In Support Of Elective Oophorectomy
With over 22,000 estimated new cases and 15,500 estimated deaths for 2012, ovarian cancer is the fifth leading cause of death among U.S. women and the fourth leading cause of death among women ages 4059. An astounding 63% of cases are diagnosed in late stages due to its early asymptomatic nature, leading to a dismal 44% 5-year survival rate for all stages. A womans lifetime risk of ovarian cancer is 1 in 70 or 1.4%. Screening methods for ovarian cancer have failed to result in decreased mortality or increased diagnosis of early stage disease. Because there is no recommended screening method for ovarian cancer, EO at the time of hysterectomy is a good option to prevent subsequent ovarian cancer. It has been estimated that as many as 1,000 cases of ovarian cancer could be avoided annually or a 12% reduction in the total cases diagnosed if EO was performed during the time of hysterectomy in women 40 years and older.,
Reactions To Surgical Menopause
A surgical menopause can be a difficult time for many women. Menopausal symptoms are often severe, and depression and anxiety are more likely.
How you react can be influenced by the reason for the surgery. If your surgery is necessary because of a diagnosis of cancer, this creates challenges to cope with at the same time as coping with menopausal symptoms. On the other hand, if your surgery is the solution to ongoing chronic pain, then a surgical menopause may offer relief.
What’s happening in your life will affect your reactions to surgical menopause. This includes your age, whether you are in a relationship, whether you have children, whether you wanted to have children or more children, and whether you have support and help.
Some women say the impact of surgical menopause is that they no longer feel like a woman other women feel a sense of freedom from pain and fear. Some women feel they might not be as sexually attractive to their partner, and others feel they can be more sexual because they are not worried about pain or heavy bleeding.
No feeling should be dismissed as silly or small. It is important to talk to someone if you are upset and distressed about a surgical menopause. You can ask your doctor for help with symptom relief and with referral to a psychologist to discuss your feelings.
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What Health Effects Will A Woman With One Ovary Experience
I’m a 19-year-old female. I had my right ovary removed three years ago due to a very large ovarian cyst. I was assured by my gynecologist that I’m still capable of bearing children but wasn’t informed thoroughly of all of the pros and cons in regards to this type of operation . If you could shed some light on this matter, it would be greatly appreciated. Thanks.
There are pros and cons to every surgical procedure. Three years ago, before your surgery, some people weighed the pros and cons to decide if the oophorectomy was the best option for you. It sounds like you weren’t too involved in this decision, or maybe things weren’t explained in a clear, understandable way. For your peace of mind, the people who decided to operate might have considered some potential benefits, such as a lower risk of ovarian cancer and its associated pain and discomfort, etc. A con might have included the general risks of any surgical procedure, among others. Ultimately, they decided to operate.
So, here you are three years later, and you want to know if this procedure will impact your life in any way. You asked specifically about the effects of the oophorectomy on estrogen. Fortunately, your body should be making the same amount of estrogen it always did. Ovulation normally alternates between the two ovaries. When one is removed, the other ovary takes over the entire fertility function, popping out an egg each month and continuing to produce estrogen.
You Don’t Necessarily Have To Get Rid Of Both Ovaries
If cancer prevention is your main objective, you’ll need to have both ovaries removed. But if your concern is with one single ovary, like a cyst, it’s perfectly safe and even advised to leave the healthy ovary be. “One ovary is enough to avoid changes in fertility potential and hormonal function,” Siedhoff says, which means you’ll keep menstruating, avoid the health risks of early menopause, and may even still be able to get pregnant.
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Potential Negative Effects Of Surgical Menopause
- Sudden and more severe onset of menopausal symptoms: in particular hot flushes, night sweats and vaginal dryness
- Loss of bone density and increased risk of osteoporosis and fracture
- Impaired sexual function due to reduced desire and to discomfort from vaginal dryness
- Reduced sex drive associated with loss of ovarian testosterone production
- Loss of fertility
- Increased risk of cardiovascular disease
Surgical menopause may have other adverse effects on health including affecting mood , cognition , dementia and potential increased risk of
Parkinsons disease but the evidence for these is not well established. Large population based studies have reached different conclusions about whether surgical menopause impacts on cardiovascular, cancer or all cause mortality.
Use of Menopausal Hormone Therapy , also known as Hormone Replacement Therapy may reduce these risks, but again there is insufficient evidence. The proven value of MHT after surgical menopause is in managing vasomotor symptoms and maintaining bone density.
Are There Any Risks And Precautions
Certain risks are common to all surgery and anesthesia. These risks depend on many factors including the type of surgery and your own medical condition. The possible, but very rare, side effects include: side effects of the anesthetic, breathing problems, infection, bleeding, scarring, and death.
