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What Happens To Ovaries After Menopause

Surgery May Be Less Complicated Than You’d Think

What is Menopause?

The least invasive way to remove the ovaries is laparoscopically, meaning a teeny camera is inserted through a small incision in the belly button to guide removal, Siedhoff says. “There’s a decrease in risk of complications like a blood clot or an infection, and you’ll spend less time in the hospital,” compared with an open surgery, he explains. A laparoscopic procedure also makes for a “better cosmetic effect,” he says, while open surgery leaves a scar much like one from a C-section. Open surgery can take a little longer to recover from but may be necessary for some women.

What Hormones Are Affected By Pcos And Menopause

Women with PCOS usually have higher levels of male hormones, including testosterone. PCOS also makes your body less responsive to insulin. That causes high blood sugar levels. High blood sugar levels can further increase male hormones, making your symptoms of PCOS worse.

Women with PCOS may also have low levels of the female hormone progesterone. Progesterone helps regulate menstruation and maintain a pregnancy.

Years before menopause begins, you naturally start to produce less estrogen and progesterone. The drop in female hormones eventually causes you to stop ovulating. Youve reached menopause when you havent had a menstrual period in a year.

PCOS and menopause both affect the levels of progesterone in your blood, but they affect your hormones in different ways. Thats why menopause doesnt treat or cure PCOS.

Menopause Will Not Cause Ovarian Cancer But Your Risk Increases During This Period Of Time Learn The Cancer Symptoms To Detect It Early

Developing ovarian cancer becomes more of a risk after menopause, even though this transition isnt considered a cause of cancer. Symptoms for ovarian cancer can be difficult to discern from other conditions. Early symptoms can be regular bloating, abdominal pain or persistent pelvic pain as well as trouble with eating. There are several cases where it isnt diagnosed until the cancer is in other organs as well. Its important to get an early diagnosis to better treat the disease.

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Common Side Effects Of Hysterectomy

Hysterectomy may affect the physical and mental health of a woman, especially when it is performed in the menopausal or perimenopausal stage. The woman suddenly and directly enters the post menopause stage without passing through the phases of perimenopause and menopause. The body cannot accept this drastic change and therefore a woman usually faces a lot of problems.

Hormonal changes do have a major impact on the womans health. Levels of hormones after hysterectomy decrease considerably. This increases the risk of cardiovascular and skeletal diseases. A reduction in the testosterone level may cause height loss and osteoporosis . Side effects of partial hysterectomy and side effects of total or radical hysterectomy are almost the same. They may vary slightly, depending upon the reason for which the surgery is performed and the procedure followed. Surgical complications are not discussed in this article.

Common side effects of hysterectomy include

  • Hot flashes
  • Development of excess facial hair on the upper lip and chin region
  • Vaginal dryness
  • Weight gain

What Is The Menopause

Hot Flashes after a Hysterectomy

The menopause refers to that time in every womans life when her periods stop and her ovaries lose their reproductive function. Usually, this occurs between the ages of 45 and 55, but in a few exceptional cases women may become menopausal in their 30s, or even younger. This is then known as a premature menopause, or premature ovarian insufficiency.

The menopause is influenced by hormones or more correctly, by a change in hormone levels. During a womans fertile years, her ability to produce an egg each month is associated with the release of three reproductive hormones , that are referred to collectively as oestrogen. Oestrogen is mainly produced by the ovaries, though small amounts are also made by the adrenal glands and by the placenta of a pregnant woman.

It is oestrogen which stimulates female characteristics at puberty and controls a womans reproductive cycle: the development and release of an egg each month for implantation in the uterus , and the way in which the lining of the womb thickens to accept a fertilized egg. The monthly period happens because no implantation has taken place there is no pregnancy and the lining of the womb is shed.

At around the age of 50-55 years, the monthly cycle stops completely so no more ovulations, no more periods and no more pregnancies. This is the menopause.

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What Is The Prime Age For A Woman To Have A Baby

Experts say the best time to get pregnant is between your late 20s and early 30s. This age range is associated with the best outcomes for both you and your baby. One study pinpointed the ideal age to give birth to a first child as 30.5. Your age is just one factor that should go into your decision to get pregnant.

