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I had a supracervical hysterectomy two years ago at age 54 with bilateral oophorectomy. I am unable to take HRT because I have three blood clotting factors. I walk three miles daily (15 minutes per mile), weigh 108 pounds and eat healthy. I have had a HX of hypertension for the past 16 years. Since my hysterectomy, my HDL has decreased from 78 to 60. I also have right carotid bruit, senile osteoporosis. I have heard that doctors now like to retain ovaries until women are 65-years-old. Is this true and why? Does menopause contribute to my above symptoms? Thank you.

Guidelines for removal of ovaries are based on the following indications:

  1. Risk reduction of breast and ovarian cancer if you have a family or genetic predisposition to breast and/or ovarian cancer.
  2. Abnormal or large masses on ovaries or definitive surgery for endometriosis or for infections in the ovaries and tubes not responding to antibiotics.

Usually for women who have oophorectomy before age 51 (average age of menopause), we advise taking hormone replacement therapy if not contraindicated.

There are positive effects of estrogen on the heart and blood vessels, but there is a higher risk of heart disease for women who have had their ovaries removed younger than age 45. Current data suggests leaving in ovaries at the time of a hysterectomy for women less than age 65 AND who are at low risk for future ovarian masses or cancer. There may be long-term survival benefits for keeping in the ovaries until age 65.

In terms of blood clotting risks, I would suggest a consultation with a women’s health specialist, particularly from The North American Menopause Society to discuss your blood clotting factors accounting for your risks and benefits of hormone use. Evidence shows the risk of blood clots is lower using transdermal hormone therapy (applied to the skin in the forms of creams, gels, sprays, or patches) compared with oral hormone therapy.

In addition, it is crucial to treat your osteoporosis and prevent future fracture. Although you have an excellent diet and exercise regularly, your low weight (less than 127 pounds) is a risk factor for low bone mass.

February 14, 2012 at 2:58pm

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