Reasons For A Hysterectomy
Conditions that may be treated by hysterectomy include:
- fibroids non-cancerous growths that form within the muscular walls of the uterus, outside the uterus or within the uterine cavity
- heavy or irregular menstrual periods however, new techniques now used to treat this include endometrial ablation or use of a levonorgestrel-releasing inter-uterine device
- severe period pain due to adenomyosis or severe recurrent endometriosis
- cancer of the cervix, uterus, ovaries or fallopian tubes
- endometriosis a condition in which cells similar to those in the lining of the uterus grow in other areas of the body, especially around the ovaries and peritoneum in the pelvis
- adenomyosis a condition where endometrial-like cells grow in the muscle of the uterus
- prolapse the uterus falls into the vagina because of loose ligaments or damage to the pelvic floor muscles, usually from childbirth
- pelvic inflammatory disease , caused by bacterial infection, often from sexually transmitted infections .
How Will I Feel After The Operation
After the operation you may have an intravenous drip for uids or occasionally blood. You may also have a catheter to drain urine.
If your operation is performed through an abdominal incision, the wound will be held together with clips or stitches. There will still be some stitches with laparoscopic surgery. The internal stitches used in vaginal hysterectomy will dissolve naturally. The wound will heal in a week or so but internal surgery will take longer. This is why the recovery period can take up to twelve weeks.
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Can A Woman Have Both Ovaries Removed For Menopause
While there are some success stories in oophorectomy pain management, this procedure may not always be effective. In general however, if your ovaries are normal, its highly recommended not to have them removed as a remedy for other pelvic conditions. Other reasons women may want to remove both ovaries and induce surgical menopause are:
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How Can I Be Prepared For More Intense Menopause Symptoms
It’s important to talk to your doctor about potential menopause symptoms before your hysterectomy. He or she can help you though this process, telling you what to expect and perhaps pointing you in the right direction to do more research on your own. If you know anyone who has already gone through surgical menopause, it may help to talk to her as well.
Another way to prepare is to consider treatments after surgery. Weigh the pros and cons of things like lifestyle changes, natural supplements, homeopathic remedies, and hormone replacement therapy . Once start, you’ll feel much more in control if you already know your options for relief.
Vaginal Dryness After A Hysterectomy
Most side effects of hysterectomy are associated with premature menopause. For example, vaginal dryness is a typical symptom of menopause many females have to put up with. Vaginal dryness is not only uncomfortable but can make intercourse painful. This can put stress on relationships for many women, which is a reason to avoid having sex.
The hormonal changes after a hysterectomy make the vaginal wall thinner and reduce its muscle tone. Vaginal lubricants and topical estrogen creams can be helpful to relieve the problem of vaginal dryness.
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Will A Hysterectomy Cause Immediate Menopause
It is a misconception among many women considering a hysterectomy that the procedure will cause menopause to occur immediately. The truth is that most women seeking hysterectomies for heavy periods, uterine fibroids or pelvic pain are able to keep their ovaries intact following the surgery. Since the ovaries regulate the hormones that facilitate menopause, women who receive a partial hysterectomy or total hysterectomy will not experience menopause immediately.
The Ovaries and Their Role in Menopause
The ovaries are two small organs located on either side of your uterus. The ovaries produce estrogen and progesterone, two hormones essential to female ovulation and reproduction. As you near menopause, the ovaries slow down their production of these two hormones so that periods become more infrequent. Eventually your periods will cease altogether and after one year with no periods, you have officially entered the menopausal period. Many women experience hot flashes, sexual dysfunction and sleep disturbances as a result of menopause.
Your Hysterectomy Options
What Are Hot Flashes
Hysterectomy can often trigger the onset of menopausal symptoms such as hot flashes. Hot flashes are sensations of intense heat in the upper body, and are usually accompanied by a rapid heart rate, a reddening of the chest, neck, and face and sometimes intense perspiration. When hot flashes occur at night they are often referred to as night sweats.
