left ovary than in the right. The right ovary ovulates more than the left, about 65-80% of the time is a woman ovulating on the right alone. And fertility clinics report, according to Dr. Brown, more pregnancies from right sided ovulations, especially with IVF, at over 3 times the rate of pregnancies. The final conclusion is that you should discuss all medical decisions with your gyno as there may be particulars of your personal case to discover.

More on Age of Menopause, See the Book Making Peace With Change

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