Surgical menopause?

June55Baby · Feb 6, 2004

My opinion is to leave the ovaries whenever possible. No amount of estrogen pills can replace the real thing coming from our ovaries.

You are wise for considering this and not just letting them do an oopherectomy. It's funny isn't it that a man would NEVER ask if he should have his testicles removed, but women often think nothing of having their ovaries taken out during a hysterectomy.

babern · Feb 7, 2004

Dear June,

My concern about leaving one ovary in, is twofold.

1. I have severe endometriosis.

2. Possible increased risk of breast cancerif you leave the ovaries.

in.

My mom died of adenocarcinoma, unknown primary.

I dont want to take HRT. And I don't want to look like an OLD LADY OVERNITE EITHER!

So any of you out there, please comment. I am 51.

My friend thinks it would be best to keep an ovary, in order to avoid being miserable, and crazy!

Will I get crazy?

P_RN, ADN, RN · Feb 7, 2004

I had a vag hx at age 34, couple of years later left ovarian cyst (huge) rupture /c peritonitis so that went, couple of years later rt one same story second verse. Premarin since then...no hot flashes, mammogram every year, no problems. I'm 59 now.

angelbear · Feb 7, 2004

I am 36 just had TAH/BSO. I am glad they took them both as 50% of the time the remaining ovary stops working fairly quickly anyway. I also did not want to take the chance of later having to have the remaining one removed. I was miserable make sure you ask for a pain management consult with the anesthesiologist. I also could not handle the no hormones I had HORRIFIC hot flashes and mood swings. I now take premarin do monthly breast exams and my md intends to do biyrly breast exams and yrly mammograms. I take premarin.

Reabock · Feb 7, 2004

I had a total hyster and BSO at 36 for extensive endometriosis. Never regretted it for a minute, have been on Menest, a synthetic hormone ever since. Have cut myself back to 1/2 of a 1.25 mg tab every other day or so and have no hot flashes unless I forget for 5-6 days, and then they are mild. (I'm cheap and it makes the script last longer:D ) I am now 51 and don'tsmoke and have had my daughters friends tell her that I do not look my age so guess I didn't age overnight from having it done!!! :D

I would opt to get everything out, why risk another surgery and possibly ovarian CA if its not needed anyway? Just my humble opinion. I was only off work for 4 weeks and only used 20 sick days, no real lifting in my job at that time though. Good luck in whatever you decide.

babern · Feb 7, 2004

P RN, Angelbear, and Reabock,

Thank you for responding, and sharing your experiences

P RN

Wow! I'm so sorry for the h--l you had to go thru ,2 more painful surgeries !

I did,t realize these risk factors.

Angelbear,

I sorry for all the misery you went thru.

Could you please elaborate on "I was miserable, make sure you ask for a pain management consult with your anesthesiologist."

What prophylactic measurements should I ask for?

What type of anesthesia did you have?

Wat would you do differently, now that you know what you know?

Mood swings? Will zoloft take care of that, in place of HRT?

babern · Feb 7, 2004

Reabock,

Wow! Thank you for your encouraging post. I'm glad you look great!

I, too, am cheap! I've taken progesterone cream 1/4 tsp.

topically for hotflashes, works great. Got it @ the GNC store.

I'm concerned about mood swings mentioned in the above post.

You do, what I do, I'm always cutting back !

I won't hesitate to have both ovaries taken out now.

You mentioned endometriosis. Did you have any problems with its reocurrence? I read that some times it can come back. Did you have it all cleaned out at the time of your hx.?

OldNewbie · Feb 7, 2004

Wow - this must be hysterectomy day - this is the second post I've replied to regarding this subject...which is of course, just my opinion -

I had 5 laps, one ovary/tube removed before the total hysterectomy - wish I would have done the total in the first place and MUCH sooner than I did - I won't go into the details like I did on the first post - suffice it to say that we women get so used to the severe (and unecessary) pain and compensating for the horredous bleeding that a lot of women die from other diseases/failures that were caused by "dealing" with the side affects of cramps and bleeding - I would have died from an apendicitis attack had one occured during those yrs - and kidney failure had I let it go further the second time...