Although oophorectomy is generally considered safe, it does have some risk of side effects or complications. These include:
- damage to nearby organs during the procedure
- blood clots
- premature menopause
- rupture of a tumour, which can lead to the spreading of cancerous cells
- continued signs and symptoms due to leftover ovary cells
If you experience any of these side effects or complications, contact your doctor immediately.
If you are concerned about any symptoms following this procedure, speak to your doctor. Take the time to be sure you understand all the risks of complications and side effects as well as any precautions you or your doctor can take to avoid them. Be sure your doctor understands all your concerns.
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What You Need To Know About Surgical Menopause
This is part of an ongoing series featuring interviews with physicians on topics related to hereditary cancer. This is a summary of a discussion with Ann L. Steiner, MD, anobstetrician-gynecologist and clinical professor at Penn Medicine. The Symptoms of Surgical MenopauseMenopause is the absence of estrogen. When women stop making estrogen, this can result in several key symptoms. On average, natural menopause occurs around 51 years of age, when periods cease. Menopausal symptoms may begin before the final menstrual period when the loss of estrogen begins gradually. But if a 35 year old woman with regular, monthly periods has her ovaries removed, she is likely to be much more symptomatic then if she had gradually gone into menopause.
Surgical menopause can affect hot flashes and mood, and can increase the rate at which a woman loses bone and may develop osteoporosis. Theres a concern that younger women who go into menopause might be at an increased risk of heart disease later in life. It could also affect cognitive function. If women dont have a history of a cancer that would contraindicate the use of estrogen, such as breast cancer, we discuss giving estrogen, both for symptoms and for potential prevention of these problems.
What Are The Risks And Potential Complications Of An Oophorectomy
As with all surgeries, an oophorectomy involves risks and potential complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
General risks of surgery
Sleep problems including or sleeplessness
Vaginal dryness, which cause burning, irritation, and painful sexual intercourse
Reducing your risk of complications
You can reduce the risk of certain complications by following your treatment plan and:
Following activity, dietary and lifestyle restrictions and recommendations before, during and after surgery or treatment
Informing your doctor if you are nursing or there is any possibility that you may be pregnant
Losing weight if you are overweight. This will help keep you as healthy as possible and may reduce your risk of heart disease and of bone fractures.
Notifying your doctor immediately of any concerns after surgery, such as bleeding, , increase in pain, or wound redness, swelling or drainage
Stopping smoking. This can help reduce the risk of and heart disease.
Taking your medications exactly as directed
Telling all members of your care team if you have any allergies
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How Is An Oophorectomy Performed
There are various ways a surgeon can remove an ovary. Each procedure carries its own risk and recovery time. Your physician will recommend the procedure best for your case.
- Laparoscopic approach: Considered a minimally invasive approach, the surgeon uses a small camera to look inside of your abdomen. The surgeon may make other small 1-2 cm incisions on your skin to allow removal of the ovary. Laparoscopic surgery has a smaller risk of infection and patients usually recover faster. In some cases, the surgeon may perform the surgery with the assistance of a robotic arm moving the instruments .
- Vaginal: This is also considered a minimally invasive approach, with a smaller risk of infection and faster recovery. Vaginal removal of ovaries is usually done at the same time the uterus is being removed through the vagina.
- Laparotomy: In some cases the surgeon decides that a longer incision is needed on your abdomen to complete the surgery. This incision is known as a laparotomy and your surgeon will tell you which type will be performed. Laparotomies, or bigger incisions, usually have a longer recovery time and higher risk of complications, although these are still low.
How Can Early Menopause Be Prevented
Though some cases of premature menopause can’t be prevented, here are some measures you can take if you suspect you are at risk:
- Stop smoking.
- Use hormone-free, organic skincare products
- Eat organic, healthy food
- Avoid processed foods
We hope you found this information useful! Are you at risk or have you experienced early menopause? Share your story with us in the comments below.
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Study Design Recruitment And Participants
During 19951997 all individuals at the age of 20 years or older in the Nord-Trøndelag County, Norway, were invited to participate in the HUNT2 Survey, which is a part of the Nord-Trøndelag Health Study . The HUNT2 Survey and the HUNT Study are described in detail elsewhere . In the present study, we aimed to include all women younger than 70 years. Data were collected by two self-administered questionnaires. The first questionnaire included questions about general health and life style. This questionnaire was distributed by mail and returned at the HUNT2 Survey health examination a couple of weeks later. The second questionnaire was handed out at the HUNT-2 Survey health examination and returned by mail. This second questionnaire included questions about sociodemographic factors, general health and reproductive history.
