Stroke Risk May Increase With Hysterectomy, Bilateral Oophorectomy
THURSDAY, Sept. 11, 2025 -- Women who have had a hysterectomy and/or bilateral oophorectomy may have increased stroke risk, according to a study published online Sept. 2 in Menopause.
Chuan Shao, M.D., from Chongqing University in China, and colleagues used data from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2018 to estimate crude and multivariable-adjusted hazard ratios for the relationship between hysterectomy and/or bilateral oophorectomy and the risk for stroke.
The unweighted NHANES cohort included 21,240 women with a median follow-up of 8.3 years. The researchers documented 193 stroke-related deaths. Hysterectomy was not significantly associated with stroke mortality compared with no hysterectomy (hazard ratio, 1.28; 95 percent confidence interval, 0.89 to 1.85). However, in a meta-analysis of 2,065,490 participants from NHANES and 15 other studies, hysterectomy was associated with significantly higher stroke risk versus no hysterectomy (hazard ratio, 1.09; 95 percent confidence interval, 1.04 to 1.15). Findings were similar for bilateral oophorectomy versus no bilateral oophorectomy (hazard ratio, 1.13; 95 percent confidence interval, 1.09 to 1.17). Consistently elevated risks were seen in a subgroup analysis stratified by surgical indication, ovarian conservation status, and reference population.
"The results of this study demonstrate increased stroke risk related to hysterectomy and/or bilateral oophorectomy, highlighting that these common procedures carry longer-term risks," Stephanie Faubion, M.D., medical director for The Menopause Society, said in a statement. "They also call attention to an opportunity for more careful assessment of cardiovascular risk and implementation of risk reduction strategies in women who undergo these surgeries."
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