Recent research indicates that undergoing a hysterectomy, particularly when combined with the removal of both ovaries, significantly elevates the risk of stroke. A comprehensive meta-analysis involving data from over 2 million individuals has revealed that women who have a hysterectomy to remove the uterus and cervix face a 5 percent higher risk of stroke compared to those who do not undergo the procedure. More concerning, this risk increases to 18 percent when both ovaries are removed, a procedure known as a bilateral oophorectomy.
Understanding the Health Risks
The findings underscore the importance of recognizing the long-term health implications associated with these common surgical procedures. According to Stephanie Faubion, medical director for The Menopause Society, “The results highlight that these common procedures carry longer-term risks. They also call attention to an opportunity for more careful assessment of cardiovascular risk and implementation of risk reduction strategies in women who undergo these surgeries.”
Hysterectomies and oophorectomies are prevalent surgical interventions in the United States, often performed for various non-terminal conditions, including uterine fibroids and endometriosis. Despite their frequency, knowledge about their potential long-term effects remains limited. Traditionally, these surgeries were considered last-resort options, but the approach to the removal of ovaries during hysterectomies has evolved. Until recent decades, it was common practice to remove both ovaries, a decision that may have serious implications for health.
Historical data reveals that a significant study conducted in 2009 indicated that women who had both ovaries removed during a hysterectomy for benign conditions faced a heightened risk of mortality, including increased chances of dying from coronary heart disease and lung cancer. Specifically, women who underwent bilateral oophorectomy had a 14 percent increased risk of stroke compared to those who retained their ovaries.
Research Evolution and Current Recommendations
The link between oophorectomy and stroke presents a complex picture influenced by various factors, such as the age of the patient at the time of surgery, the use of hormone replacement therapy, and differing definitions of stroke. A study from 2018 suggested that younger women who opt for an oophorectomy and utilize estrogen replacements may not necessarily face an elevated stroke risk. However, a subsequent meta-analysis released in 2024 contradicted these findings, reaffirming the association between hysterectomy and stroke risk, particularly when both ovaries are removed.
In an effort to clarify these conflicting results, researchers in China analyzed extensive national health data from the United States, examining over 21,000 women from 1999 to 2018. This research, combined with data from 15 additional studies for statistical comparison, indicated that while hysterectomy alone did not significantly correlate with stroke risk, the removal of both ovaries was indeed associated with an increased risk. The overall findings suggest that previous studies may have lacked sufficient sample sizes to detect significant associations reliably.
The authors of the recent meta-analysis concluded, “The current study indicates that hysterectomy and/or bilateral oophorectomy are associated with an increased risk of stroke, underscoring that women who have had these surgeries should be closely monitored and require proactive preventive health measures for early signs of stroke.” They further urged clinical researchers to investigate safer surgical techniques or alternative treatments for conditions necessitating hysterectomy and bilateral oophorectomy.
The study has been published in the journal Menopause, contributing crucial insights to the ongoing discussion about the long-term health effects of these surgeries. As awareness grows regarding the potential risks associated with hysterectomies and oophorectomies, healthcare providers are encouraged to engage in more comprehensive discussions with patients about the implications of these procedures.