Can A 49 Year Old Woman Get Pregnant

Its exceptionally rare for patients to get pregnant naturally at 50 or over 45. They make history, said Dr. David Keefe, an obstetrician-gynecologist and fertility researcher at New York University. In part thats because around age 50, many women are entering menopause, after which egg harvesting isnt possible.

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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 Is Surgical Menopause

After menopause: 4 questions women ask about post-menopause – Part 1

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.

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Your Hormone Levels Will Dropand You’ll Probably Want To Do Something About It

Yes, the benefits, like a lower risk of both ovarian and breast cancer, are big, but that doesn’t mean ovary removal is without risks. In fact, it’s been linked to a seriously higher risk of heart disease, osteoporosis, dementia, and death by any cause, likely due to that drastic drop in estrogen. Research suggests that premenopausal women who have their ovaries removed at age 35 or younger have nearly twice the risk of developing cognitive impairment or dementia, a seven times higher risk of heart disease, and an eight times higher risk of a heart attack, explains Philip Sarrel, MD, a professor emeritus of obstetrics, gynecology, and reproductive sciences and psychiatry at Yale and president of the Advancing Health After Hysterectomy Foundation.

Ideally, you’d start taking hormone therapy right after ovary removal , Sarrel says, to avoid acute hormone withdrawal. The timing matters, he says, because the older you are when you start hormone therapy, the riskier it can be, as the WHI findings show, and the more damage to your health is already done. For example, starting hormone therapy 6 years after oophorectomy led to greater decline in bone health than starting it 3 years after surgery, which in turn was linked to weaker bones than starting it within 2 months.

Treatment Of Ovarian Cysts After Menopause

Treatment options may involve surgery to remove the cysts or other treatments for health conditions that may be causing them. Surgery, including ovary removal, may be recommended for postmenopausal women with large, non-simple cysts and other risks factors, such as history of ovarian or breast cancer.

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What Does It Mean When An Ovary Cannot Be Seen On Ultrasound

Vaginal ultrasound can help to show whether any cysts on your ovaries contain cancer or not. If a cyst has any solid areas it is more likely to be cancer. Sometimes, in women who are past their menopause, the ovaries do not show up on an ultrasound. This means that the ovaries are small and not likely to be cancerous.

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What Does Ovarian Cysts Pain Feel Like

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The pain from an ovarian cyst changes from woman to woman. For some women, they may feel slightly uncomfortable. For others, the pain can create significant distress. Ovarian cysts pain occurs in the lower abdomen and pelvic area and may feel like a chronic ache or jabbing and sudden pain. Acute pain typically happens when a cyst ruptures or becomes twisted.

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The Ovaries Through The Lifespan

You are born with all of the eggs youll ever need, around one million in each of the ovaries. By puberty, when youll most likely receive your first period, the number of eggs in each ovary is around 200,000 to 400,000. During the childbearing years, approximately 300 to 500 eggs will develop and be released during ovulation. After menopause, the ovaries will stop producing eggs and atrophy . Due to a loss of ovarian functioning and loss of estrogen production, postmenopausal women and people commonly experience symptoms like hot flashes and vaginal dryness. Estrogen deficiency also increases your risk of developing osteoporosis, which increases your risk of bone fracture.

Your Hormone Levels Will Dropand Youll Probably Want To Do Something About It

Yes, the benefits, like a lower risk of both ovarian and breast cancer, are big, but that doesnt mean ovary removal is without risks. In fact, its been linked to a seriously higher risk of heart disease, osteoporosis, dementia, and death by any cause, likely due to that drastic drop in estrogen. Research suggests that premenopausal women who have their ovaries removed at age 35 or younger have nearly twice the risk of developing cognitive impairment or dementia, a seven times higher risk of heart disease, and an eight times higher risk of a heart attack, explains Philip Sarrel, MD, a professor emeritus of obstetrics, gynecology, and reproductive sciences and psychiatry at Yale and president of the Advancing Health After Hysterectomy Foundation.

Ideally, youd start taking hormone therapy right after ovary removal , Sarrel says, to avoid acute hormone withdrawal. The timing matters, he says, because the older you are when you start hormone therapy, the riskier it can be, as the WHI findings show, and the more damage to your health is already done. For example, starting hormone therapy 6 years after oophorectomy led to greater decline in bone health than starting it 3 years after surgery, which in turn was linked to weaker bones than starting it within 2 months.