The duration of hot flashes is different for every woman, but a typical episode lasts between thirty seconds and five minutes. After a hysterectomy, women will experience variations in the intensity and frequency of hot flashes.
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Does Menopause Cause Bone Loss
Lower estrogen around the time of menopause leads to bone loss in women. Bone loss can cause bones to weaken, which can cause bones to break more easily. When bones weaken a lot, the condition is called osteoporosis.
To keep your bones strong, women need weight-bearing exercise, such as walking, climbing stairs, or using weights. You can also protect bone health by eating foods rich in calcium and vitamin D, or if needed, taking calcium and vitamin D supplements. Not smoking also helps protect your bones.
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What Is A Hysterectomy
Hysterectomy is surgical removal of the uterus and sometimes the cervix and supporting tissues. It is the most common non-pregnancy-related major surgery performed on women in the United States, with one in three women having a hysterectomy by age 60. If you have not reached menopause, a hysterectomy will stop your monthly bleeding . You also will not be able to get pregnant. If the ovaries are removed in a woman before she reaches menopause, the loss of female hormones will cause her to suddenly enter menopause .
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Leaking Urine After Hysterectomy
Lack of bladder control is one of the side effects of a hysterectomy quite a few women have to deal with. During a hysterectomy, they cut through muscles, nerves, and tissues that normally support your bladder. To maintain proper bladder function, the bladder and urethra need to be sufficiently supported by these structures.
When they remove the uterus, that support is often compromised. If you are leaking urine after your hysterectomy surgery, you may benefit from pelvic floor physical therapy to restore the muscle tone of the pelvic floor and the sensation in that area.
Why Do Menopause Symptoms Occur
Every woman experiences menopause differently. Some women may not experience any noticeable symptoms, while others may feel as if they are experiencing every listed symptom of menopause. Symptoms can last for a few months or for several years and are caused by changes in the female hormones estrogen and progesterone.
Recent studies show that 15 percent of females have bothersome hot flashes into their 80s. Changes in hormones are a result of aging, or are medically induced through medication or an operation.
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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.
How Can I Manage Hot Flashes After A Hysterectomy
Most doctors recommend a healthy diet, regular exercise, lifestyle changes, and alternative medicine to manage hot flashes. If you are seeking medicinal treatment, talk to your doctor to find a treatment that is right for you.
- National Health Service. . Hysterectomy. Retrieved from http://www.nhs.uk/conditions/hysterectomy/Pages/Introduction.aspx
- Office on Womens Health. . Hysterectomy. Retrieved from http://www.womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.html
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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.
Your Sex Life And Sex Drive May Be Among The Topics Not Discussed Before Surgery
Although hysterectomy is one of the most common surgeries for women living in the United States, myths about removal of the uterus abound.
As many as 600,000 American women have hysterectomies each year, according to the U.S. Centers for Disease Control and Prevention . If you are about to be one of them, a frank discussion with your gynecologist is an essential first step.
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Dating back more than 4,000 years, hysterectomy was used as a treatment for women with “hysteria” a broad diagnosis that covered symptoms like anxiety and depression.
Now hysterectomy is one of many options if you have fibroids , excessively heavy periods, or uterine prolapse . Hysterectomy may be a real medical necessity, not simply another option, if you have invasive cancer of the reproductive organs the uterus, cervix, vagina, fallopian tubes, or ovaries.
A partial hysterectomy is surgical removal of the uterus alone, and a myomectomy is removal of only fibroids. A total hysterectomy removes the cervix as well as the uterus. In certain cancer cases, the upper vagina is also taken out. This surgery is called radical hysterectomy, and is extremely rare.
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Unless you ask, certain crucial and highly sensitive topics may not come up when you discuss hysterectomy pros and cons with your doctor.
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Sex Drive And Functioning
Research shows that a womanâs sex drive after a hysterectomy tends to actually be the same or better, perhaps due to a reduction in symptoms like pain or bleeding. Every woman is different, however, and some women do notice a reduced libido after surgery.
