What Menopausal Treatments Are Most Appropriate For Women With Previous Endometriosis
If a woman with a history of endometriosis does decide to opt for HRT, then the next decision must be to choose the most suitable preparation. Again, there is limited high-quality evidence on which to base this decision. Two studies, retrieved by our search, provide some insight into this question. The first was a RCT comparing HRT using transdermal oestradiol with tibolone, and the second was an observational study comparing oestrogen-only HRT with combined HRT. Both were assessed as very low quality using the GRADE system.
The RCT compared HRT and tibolone in women with residual endometriosis after bilateral oophorectomy. Patients were randomized into one of the two treatment groups and followed for 1 year. Four patients in the oestradiol group experienced moderate pelvic pain during treatment compared to only one patient in the tibolone group. Furthermore, one patient in the HRT group discontinued treatment at 8 months due to the development of dyspareunia and post-coital bleeding from a vaginal mucosal endometriotic deposit. The authors concluded that tibolone may be a safer alternative for postmenopausal women with residual endometriosis, although note that their trial was very small.
What Medications Are Used To Treat Postmenopausal Symptoms
Hormone therapy could be an option, although healthcare providers often recommend using it for a short amount of time and in people under the age of 60. There are health risks associated with hormone therapy like blood clots and stroke. Some healthcare providers do not recommend using hormone therapy after menopause has ended or if you have certain medical conditions.
Some medications your healthcare provider may consider helping with postmenopausal symptoms are:
- Antidepressants for mood swings or depression.
- Vaginal creams for pain related to sexual intercourse and vaginal dryness.
- Gabapentin to relieve hot flashes.
Oftentimes your provider will recommend lifestyle changes to help manage your symptoms.
How Can I Reduce My Perimenopause Or Menopause Symptoms
Effective natural options include phytotherapy, vitamins and minerals, and simple dietary and lifestyle adjustments that can provide relief by resolving the single root cause of all your symptoms. Certain herbs known as phytocrines share functional features with our hormones, allowing them to provide powerful symptom relief. Phytocrines also support your bodys ability to make and use its own hormones. These actions help alleviate your worst symptoms, but without side effects.
While certain herbs address specific symptoms, I always suggest using a multi-sourced botanical formula, as science suggests that a combination of herbs can restore hormonal balance under a variety of circumstances.
We understand that perimenopause and menopause can be scary times in a womans life. Symptoms can leave you exhausted, miserable and discouraged. But in working with many women over the years, weve found that when we have the information we need to be more resourceful we can overcome difficult situations.
And many women tell us that because they were prepared and knew what to expect, they can look back at perimenopause and menopause and think that wasnt nearly as bad as I thought it was going to be! It can be that way for you too. Please dont hesitate to give our Customer Support Team a call at 1-800-448-4919 to find out which herbal solution might work best for you.
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The Female Reproductive System
The female reproductive system is made up of the:
- womb a pear-shaped organ in the middle of your pelvis where a baby develops the lining of the womb is shed during a period
- cervix the neck of the womb, where the womb meets the vagina the cervix is the lower part of the womb and not separate
- vagina a muscular tube below the cervix
- fallopian tubes tubes that connect the womb to the ovaries
- ovaries small organs by the fallopian tubes that release an egg each month
Page last reviewed: 01 February 2019 Next review due: 01 February 2022
How Long Do They Last
There is a chance that hot flashes and other menopause symptoms can evolve within five years of having the procedure, even if one or both ovaries are left intact. Once women start suffering from hot flashes after hysterectomy, it is hard to determine when they will permanently end, although they are known to last for an extended period of time.
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Removal Of The Ovaries
The National Institute for Health and Care Excellence recommends that a woman’s ovaries should only be removed if there’s a significant risk of associated disease, such as ovarian cancer.
If you have a family history of ovarian or breast cancer, removing your ovaries may be recommended to prevent you getting cancer in the future.
Your surgeon can discuss the pros and cons of removing your ovaries with you. If your ovaries are removed, your fallopian tubes will also be removed.
If you have already gone through the menopause or you’re close to it, removing your ovaries may be recommended regardless of the reason for having a hysterectomy.
This is to protect against the possibility of ovarian cancer developing.
Some surgeons feel it’s best to leave healthy ovaries in place if the risk of ovarian cancer is small for example, if there’s no family history of the condition.
This is because the ovaries produce several female hormones that can help protect against health problems such as weak bones . They also play a part in feelings of sexual desire and pleasure.
