I'm 51 and have fibroid tumors. The doctor wants to give me a hysterectomy. He says at my age I should have my ovaries removed also. Nothing is wrong with my ovaries. Should I have them removed since I'm going through menopause anyway?

-- Sue

The first question has to be whether you should even have your uterus removed! The answer to that depends on whether you are having any symptoms due to your fibroids (heavy bleeding, cramping, pain or pressure), how big they are (if everyone keeps asking when the baby's due, then the fibroids are big!), and how rapidly they have grown. If you are not having any problems, you may need to discuss other options with your physician.

If indeed a hysterectomy is indicated, then the next question is whether to remove or spare your ovaries. Certainly if you are already in menopause, the accepted route is to remove the ovaries; they are no longer producing appreciable amounts of hormones, and if left behind they may cause problems later in life. The chance of developing cancer or another problem with your ovaries that would require reoperation is about 2 percent.

If a woman is not yet in menopause or approaching menopause, then it may be best to leave the ovaries behind. Certainly a 35-year-old with normal ovaries should keep them; the decision becomes less clear-cut for women in their mid-40s. This decision, like the one as to have any surgery at all, is ultimately yours and yours alone. Your doctor should discuss potential risks as well as potential benefits with you, and should respect whatever decision you make in the end.