After a Hysterectomy
Coping with Hormonal Imbalance and Other Post-Surgical Issues
A hysterectomy is a surgical procedure in which the uterus is removed. In some instances – about 40% of the time - the ovaries and fallopian tubes may be removed as well. It is the second-most often performed surgery on women: the most performed non-obstetric surgery.
By the age of 60, in the United States alone, one out of every three women will have this surgery. Every year, over 600,000 hysterectomies are performed.
Reasons Behind the Necessity for a Hysterectomy
The reasons behind a woman’s need for the removal of her uterus are numerous. Some of the most common causes are uterine fibroids, abnormal vaginal bleeding, cervical dysplasia, endometriosis, and uterine prolapse.
- Uterine Fibroids – Fibroids tumors that grow in the wall of the uterus and are usually of a benign (non-cancerous) nature. These tumors may be single or many and can range from apple seed sized to grapefruit sized. Some women with fibroids will not have symptoms. The women who do show symptoms – pain, heavy menstrual bleeding – tend to find the severity of the symptoms difficult to live with.
- Abnormal Vaginal Bleeding – This would include excessive bleeding between regular menstrual cycles as well as expelling an abnormally large volume of blood during the cycle. The abnormal vaginal bleeding may lead to anemia.
- Cervical Dysplasia – Considered to be a precancerous condition, cervical dysplasia is simply the appearance of abnormal cells on the surface of the cervix. Though the appearance of the cells themselves aren’t the cause of health problems, if left untreated, it can eventually develop into cervical cancer.
- Endometriosis – A condition where tissue which is akin to the tissue lining the uterus is found elsewhere in the body (the ovaries, the fallopian tubes, and on the pelvic sidewall). 5% to 10% of women suffer from this condition which can lead to infertility. Symptoms of endometriosis include extremely painful menstrual cramps; lower back pains which may be accompany by abdominal pain; pain during intercourse; excessive menstrual bleeding.
- Uterine Prolapse – This is when the uterus falls from its normal position. Some of the causes for uterine prolapse include muscle weakness and stretching (usually caused by pregnancy/ trauma during the delivery of a child – especially large baby), and muscle tone loss usually related to aging and the loss of certain hormones following menopause. In some cases, the prolapse may be caused by a tumor.
Barely 10% of the yearly surgeries performed are due to cancer leaving room for the argument proposed by Dr. Stanley West, Chief of Reproductive Endocrinology and Infertility at St. Vincent's Hospital in New York City, and like minded critics who say that nearly 90% of all hysterectomies are unnecessary.
Side Effects Associated with a Hysterectomy
Regardless of the necessity, once the surgery is performed, as with any procedure, side effects are widely reported. After uterine removal, many women complain of common symptoms such as hot flashes, fatigue, severe depression, weight gain, urinary problems, memory loss, hair loss, vaginal dryness, headaches, anxiety, irritability, dizziness, and diminished sex drive.
The loss of libido (sex drive and sexual enjoyment) is attributed to low testosterone levels following a hysterectomy. It is recommended that a doctor be consulted regarding testosterone replacement therapy.
A woman after having a hysterectomy is also more likely to develop coronary disease of some kind and tends to be more prone to osteoporosis and thyroid deficiency.
Hormone Levels are the Key in Lessening Side Effects
It is extremely important that women and their doctors pay attention to their hormone levels following a hysterectomy even if the ovaries are not removed. Often, the removal of the uterus will lessen the blood flow to the ovaries, which leads to fluctuations in hormone levels.
Many of the side effects previously mentioned are directly connected to low levels of not just estrogen, but of testosterone and progesterone as well. So along with the doctor recommended estrogen replacement therapies, progesterone replacement is also suggested.
There are safe and effective herbal supplements that can be used in lieu of synthetic hormone replacement therapies. These natural remedies not only help to balance hormones, but also aid in curbing the most of the side effects commonly reported. As with everything, consult your physician before replacing, substituting or beginning any medication – even natural supplements.
Sources:
- Ewalds-Kvist S. Béatrice M. Hirvonen, Toivo. Kvist, Mårten. Lertola, Kaarlo. Niemelä, Pirkko. “Depression, Anxiety, Hostility and Hysterectomy”. Journal of Psychosomatic Obstetrics & Gynecology; Sep2005, Vol. 26 Issue 3, p193-204
- “Hysterectomy” United States Department of Health and Human Services. Retrieved 2009-07-12
- West, Stanley. Dranov, Paula. “The Hysterectomy Hoax: The Truth About Why Many Hysterectomies Are Unnecessary and How to Avoid Them” Random House. 2002. 3rd ed
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