Just my opinion, but I wouldn't leave anything in - too much risk of having to go back in...I was in my 30's when I got everything out - and I shouldn't have waited as long as I did - as with many that replied to this - I could not/would not deal with the severity of the hot flashes and mood swings, so HRT was never a question for me....everything worked like a charm - I never looked like an "old lady" going through mentopause (sp?) in 3 hrs -

I would like to add one thing though - the first 6 mos of premarin worked wonderfully - then all the sudden 50-60 severe hot flashes a day - one about every 30 mins - needless to say, I wasn't sleeping, felt like 10 guys beat me up I was so exhausted from the flashes - anyway - went to the doc immediately, and thankfully he figured out why that day - sometimes your bowels and intenstines quit absorbing the HRT (premarin) or oral HRT I should say - no one really knows why - it just happens sometimes - well it happened to me and I was miserable and scared that there was no alternative - there is! After he gave me one of the most painful shots I'd ever had (oil based estrogen) to quickly raise my estrogen level, I started on estrogen patches - they work just as wonderfully as the pills did, and for me it's better because I don't have to remember to take the pill everyday...the only trouble I had was finding ones that would stick - after 5 or 6 brands (doctor samples thankfully) - I FINALLY found one that sticks until you take if off regardless if you swim, shower, or soak in the bath tub for hours - they're Vivelle (I have 0.1 - but they come in many strengths)....been on them for 7 yrs now and still feel great!

You won't end up (or are by the way) an "old lady" and you'll feel 100% better - believe me - you have no idea how bad you feel until you don't feel bad anymore!

Good luck!:)

Jay-Jay, RN · Feb 7, 2004

I had a large ovarian cyst, endometriosis and fibroids. I was also perimenopausal, and having irregular periods, heavy bleeding, PMS, migranes, the works! So, the doctor recommended a total abdominal hysterectomy.

The one ovary had to go due to the cyst. The other could have been left in, but it looked like it was postmenopausal anyway. I had recenty had a patient with Ca. of the ovary. She'd had one ovary removed due to polycystic ovaries, and they left in only 1/4 of the other ovary. Still, she developed Ca. which had already spread to her lungs by the time it was diagnosed. I've seen a lot of horrible deaths from Ca. of the ovary, so I said to my gyne, "Take 'em BOTH out!"

Currently on Estrogel daily. Won't touch Premarin...I have very strong issues about the way it is collected (from pregnant mares) and the fact it's HORSE estrogen, not human!

I was home from hospital in 3 days. (I spiked a temp. after the surgery, or I would have been home sooner.) The next day, I was out in the garden, pulling a few weeds, and helping bathe the dog, who had managed to get herself skunked! Was going bananas with boredom by the time the recommended 4 weeks recuperation period was over.

No more hot flashes, no more mood swings or PMS, no bleeding...it's great! I do have some abdominal pain which may be due to adhesions caused by the endo, or the fact the pressure from the cyst against the large bowel caused diverticulitis. I also have some sciatica on the same side, so it's a bit hard to know sometimes if my back pain is due to sciatica or adhesions! (If it eases after a BM, it's the adhesions/diverticulitis.)

Sis123 · Feb 7, 2004

Hi BabeRN,

I am 45, and am 2 months post op from a TAH-BSO for continual bleeding, fibroids etc. I used to have severe endo, and had 3 previous surgeries to treat it, unsuccessfully. Since my doc. checked my hormone levels before the surgery and found that I was in "ovarian failure" (which is a estrogen level below a certain level) I was already having hot flashes. I wanted to keep my ovaries to get the teensy bit of natural estrogen, but it really wasn't enough to do all the things it's supposed to do, and doc said that they usually have to go in again and take them out later in endo ladies anyway. So, we agreed they needed to go.

I also take vivelle dot .1. It is not a high enough level to make the endo grow. It's just right for me, doesn't have to go through the digestive system and liver, the patch sticks and stays on great, and I do NOT look like an old lady. I also have not gained weight, like lots of post-hyst gals do. The vivelle dot is molecularly identical to human estrogen, so that's better for me than horse estrogen!

A hyst isn't a guaranteed fix, but it sure worked for me! Good luck in what you decide....

Reabock · Feb 9, 2004

BABE RN, no , never had a recurrence of the endo, nor any problems with adhesions, at least not yet and surgery was about 15 years ago. Did not even know I had endometriosis, just knew I hurt awful, almost doubled over at times with the pain. MD said it was "disentigrating fibroid" on the ultrasound which is why we did the surgery, found the endometriosis during the surgery which is why I'm glad I had an open procedure and not an LAVH.

The folks having the LAVH's get back to work quicker though and seem to do fine. (Lap assisted Vag hyster= LAVH) never really had a problem with mood swings , but then my family thinks I am a Bi***h anyway , though I have mellowed over the years!

The patch sounds like a really good option, maybe you could explore that route of HRT. It was not available when I started needing it and don't want to try something new when the old stuff is working fine.

I never could understand those women that said they didn't feel like a woman without a uterus, DUH, thats not the only defining factor ladies!!! :rolleyes: I felt so much better without it, have never regretted the surgery.