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Does A Hysterectomy Bring On Early Menopause

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Can a Hysterectomy Cause Early Menopause?

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How Is Premature Menopause And Primary Ovarian Insufficiency Treated

Management of the condition can vary depending on why menopause started earlier than normal. Given the health risks associated with early menopause, hormone replacement therapy is routinely recommended to all women with premature menopause or primary ovarian insufficiency, unless there is a compelling reason it cant be used. There is a lot of confusion about the safety of hormone therapies. Many of the risks of hormone therapy used after natural menopause are not thought to apply to women who have premature menopause. It is important to discuss the pros and cons of hormone therapy with your doctor. Some healthcare providers have additional certification in the management of menopause, and these providers will be a valuable resource when receiving conflicting information about the safety of hormone therapy.

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.

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Why Does Inducing A Menopause Help The Symptoms Of Endometriosis

Endometriosis can develop when deposits of endometrium exist outside the uterine cavity which can then be stimulated and bleed with every cycle. By suppressing the menstrual cycle, the symptoms may resolve. Inducing menopause will stop ovarian cyclical activity and hence cyclical stimulation of endometriotic deposits.

The methods of inducing menopause are:

  • Gonadotrophin releasing hormone agonists: These downregulate the pituitary gland and lower estrogen levels to within the menopausal range. They induce amenorrhoea and often menopausal symptoms.
  • Surgery involving bilateral oophorectomy. This may be with or without a hysterectomy but will permanently induce menopause. The loss of libido is often more marked with a surgically induced menopause.

The Effect On Hormones

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When a person has both a hysterectomy and their ovaries removed, their estrogen production is dramatically reduced. This hormone is responsible for a number of bodily functions. Chief among them is menstruation. When ovaries are removed, menstruation stops abruptly, and menopause begins if you are not yet postmenopausal.

For people who dont remove their ovaries during a hysterectomy, there is a risk for ovarian failure. In fact, people who do not have an oophorectomy at the time of their hysterectomy are compared to people who have their uteri. This, too, will lead to a decrease in estrogen, though likely more gradually.

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Why Does Inducing Menopause Help With The Symptoms Of Endometriosis

Endometriosis means that deposits of endometrium exist outside of the womb cavity and they thicken and bleed with every cycle. Inducing menopause causes suppression of the menstrual cycle and activity of the ovaries meaning that the symptoms of endometriosis may resolve. The methods of inducing a menopause are:

  • Hormones by injection or nasal spray: These suppress your own hormones and stop your menstrual cycle. This means that your periods stop and you are likely to experience menopausal symptoms.
  • Surgery involving removal of both ovaries. This may be with or without a removal of your womb but will permanently induce a menopause. The loss of libido is often felt more with a surgically induced menopause.

How Is Premature Menopause Early Menopause And Primary Ovarian Insufficiency Diagnosed

If you begin to have symptoms of menopause before the age of 40, your healthcare provider will do several tests and ask questions to help diagnose premature or early menopause. These tests can include:

  • Asking about the regularity of your menstrual periods.
  • Discussing your family history of menopause at an early age.
  • Testing your hormone levels .
  • Looking for other medical conditions that may be contributing to your symptoms.

Women who have not had a menstrual period for 12 straight months, and are not on any medication that could stop menstruation, may have gone through menopause.

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When Will You Go Through Menopause After A Hysterectomy And How Will You Know It It Depends On The Type Of Hysterectomy

Dear HealthyWomen,

I’m 43 and have been suffering with abnormal and heavy bleeding and pain from uterine fibroids, which were discovered during a pelvic exam and subsequent ultrasound.

After trying various treatments with little improvement or success, I’m scheduled for a total hysterectomy. I’m OK about this, because I’m finished having children, and, frankly, I’ll be relieved to end the frequent bleeding and pain.

Many of my friends are starting to go through menopause and commiserating over hot flashes, insomnia, vaginal dryness and the like. That makes me very curious about something: I haven’t gone through menopause yet, so how will I know if I’m going through it if I’ve had a hysterectomy?

Signed,

Waiting for Menopause

Dear WFM,

First, let’s discuss what a total hysterectomy is. Your uterus and cervix will be removed. If you are having your fallopian tubes and ovaries removed as well , that makes it much more likely that menopause will begin abruptly, since your body will no longer be producing as much estrogen.

You will experience menopause differently than your friends who are going through a “natural” menopause. Your menopause is known as a surgical or induced menopause, and symptoms will likely begin immediately after the procedure. Because a surgical menopause is more sudden and abrupt than a gradual and natural menopause, it’s likely your symptoms will be more severe.

Read: What Every Woman Should Know About Menopause.

Management & Treatment After Surgical Menopause

Partial Hysterectomy?

