Does hysterectomy without ovary removal cause bone loss?
My question today is does having a hysterectomy while leaving the ovaries intact cause earlier bone mass loss before menopause?
Not that I know of just due to hysterectomy. Bone loss does take place naturally before menopause, however. After about age 35-40, bone loss takes place at about 0.5% a year.
When menopause takes place, bone loss is about 1.0-1.5% a year if estrogens are not replaced. For the 1st 20 years after menopause (without ERT), there is a 50% loss of trabecular bone (the spongy, inside bone) and about 30% reduction in cortical (outside, smooth bone). The process is less in blacks but I'm not sure of the exact numbers.
I read something on another site that stated that such loss can occur even with retention of the ovaries. Am I in danger of osteoporosis?
Not from the premenopausal loss of bone, in my opinion. I have seen the Medscape abstract of the 1995 article and its discussion. Women who have hysterectomies have a lower bone density than women who don't.
However, I am extremely skeptical that it is the hysterectomy that causes it. You have to remember WHY younger women (who don't have their ovaries removed) get hysterectomies: chronic pain (decreased physical activity), chronic dysfunctional bleeding (low estrogens for years preceding the surgery), endometriosis (received medications to suppress the ovaries), etc.
None of the studies matched on weight at the time of the surgery or smoking at the time of the surgery, only years later postmenopausally.
Finally, it makes no physiologic sense other than two things: having a hysterectomy puts you at bed rest and decreased activity for about 6 weeks and not quite normal physical activity during the next 6 months; secondly there is some question that surgery (of any type) around the perimenopausal time may stimulate an earlier menopause by one or two years.
The bone loss from those two factors could explain the small differences found in the study.