Besides a change in sex drive, some women experience physical changes that affect their sexual functioning, such as:
- Difficulty reaching orgasm
- Vaginal shortening
- Loss of vaginal lubrication
If you are experiencing a loss of sexual desire or functioning after your hysterectomy, be sure to reach out to your doctor for a proper evaluation and treatment plan. Your doctor can discuss several therapies with you, including non-medication and medication options like:
- Sexual education and partner involvement
Hormone Therapy Could Help With Physical Changes After Surgery
If you have a hysterectomy that removes your ovaries, then you should talk about the pros and cons of estrogen therapy with your doctor, Streicher says. After the ovaries are removed, estrogen therapy can help relieve uncomfortable symptoms of menopause. However, oral hormone therapy carries increased risks of stroke, blood clots like deep vein thrombosis, and heart disease, which you should also discuss with your doctor.
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What Causes Hot Flashes After A Hysterectomy
Declines and fluctuations in the level of the hormone estrogen after a hysterectomy affects the function of the body, especially the hypothalamus the part of the brain that regulates body temperature.
Falling estrogen levels caused by a hysterectomy can cause the hypothalamus to falsely detect an increased body temperature and release chemicals that make skin blood vessels dilate so that heat can be released and the body cooled down. This results in a hot flash.
Hot flashes and other menopausal symptoms usually subside when a woman is postmenopausal. Experiencing menopause that is induced by a hysterectomy can be a little different than natural menopause.
This is because when a woman naturally goes through menopause her body has more time to adjust as the levels of hormones in her body decrease. With a hysterectomy, the ovaries are removed, which is where estrogen is produced. This means there is a rapid cutoff of estrogen production which can result in more severe menopausal symptoms.
Hysterectomy With Ovaries Left Intact
People who have their ovaries intact, but without their uterus, won’t get their period anymore. They may, however, still experience premenstrual syndrome or premenstrual dysphoric disorder because the hormones made by the ovaries cause the body to continue to “cycle” monthly.
Occasionally, people whose ovaries were not removed during a hysterectomy experience hot flashes and other menopausal symptoms. This is mostly due to the disturbance of the blood supply to the ovaries during surgery.
In addition, some people may undergo menopause a few years sooner than they normally would if they never underwent a hysterectomy .
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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.
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Sore Breasts After Hysterectomy
Breast pain is one of the unexpected side effects of hysterectomy that some women experience. When they leave the ovaries, you will continue to cycle after the hysterectomy. You wont have monthly menstrual bleeding because you have no uterus. But you will still have ovaries that are producing hormones. Thats why you still may have premenstrual symptoms such as tender, swollen and painful breasts, also known as cyclical mastalgia.
A woman who has her ovaries removed at the time of the hysterectomy may also experience breast soreness if she takes HRT.
There are many more reasons women can experience breast pain. They can be innocent, like off consuming too much caffeine, chocolate, or other things in her diet. Our first thought usually is that it may be a sign of breast cancer. So if it worries you or when you can feel a lump, a mass, or see any skin changes in your breast, you need to get it examined by a doctor.
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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.
Common Problems After Partial Hysterectomy
Hysterectomy is only really necessary in cases when cancer is involved, to stop hemorrhage, uterine prolapse and very few other cases. In the case of fibroids, it may be necessary to stymie heavy bleeding caused by fibroids, if the fibroids are so large that they are pressing against vital organs, this can be so serious as to require a hysterectomy. Very rarely are fibroids cancerous.
Unfortunately there are too many women with fibroids having hysterectomies when there are other methods that would be just as effective. So before you opt for a hysterectomy, do make sure that it is the last option after considering other alternatives.
In addition, there are many types of hysterectomies as well as different methods of performing a hysterectomy. If you do opt for a hysterectomy, you and your doctor can come up with the best type and method.
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