Because symptoms of a surgical menopause are likely to be more severe, often the best way to manage and treat symptoms is with menopausal hormone therapy, or MHT . Your doctor can advise you about the risks and benefits of using MHT.

If the ovaries have been removed but not the uterus , MHT will include both oestrogen and progestogen, with or without testosterone. Progestogen is used to protect against uterine cancer. When a woman is on oestrogen therapy, she needs a progestogen to stabilise the lining of the uterus, which reduces her risk of cancer of the uterus.

If both an oophorectomy and hysterectomy are performed, oestrogen and possibly testosterone are needed. Progestogen is not needed, as there is no risk of cancer of the uterus. The hormone therapy is best started within 2448 hours after surgery.

Sometimes MHT is not an option after surgical menopause, perhaps because of a woman’s increased risk of breast cancer, or a clotting condition such as Factor V Leiden mutation, which increases the risk of deep vein thrombosis .

The alternatives to MHT may include:

  • some complementary therapies, although there is no evidence to support their use in surgical menopause for more information go to Menopause & herbs
  • some antidepressant, anticonvulsant and migraine/blood pressure medications, which work to reduce hot flushes.

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What Is Likely To Happen During Induced Or Surgical Menopause

The menopause symptoms women experience are the same as with natural menopause but they usually develop suddenly in induced or surgical menopause and can feel a bit overwhelming if theyre not expected. Women tend to experience hot flushes and night sweats, low or changing moods and loss of sexual drive. Some women experience memory loss and develop anxiety. There can be joint pains and muscle aches and some women say they lose more hair than usual. Some women experience repeated urine infections or can feel that their vagina is dry, sore or itchy.

If My Cervix Was Removed In My Hysterectomy Do I Still Need To Have Pap Tests

If you have had a total hysterectomy in which the cervix was removed along with the uterus, you will not usually require Pap testing. An exception is if your hysterectomy was done because of cervical cancer or its precursors. Ask your health care provider if you need to have periodic Pap tests. It is important for all women who have had a hysterectomy to have regular gynecologic exams as part of their health care.

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The Cons: Reasons To Lean Against Hrt After Surgical Menopause

  • Your menopausal symptoms aren’t bothering you, or other treatments work fine. Some women don’t have very severe symptoms after surgical menopause and don’t want or need treatment. Even if you do have acute symptoms, HRT is not the only way to control them. Other drugs or lifestyle changes can help. Talk to your doctor.
  • You’re 50 or older. Many women who go into surgical menopause at 50 or older — the natural time of menopause – decide not to get HRT. That’s because their supply of estrogen would naturally drop during menopause anyway. There is some evidence that the older you are when you start HRT, the higher the cardiovascular risks – at least initially.
  • You have liver disease. Estrogen pills can put a lot of stress on the liver. So if you have liver disease, your doctor may not want you to take oral HRT. Other ways of getting estrogen – like patches and gels – bypass the liver and are safer options.
  • You’re concerned about the side effects. HRT can also cause symptoms of its own. Many resemble the symptoms of premenstrual syndrome — swollen and painful breasts, headaches, and nausea.
  • You’re at a higher risk of health problems like:

o Strokes. Hormone therapy can increase the risk of stroke, although your odds are still very low.

o Blood clots. Oral estrogen, at least, may also raise the risk of blood clots. Estrogen patches and creams may pose a lower risk, but that’s still unclear.

Can A Woman Have An Orgasim After Menopause

Early initiation of menopausal HT reduces all

orgasmAfter menopausecangethaveHere is a list of 11 natural ways to reduce the symptoms of menopause.

  • Eat Foods Rich in Calcium and Vitamin D.
  • Achieve and Maintain a Healthy Weight.
  • Eat Lots of Fruit and Vegetables.
  • Avoid Trigger Foods.
  • Eat More Foods That Are High in Phytoestrogens.
  • Drink Enough Water.
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    Ial Hysterectomy Leaving The Ovaries In Place

    With this kind of operation most women will get the menopause at roughly the same time they would have done had they not had the operation, because their ovaries are still able to produce hormones and go through the normal menopausal process of producing fewer and fewer around the age of 50 or so. You can therefore treat all the symptoms naturally if you wish, as long as they are not too severe.

    The confusing issue is that because you are not getting any periods, you cant use changing/missing periods as a guideline to when things start to change. Instead you need to rely on spotting some of the other usual symptoms such as flushes, joint pain, low mood, etc.

    In general the average age to start the menopause is 45-55, so if you are getting menopause-like symptoms at this point then it is more than likely you are on your way! Your doctor may be able to test your hormone levels and this will give you a better idea as to what is happening.

    Is There A Risk Of Worsening Endometriosis On Add

    The estrogen threshold theory suggests that add-back HRT therapy or HRT after removal of the ovaries contains a low enough dose of estrogen for maintenance of bone density and relief of hypoestrogenic and vasomotor symptoms but not enough to reactivate endometriosis.

