Previous studies have suggested that ovarian hormones may provide protective effects on cardiovascular diseases (CVD). Surgical removal of the uterus (hysterectomy) is a common surgery performed particularly among pre-menopausal women. However, this affects ovarian function and may lead to early onset of ovarian failure. Hysterectomy with further removal of both ovaries (hysterectomy with bilateral oophorectomy) is sometimes also performed as a prophylactic procedure and can lead to a surgical menopause. The relationship between these procedures on CVD risk in women is uncertain, particularly in Chinese women where the burden of CVD is higher than in Western countries. In a recent study published in Stroke using data from the China Kadoorie Biobank (CKB), researchers investigated the differences between treatment for CVD provided to men and women in China.
Using data from CKB, the study found evidence that both proceedures were significantly associated with a greater risk of ischemic stroke and ischaemic heart disease, particularly if the procedure had been performed at an earlier age. Women who had undergone surgery before the age of 48 compared to those who had it later were found to have 8% and 24% higher risk of ischaemic stroke for hysterectomy only and hysterectomy plus oophorectomy respectively.
These findings suggest that women, especially those who undergo these procedures earlier in life, may benefit from additional screening for risk factors of CVD to help prevent disease onset. These risks should also be considered when advising women on the possible adverse effects of surgery, particularly when deciding whether to remove or conserve the ovaries in women who require a hysterectomy.