A hysterectomy is the surgical removal of the uterus, usually done by a gynecologist. Hysterectomy may be total (removing the body and cervix of the uterus) or partial (also called supra-cervical). In many cases, surgical removal of the ovaries (oophorectomy) is performed concurrent with a hysterectomy. The surgery is then called “total abdominal hysterectomy with bilateral salpingo-oophorectomy” (sometimes abbreviated TAH-BSO). However, the term “hysterectomy” is often used colloquially yet incorrectly to refer to removal of any parts of the female reproductive system. According to the National Center For Health Statistics there were 617,000 hysterectomies performed in 2004 with the surgical removal of the ovaries (oophorectomy) performed in 73% of women undergoing hysterectomy. In the United States, 1/3 of women can be expected to have a hysterectomy by age 60. Removal of the female gonads, the ovaries is female castration, and the removal of the testes in male castration. There are 22 million women alive in the United States whose female organs have been surgically removed.
Women who undergo total abdominal hysterectomy with bilateral salpingo-oophorectomy surgeries lose most of their ability to produce the hormones estrogen and progesterone, and lose about half of their ability to produce testosterone. Although removal of the ovaries is often referred to as surgical menopause it is an incorrect term. A menopausal woman has intact functional female organs, a woman who has been hysterectomized and castrated does not. In natural menopause, the ovaries generally continue to produce low levels of hormones, while in surgical menopause, the ovaries are absent and those low levels of hormones are absent. The uterus is a hormone responsive sex organ that supports the bladder and bowel. When only the uterus is removed women are at three times greater risk of cardiovasular disease–removal of the uterus often interferes with blood flow to the ovaries, so women who undergo hysterectomy experience menopausal symptoms an average of 3.7 years sooner than the average age of natural menopause. When the ovaries are removed a woman is at a seven times great risk of cardiovascular disease. As in the case of other glands, ovarian hormones cannot be replaced and substitute hormones cannot replicate the functions of the ovary. The ovaries produce dozens of hormones a woman needs throughout her entire life,, released directly into the blood stream in a continuous fashion, in response to and as part of the complex endocrine system.