    Is there a risk of reactivating endometriosis after oophorectomy on HRT and is there a risk of reactivated endometriosis transforming into cancer?

    There is little high-quality data to answer these questions so the absolute risk of disease reactivation and malignant transformation cannot be quantified5 but it has occurred in the literature. Consensus opinion is that for women after oophorectomy with little or no residual disease, treatment with HRT brings no or little extra risk of endometriosis recurrence or ovarian cancer. For women with significant residual disease, benefits of HRT may outweigh the risks if the woman is less than 45 years old at the age of menopause or if symptoms are severe6.

    Therefore, for women who still have their uterus continuous combined HRT or Tibolone should be prescribed. For hysterectomised women with very little or no residual disease, estrogen-only HRT could be considered after initial therapy with continuous combined HRT as it may have a better safety profile in women over the age of natural menopause.

    If recurrence does occur these women should be referred to a specialist with an interest in menopause and investigated for malignant change if symptoms persist.

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    What Is Surgical Menopause

    Menopause means the final menstrual period. The average age of menopause is around 51 years, but most women will start to notice menopausal symptoms from around 47 years.; This may be noticed as the onset of hot flushes, night sweats or vaginal dryness or a change in menstrual periods to more infrequent and sometimes heavier menstrual bleeding . Removal of both ovaries before the normal menopause is called surgical menopause.

    What You Can Do

    Will a Hysterectomy Cause Early Menopause?

    If you are planning to have both ovaries removed during a hysterectomy, you may want to discuss hormone therapy with your medical professional. This treatment can help your body slowly adjust to the loss of estrogen so the signs and symptoms of menopause arent so sudden and severe.

    In turn, hormone therapy can help reduce your risk of age-related health issues common in people with a hysterectomy and ovary removal, including bone loss and osteoporosis.

    Some people may be able to take hormone therapy short term. Others may need to remain on it until they reach the age of natural menopause, or 45 to 55. The average age of menopause is 51.

    Likewise, your healthcare professional may recommend lifestyle adjustments that can help prevent health issues related to early menopause and estrogen loss. Exercise and an improved diet may be helpful.

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    What Are The Common Symptoms Women Can Experience In Induced Menopause

    The symptoms women experience are wide ranging but may include:

    • Vasomotor symptoms including hot flushes and night sweats
    • Musculoskeletal symptoms including joint and muscle pains
    • Low or changed mood and loss of libido
    • Memory loss and anxiety
    • Urogenital symptoms including vaginal dryness and recurrent urinary tract infections
    • Hair loss

    Does A Hysterectomy Bring On Early Menopause

    Hysterectomy increases risk for earlier menopause among younger women, study finds. Summary: In a finding that confirms what many obstetricians and gynecologists suspected, researchers report that younger women who undergo hysterectomies face a nearly two-fold increased risk for developing menopause early.

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    Hysterectomies That Save Ovaries Still Carry Health Risks Study Finds

    Women who have had their uterus and ovaries removed need to be monitored for high blood pressure, weight changes and high cholesterol, a new study suggests. This photo is from a blood pressure check at the Centers for Disease Control and Prevention in 2005.

    CLEVELAND, Ohio — For years, surgeons performing hysterectomies have opted to leave the patients’ ovaries in place, when possible, to reduce the risk of heart disease and other health problems.

    But preserving ovaries may not help as much as was previously thought, a new study suggests.

    A recently published 22-year-long study found increased risks of hypertension, obesity, heart disease and coronary artery disease, even when ovaries were left intact after a hysterectomy.

    “That was a surprise,” said Dr. JoAnn Pinkerton, executive director of the;North American Menopause Society, and professor of gynecology at the University of Virginia Health System. She spoke by phone from Charlottesville, Virginia.

    Women who had hysterectomies – especially those women younger than 35 – faced increased health risks. The study also suggested that if women take estrogen until 51, the average age of menopause, their health risks dropped to average levels.

    This study could help women who are considering a hysterectomy to make important health decisions, and to look for alternatives to the surgery, Pinkerton said.

    Note to readers: if you purchase something through one of our affiliate links we may earn a commission.

    What Can I Do To Help With Lack Of Sex Drive

    A New Treatment for Menopause May Be on the Way

    Lack of libido or sex drive can be due to many factors but in women with endometriosis it can relate to pain during intercourse or an induced menopause causing lack of the male hormone testosterone which plays an important role in the sex drive. Vaginal estrogen treatment can help vaginal dryness and pain and can be used along with lubricants during sex. An HRT called Tibolone can also be helpful as it has some androgen in it along with estrogen and progesterone and may help with women with a reduced sex drive. In some cases, your doctor may suggest using a small amount of testosterone gel alongside your continuous combined HRT to increase libido. This may take several months to take effect.

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