Without a uterus or ovaries, the risk of stroke increases

Women who, due to gynecological cancers, fibroids, endometriosis, ovarian cysts, etc., have to have their uterus and/or ovaries removed are at greater risk of developing a stroke than others. This is the conclusion of a meta-analysis conducted by a team of gynecologists from Chongqing University (China) just published in the review Menopause.

The sudden drop in estrogen levels is blamed

Until now, studies that have looked at this subject have been rather contradictory, but this recent work clearly finds a higher risk of stroke of 18 % in women who have had their uterus – but also both ovaries – removed, whereas it is only 5 % if only the uterus has been removed. Here, more than 21,000 women were followed for 8 years and 193 deaths linked to a stroke were recorded during this period.

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Various mechanisms have been proposed by the group of researchers, but it is mainly the sudden drop in estrogen levels after the procedure, compromising long-term cardiovascular protection due to the loss of the protective effect of hormones on the vessels, which explains this increased risk. Other explanations, such as changes in blood viscosity observed after the procedure or the choice of surgical approach – the so-called classic, abdominal and non-laparoscopic one, which ultimately promotes the development of inflammation in the walls of all the body's vessels – are also put forward.

Better long-term monitoring of women who have undergone surgery

Another study published in 2022 in the leading journal Stroke had also demonstrated the increased risk of stroke (more 34%) in women with endometriosis compared to those who were not affected.

On the other hand, the Chinese study does not allow us to differentiate the level of risk according to the type of intervention (benign or malignant) and further work would be welcome.

What is most important is to monitor women who have undergone surgery better over the long term. Moreover, as Dr. Stéphanie Faubion, medical director of The Menopause Society In the press release, "These findings highlight that these common surgical procedures carry long-term risks. They also highlight an opportunity for more careful assessment of cardiovascular risk and implementation of risk-reduction strategies in women who undergo these surgeries."