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What Happens During Menopause

Natural menopause isnât caused by any type of medical or surgical treatment. Itâs slow and has three stages:

  • Perimenopause. This phase usually begins several years before menopause, when your ovaries slowly make less estrogen. Perimenopause lasts until menopause, the point at which your ovaries stop releasing eggs. In the last 1 to 2 years of this stage, estrogen levels fall faster. Many women have menopause symptoms.
  • Menopause. This is when it’s been a year since you had a period. Your ovaries have stopped releasing eggs and making most of their estrogen.
  • Postmenopause. These are the years after menopause. Menopausal symptoms such as hot flashes usually ease. But health risks related to the loss of estrogen increase as you get older.

Can Ovarian Cancer Be Prevented

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The majority of women have at least one risk factor or two for ovarian cancer. These common factors generally only slightly increase your risk. Risk factors havent helped prevent most cancer cases as of now. There are some ways you can reduce your risk for epithelial ovarian cancer. There is little known about lowering the risk of stromal tumors or germ cell problems in the ovaries. The following discussion is of epithelial ovarian cancer, specifically.

Some strategies may only provide a minor reduction, while others are more helpful. Some may be easy to try, while others involve surgery. If you are worried about ovarian cancer, you should speak with your doctor, so they can help you develop a plan.

Oral Contraceptives

Taking birth control pills, or oral contraceptives can lower the risk of ovarian cancer, particularly for those who use them for several years. Those who used birth control pills for five or more years saw as much as a fifty percent decrease in risk of ovarian cancer compared to those who didnt take the pill for so long. Its important to think about the side effects and risk of birth control pills if youre considering using them. It should be discussed with your doctor to see if it is right for you.

Gynecologic Surgery

A hysterectomy or even tubal ligation can risk your chance of ovarian cancer. Generally, doctors agree these procedures should be reserved for medical reasons other than prevention of cancer.

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What Is The Effect On Your Body If You Remove Your Ovary After Menopause

In the United States, 600,000 hysterectomies are performed each year. And about 50% of those also choose to remove their ovaries electively. The argument for the removal of ovaries after menopause believes that since the ovaries have fulfilled their primary role in a womans life, theyre no longer necessary. Additionally, proponents of postmenopausal oophorectomy say that the 1.3% lifetime risk for ovarian cancer is not worth keeping ovaries in place. The newer line of reasoning states that the ovaries, despite the cessation of their reproductive roles, still secrete some hormones and may serve important roles for the later stages of life.

Removing ovaries as a preventative measure for ovarian cancer may deprive the body of the hormones released from postmenoapausal ovaries, causing decreased libido, lower energy, cardiovascular issues, and cognitive decline. Thus, although the probability of ovarian cancer is eliminated with oophorectomy, it may not reduce overall cancer risk.

What Causes Postmenopausal Bleeding

Vaginal bleeding during postmenopause isn’t a normal side effect of decreasing hormone levels. In some cases, the dryness in your vagina could cause some light bleeding or spotting after sex. In other cases, it could indicate a condition like endometrial hyperplasia or uterine fibroids, infections like endometritis, or cancer. Contact your healthcare provider if you experience any vaginal bleeding so you can be evaluated.

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What Percentage Of Postmenopausal Ovarian Cysts Are Cancerous

A vast majority of ovarian cysts in women after menopause are not cancerous. Out of the 5-10% of women who undergo surgical evaluation for ovarian cysts, only 13-21% of those turn out to be malignant . Thus, most ovarian cysts are not precancerous and will not cause cancer later in a womans life. However, because of the tragic consequences that may occur due to untreated ovarian cancer, most healthcare providers err on the side of caution when evaluating and treating ovarian cysts in postmenopausal women.

In Support Of Elective Oophorectomy

Hysterectomy &  Surgical Menopause

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.,

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Consulting With A Doctor

Women who have concerns with ultrasound or CA125 studies should have a consultation with a fellowship-trained subspecialist in womens cancers. Gynecologic oncologists have specialized training in the management of and surgery for womens cancers. Consultation can help a patient understand her risks for a cancer and plan for the proper surgical procedure. Gynecologic oncologists are five times more likely to completely remove ovarian tumors, and 80 percent of ovarian cancer patients receive inadequate surgical staging from non-gynecologic oncologist surgeons. Most importantly, survival outcomes are vastly improved when gynecologic oncologists are involved in a patients care.

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