If you’d prefer to keep your ovaries, make sure you have made this clear to your surgeon before your operation.
You may still be asked to give consent to treatment for having your ovaries removed if an abnormality is found during the operation.
Think carefully about this and discuss any fears or concerns you have with your surgeon.
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.
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Why Do They Happen
Although women who had hysterectomies were scientifically found to have a higher risk of suffering from hot flashes, the exact cause has not been identified. It is most likely due to an interrupted blood supply to the ovaries.
Hot flashes after hysterectomy can also be due to the fact that women are entering menopause around the time of the procedure. A disturbed blood supply may be the reason why they are entering menopause sooner than they naturally would as well.
What Are The Symptoms Of Menopause After Hysterectomy
For most women, menopause occurs when they are between the ages of late 40s to early 50s. However, women who undergo hysterectomy surgery may start experiencing the symptoms of menopause much earlier than this.
The procedure involves removal of the uterus and is used to treat a variety of conditions such as chronic pain, infection and even certain kinds of cancer. Typically, the extent of surgery required will vary depending on the reason why you are having hysterectomy. Sometimes the doctor may also recommend taking out the cervix and ovaries, which can ultimately affect the symptoms you are experiencing.
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How Long Will Menopause Last After Total Hysterectomy
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How Long Do The Symptoms Last
Generally, the period between onset and offset of all hysterectomy menopause symptoms is 2 to 10yrs, though some women may experience healing much earlier or later than this.
Nevertheless, if you have already undergone menopause naturally and require a hysterectomy, chances are that you wont experience any new symptoms due to the surgery, no matter the kind of operation that will be performed.
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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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Potential Positive Effects Of Surgical Menopause
- Reduced risk of ovarian cancer in women who are known to be at high inherited risk. Having this operation also usually reduces anxiety about developing ovarian cancer. In some high risk women, surgical menopause may also reduce their risk of breast cancer.
- Reduced pelvic pain for women with endometriosis or dense adhesions around the ovary.
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Factors That Influence Menopause Duration And Symptoms
Like puberty and pregnancy, perimenopause begins and ends at different times for each woman. There are so many factors influencing the timing and experience of perimenopause that every woman will write her own story. Genetics, lifestyle, diet, stress, general health, and cultural perspective are all elements of when and how dramatically you will experience menopause-related symptoms.
That being said, the vast majority of women will experience their “menopause” in a two- to 10-year window of time, probably from their mid-forties to their mid-fifties.
But even if you begin much earlier or end later, you may still be having your own version of a healthy menopause. And whether you never feel a single hot flash, or continue to have them into your late 60s, it can be normal for you.
Why Are My Menopause Symptoms Getting Worse
Symptoms of perimenopause leading up to menopause may increase in frequency and intensity as hormonal shifts become more severe. Around the age of 35, estrogen and progesterone production enters a phase of gradual decline. You may notice any symptoms from these gradual shifts.
In your 40s, the ratios between estrogen and progesterone will be in flux. Ovulation may not happen with every period or your periods may become irregular. These shifts in your hormones can cause more noticeable symptoms.
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Will The Hysterectomy Cause Me To Enter Menopause
All women who have a hysterectomy will stop getting their period. Whether you will have other symptoms of menopause after a hysterectomy depends on whether your doctor removes your ovaries during the surgery.
If you keep your ovaries during the hysterectomy, you should not have other menopausal symptoms right away. But you may have symptoms a few years younger than the average age for menopause .
Because your uterus is removed, you no longer have periods and cannot get pregnant. But your ovaries might still make hormones, so you might not have other signs of menopause. You may have hot flashes, a symptom of menopause, because the surgery may have blocked blood flow to the ovaries. This can prevent the ovaries from releasing estrogen.
If both ovaries are removed during the hysterectomy, you will no longer have periods and you may have other menopausal symptoms right away. Because your hormone levels drop quickly without ovaries, your symptoms may be stronger than with natural menopause. Ask your doctor about ways to manage your symptoms.
What Should I Do If I Am Told That I Need A Hysterectomy
Talk to your doctor. If you have a condition that is not cancer, such as fibroids, endometriosis or uterine prolapse, there are other treatments that can be tried first. In most cases, a hysterectomy need not be done immediately. There is usually time for you to get more information, look into possible alternatives or seek a second opinion. In cases of serious disease, such as cancer, a hysterectomy may not be optional and may be a life-saving choice. Before you decide what to do, it is important you understand your condition and your options for dealing with it. If you are suffering from continuing severe problems with pelvic pain and abnormal uterine bleeding and other treatments have not helped, a hysterectomy may provide relief. Studies have shown that a hysterectomy often improves sexual functioning and quality of life for women suffering from these problems.
