[Ovarian function after premenopausal hysterectomy]

In Denmark, about 6000 hysterectomies are performed annually, and about 75% are performed on benign indications in women less than 50 years of age. When deciding on oophorectomia per occasionem, the risk of disease in the retained ovaries must be weighed against the advantages of continued ovarian function. The literature about ovarian function after hysterectomy consists predominantly of older, retrospective and uncontrolled investigations describing earlier menopause, increased frequency of climacteric symptoms and increased risk of benign ovarian cysts. Hysterectomy is followed by histological changes in the retained ovaries, but a significant reduction in the ovarian hormone production is not documented. Several studies have indicated that hysterectomy is followed by an increased risk of ischaemic heart disease, but the literature is equivocal. A possible explanation for the altered ovarian function after hysterectomy is reduced ovarian blood supply caused by the operation, but the existence of a direct endocrine function of the uterus can not be excluded. Solid prospective studies of the ovarian function following hysterectomy are needed.