A study published on-line by the journal Obstetrics & Gynecology called “Effect of Hysterectomy With Ovarian Preservation on Ovarian Function” shows that menopause occurs about 2 years earlier in women with hysterectomy compared to women who did not have a hysterectomy.
The study is important to infertility patients because one of the main theories regarding the mechanism for the early menopause is that the surgery compromises ovarian blow flow, which leads to decreased eggs and menopause. Surgery of the fallopian tubes and uterus can affect the blood supply of the ovary because these organs share blood vessels, either directly or via collateral circulation. We, infertility surgeons, operate on hydrosalpinx or ovarian cysts and we should be aware that interruption of the blood supply could lead to decreased blood to the ovary and thus faster loss of eggs and an early menopause.
Take Home Message
- Hysterectomy increases the chance of an earlier menopause by a factor of 2-3
- The onset of menopause was about 2 years earlier in women with a hysterectomy
- The risk was highest when hysterectomy was combined with ovary removal (loss of 50% of the remaining eggs)
- The prominent theory is that hysterectomy damages the blood supply to the ovary
- This data may add additional support that surgery of the tubes or uterus can affect ovarian blood supply and speed the loss of eggs and the onset of menopause
If you had a hysterectomy when you were young (<40 years old) but wanted to use a surrogate and your own eggs, then this information also suggests that time is also critical for you. Pay close attention to the data for the youngest women. While the significance is lacking except when an ovary was also removed, the rage of risk is quite high and suggests suspicion that a larger sample size might well show significant risk for this group.
You can access the abstract online here