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Do Symptoms Vary With The Person Or They Are The Same Across The Board
No two women can experience the same symptoms of menopause. While some may experience immediate onset of hot flashes and other changes caused by hysterectomy, others might undergo the same surgery but have less severe symptoms.
Likewise, among those who undergo partial surgeries its still hard to predict how menopause will affect them, or the intensity and duration of symptoms experienced.
Generally, women who undergo partial hysterectomy, without removal of their ovaries, are unlikely to experience early onset of symptoms since they continue producing estrogen. Though they will no longer be able to menstruate, such women will usually enter menopause during the same age-range as women who havent undergone hysterectomy surgery. Nevertheless, some studies still show that such individuals experience menopause about 2yrs earlier than the average woman.
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What Happens After Menopause
During post-menopause the time after menopause your body is still producing hormones. As reproductive hormones, estrogen and progesterone decline once your childbearing years end. But that doesnt mean theyre not needed at all, so your body still makes them, just in lower amounts.
In the years of post-menopause, you may still experience symptoms of hormonal imbalance or maybe even have certain symptoms for the first time. For example, its not unusual to have continuing hot flashes as a result of estrogen deficiency. Some women in post-menopause experience vaginal dryness, which affects a womans interest in sex and can make sexual activity uncomfortable or even painful. The most common post-menopausal symptoms are:
- Hot flashes
- Bone loss and fracture
- Memory loss
If you experience postmenopausal bleeding no matter how slight or brief talk with your OB/GYN healthcare provider as soon as possible to rule out any serious issues.
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How Long Does It Take To Recover From A Hysterectomy
Recovering from a hysterectomy takes time. Most women stay in the hospital one to two days after surgery. Some doctors may send you home the same day of your surgery. Some women stay in the hospital longer, often when the hysterectomy is done because of cancer.
Your doctor will likely have you get up and move around as soon as possible after your hysterectomy. This includes going to the bathroom on your own. However, you may have to pee through a thin tube called a catheter for one or two days after your surgery.
The time it takes for you to return to normal activities depends on the type of surgery:
- Abdominal surgery can take from four to six weeks to recover.
- Vaginal, laparoscopic, or robotic surgery can take from three to four weeks to recover.
You should get plenty of rest and not lift heavy objects for four to six weeks after surgery. At that time, you should be able to take tub baths and resume sexual intercourse. How long it takes for you to recover will depend on your surgery and your health before the surgery. Talk to your doctor.
Why Would I Need A Hysterectomy
You may need a hysterectomy if you have one of the following:1
- Uterine fibroids. Uterine fibroids are noncancerous growths in the wall of the uterus. In some women they cause pain or heavy bleeding.
- Heavy or unusual vaginal bleeding. Changes in hormone levels, infection, cancer, or fibroids can cause heavy, prolonged bleeding.
- Uterine prolapse. This is when the uterus slips from its usual place down into the vagina. This is more common in women who had several vaginal births, but it can also happen after menopause or because of obesity. Prolapse can lead to urinary and bowel problems and pelvic pressure.
- Endometriosis. Endometriosis happens when the tissue that normally lines the uterus grows outside of the uterus on the ovaries where it doesn’t belong. This can cause severe pain and bleeding between periods.
- Adenomyosis. In this condition the tissue that lines the uterus grows inside the walls of the uterus where it doesn’t belong. The uterine walls thicken and cause severe pain and heavy bleeding.
- Cancer of the uterus, ovary, cervix, or endometrium . Hysterectomy may be the best option if you have cancer in one of these areas. Other treatment options may include chemotherapy and radiation. Your doctor will talk with you about the type of cancer you have and how advanced it is. Learn more about treatment options for these cancers at the National Cancer Institute.
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Will Menopause Begin Right After Shortly After Or What Is The Time Frame To Expect
For women who have hysterectomy surgery that involves the removal of ovaries, they may begin experiencing menopause symptoms after 24hours following their operation.
The abrupt inducement of menopause often results in exaggerated symptoms such as hot flashes and changes in libido.
Another possible outcome is that ovarian failure may occur much earlier than the anticipated time frame of menopause, around 1 to 2 yrs after the hysterectomy surgery. In such cases, a person may or may not experience the immediate symptoms of menopause.