Menopause Mondays: The Ins & Outs of Hysterectomies
There is no one-size-fits-all perimenopause and menopause experience. Many women breeze through (hold onto those genes!) while others experience one or more of 34 symptoms. There are several effective options for women in dealing with reproductive changes like fibroids, endometriosis and heavy periods, but the option many women elect is a hysterectomy, the removal of the uterus. It is true that after you turn 45, your ovaries produce a lower level of estrogen, but they continue to produce testosterone and androstenedione, which covert to estrogen as they circulate the body. They provide crucial protection against heart disease and osteoporosis. Testosterone helps maintain our sex drive, boost energy levels, and maintain lean body tissue (“The Endangered Uterus“). Hysterectomies that include the removal of your ovaries take your body’s production of these hormones from you.
There are three different types of hysterectomies. A partial (supracervical) hysterectomy is the removal of the upper part of the uterus, and the cervix is left in its place. A total hysterectomy is the removal of the entire uterus as well as the cervix. A radical hysterectomy is the removal of the uterus, the upper part of the vagina, and the tissue on both sides of the cervix. Radical hysterectomies are most common in the treatment of cancer (NIH).
Some of the alternatives for pelvic problems include laparoscopic technology, which allows OB-GYNs to remove endometriosis and fibroids without cutting the abdomen. Uterine artery embolization can shrink fibroids by cutting off the blood supply to them with only a small incision in the groin. Birth control pills and IUDs have proven to relieve the pain caused by a fallen uterus. The North American Menopause Society is now backing hormone replacement therapy as a good option for menopause symptom relief. But these are all options doctors don’t always tell you because they are comfortable performing hysterectomies. In the 1980s, 600,000 women a year were having hysterectomies, and the number has not significantly lowered since (“The Endangered Uterus”).
For some women, though, a hysterectomy is the only option, and it is a good one. When deciding whether to have a hysterectomy, it is important to be cautious – get more than one opinion to be sure that you need the surgery, as it can have negative side effects that aren’t as well known. To get a better idea of what to expect in this process, we asked Karen Giblin, Founder and President of Red Hot Mamas, to give us a personal account of her experience.
Oh, how I hated having my bathroom cabinet cluttered with a lifetime supply of sanitary napkins. And, I also despised having monthly PMS symptoms. So, for me, having a hysterectomy and saying arrivederci to ‘big red’ was a celebratory event. However, I wish I had more information prior to my surgery than the typical thirty-minute (if that) pre-operative consultation. There definitely was not enough time allotted to me to discuss all I needed to know. So, I strongly advocate to all of you who are considering having a hysterectomy to not superficially discuss it with your doctors, but get in-depth information. By doing this, you will better have better long-term outcomes.
On a personal note, my life changed for the better after having a hysterectomy with removal of my ovaries (an oophorectomy). Are you wondering why life got better for me? It was a positive experience for me as I was not just saying arrivederci to my monthly periods, I was also putting an end to the chronic pelvic pain and worries I had each month due to unusually heavy and abnormal bleeding. The only thing I did wrong was not ask my doctor the right questions. I did not have the proper knowledge as to how to prepare myself for recovery issues that followed and how to deal with the menopausal symptoms that followed. If you want to learn more about my experiences, please read “A Personal Account of My Hysterectomy: Arrivederci Big Red!”
Hysterectomy is the second most common major surgical procedure performed in the United States. About 600,000 hysterectomies are performed each year. In half of all hysterectomies, the ovaries as well as the uterus are removed at the time of the hysterectomy. Most times the reason for removing ovaries is to reduce the risk of developing ovarian cancer. Oophorectomy is referred to as “surgical menopause” because menopause will happen instantly rather than occur as a result of natural aging. Approximately 20 to 30 percent of hysterectomies are done for excessive uterine bleeding, like I had experienced. Other conditions most commonly treated with hysterectomy are uterine fibroids, endometriosis, uterine prolapse (NIH) and cancer.
The decision to have a hysterectomy is a difficult one to make for many women and should not be taken lightly. It is a surgical procedure and, like any surgical procedure, it carries some risks. So it is important for women to discuss with their doctors about every aspect of the procedure, including details of the surgery itself, postoperative recovery, treatment options for menopausal symptoms, as well as what are the alternatives to having a hysterectomy/oophorectomy.
To help you sort through the confusion, you need to be sure to discuss with your doctor the least invasive procedure. You also should be provided with an overview of the different types of hysterectomies; discuss what happens with removal of the ovaries and cervix; the pros and cons of alternatives; anesthesia options; the details of the surgery itself; post-operative hormone therapy and potential complications. Having reliable and accurate information can be a very empowering experience for women and can aid them in making informed health choices.
Educating yourself on the latest information and discussing all the options with your perimenopause and menopause specialist is imperative when deciding whether to have a hysterectomy. Be detailed and thorough in your conversation, and don’t be shy. If you find, after getting multiple opinions, that a hysterectomy is the only solution for you, then be sure to find a doctor who will take the time to tell you what you’ll be experiencing and help you understand your options. Thank you to Karen Giblin, and to read more, visit redhotmamas.org and read “The Endangered Uterus”!
Remember: Reaching out is IN. Suffering in silence is OUT!