Of all eligible women at 20 years old or older, 73.5% answered the first questionnaire, and among these women, 87.0% returned the second questionnaire. A total of 28 418 women between 20 and 69 years old who had answered both questionnaires could be included in our study. We excluded 4749 women without information on whether or not they still were having menstrual periods and 89 women without information about BMI, leaving 23 580 women to our study sample.
Menopause And Hormone Replacement Therapy
If you are premenopausal and had both of your ovaries removed, expect to enter menopause immediately after surgery.
Symptoms of medical or induced menopause are the same as natural menopause, but they tend to be more severe and prolonged due to the abrupt loss of ovarian function.
The sudden estrogen depletion of an oophorectomy is also associated with more severe health consequences than natural menopause, such as an increased risk of coronary artery disease, stroke, cognitive problems, mood disorders, osteoporosis, sexual dysfunction, and early death.
As a result, hormone replacement therapy is generally recommended right after surgery until the typical age of natural menopause .
In addition to easing the symptoms of surgical menopause, HRT reduces the risk of developing the long-term health conditions associated with early menopause.
That said, there are some risks associated with taking HRT and not everyone is a candidate. It’s best to talk with your surgeon about HRT prior to your operation, if possible.
Keep in mind, if you decide to take HRT, you will need regular follow-up with your gynecologist to have your hormone levels checked.
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In The Months After Prophylactic Ovary Removal
Your surgeon will see you for an office visit at about 2 weeks and again at about 4-6 weeks after surgery. The surgeon will check to make sure your incision is healing properly.
For some women, the symptoms of surgical menopause can continue for many months. You might plan on seeing your regular doctor or gynecologist more frequently during the first year after surgery, or for as long as it takes your body to adjust.
Some women choose to take short-term hormone replacement therapy for relief from hot flashes, vaginal dryness, and sexual side effects. Although HRT has been found to increase breast cancer risk, research also has shown that short-term HRT is safe for high-risk women who undergo ovary removal. In other words, if you take HRT to help with the symptoms of surgical menopause, this does not wipe out the reduction in breast cancer risk that comes from having the ovaries removed. The general recommendation is to use the lowest dose needed for the shortest time possible.
Still, individual doctors may have different opinions about whether or not you should take HRT after ovary removal. You can work with your doctor to weigh the risks and benefits and determine what is right for you.
Orgasms Are Still On The Cards
Let’s get one thing straight Ã¢â¬â having an oophorectomy doesn’t make sex worse. It is still possible to orgasm after having an oophorectomy although the way that you achieve this might change.
In particular, your clitoris and G-spot won’t be affected by having an oophorectomy. 75% of women only reach orgasm through clitoral stimulation. So if like a lot of women, these are the keys to your kingdom there’s nothing to worry about!
You will still be able to enjoy yourself just as much after an oophorectomy.
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What To Expect When Removing Fallopian Tubes
You may have pain in your belly for a few days after surgery. If you had a laparoscopy, you may also have a swollen belly or a change in your bowels for a few days. After a laparoscopy, you may also have some shoulder or back pain. This pain is caused by the gas your doctor used to help see your organs better.
Give Yourself Plenty Of Recovery Time
An oophorectomy is a major surgical procedure, so it is perfectly normal not to feel particularly sexy after it. It is important to give yourself time to recover both physically and mentally.
Of course, you should follow any advice from your doctor about sex and other physical activity after surgery. The last thing you want is to rush things and end up doing more damage.
Often, undergoing an oophorectomy, especially a bilateral one, means that you will no longer be able to get pregnant. This can be very difficult to get to grips with.
Any sort of emotional transition can have a big impact on your libido, so it is important to acknowledge this. Addressing how you are feeling in a safe and supportive environment can do wonders for anyone’s sex life.
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In Support Of Ovarian Conservation
The risk of developing ovarian cancer after hysterectomy with ovarian conservation performed for benign disease is 40% lower than with women who do not undergo hysterectomy., However, performing EO to reduce cancer risk at the time of hysterectomy may unintentionally cause more deaths from all causes by age 80 than the number of lives saved from ovarian cancer.
What Happens During The Procedure
There are two methods for performing this procedure. Both are done under general anesthesia so you will not be awake.
In the first method, the doctor makes an incision in the abdomen below the belly button. The doctor locates the ovaries below the abdominal muscles. One or both ovaries are then removed. The fallopian tubes may be removed at this time as well.
In the second method, a small incision is made in the navel and a laparoscope is inserted. A laparoscope is a thin tube with a camera and light on the end so the doctor can see the area. Other instruments are used to cut and remove one or both ovaries .
The procedure usually lasts about 1 to 4 hours.
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