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Hormone Imbalance After Complete Hysterectomy

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What to expect with a hysterectomy

Written by Sandhya Raghavan | Updated : February 10, 2017 6:42 PM IST

The uterus has some pretty impressive functions like expanding many times its original size to accommodate a baby during pregnancy and providing support to the bladder and the pelvic bones. However, problems such as fibroids, endometriosis and uterine cancer force many women to undergo hysterectomy, where a part of the uterus or the entire organ is removed. When such an important organ is removed, there are bound to be some changes in the woman s body. Dr Maya Lulla, Consultant Obstetrician and Gynaecologist at Nanavati Super Speciality Hospital uncovers some of the ways in which your life might change after a hysterectomy.

No weight gain: It s a misconception that many women put on weight after a hysterectomy. The real culprit here, according to Dr Lulla, is not the hysterectomy or the loss of uterus itself, but the inactivity on the part of the women. Many women limit their physical mobility and exercise after they undergo hysterectomy, explains Dr Lulla. They should be more active.”

Ovarian functions may diminish: Dr Lulla says even in cases where there the ovaries have been kept intact, the loss of ovarian functions may happen over a period of time. Uterus and the ovaries share blood supply, so it is evitable that once the uterus is removed the ovaries stop functioning to their fullest capacity.

What About Side Effects

Youve probably heard about side effects of undergoing any type of Hormone Replacement Therapy. While there are some possible effects like mood swings that seem a lot like what you were experiencing before the hysterectomy, rest assured that these indicate that the HRT needs some adjustment. No two people are exactly alike, so the dosage and frequency may be different for you. By keeping your doctor up to date on how you are feeling, it wont take long to determine how much you need in order to bring your balance back in line.

Does Having Or Not Having A Uterus Make A Difference In Deciding What Type Of Hormone Therapy I Should Take

Yes, it does.

If you still have your uterus:

Progesterone is used along with estrogen. Taking estrogen without progesterone increases your risk for cancer of the endometrium . During your reproductive years, cells from your endometrium are shed during menstruation. When the endometrium is no longer shed, estrogen can cause an overgrowth of cells in your uterus, a condition that can lead to cancer.

Progesterone reduces the risk of endometrial cancer by making the endometrium thin. If you take progesterone, you may have monthly bleeding, or no bleeding at all, depending on how the hormone therapy is taken. Monthly bleeding can be lessened and, in some cases, eliminated by taking progesterone and estrogen together continuously.

If you no longer have your uterus :

You typically wont need to take progesterone. This is an important point because estrogen taken alone has fewer long-term risks than HT that uses a combination of estrogen and progesterone.

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Are There Any Alternatives To Estrogen In Surgical Menopause

In the case of breast cancer, studies suggest that estrogen does not increase risk of breast cancer when used in surgical menopause, even among those who are BRCA1 or BRCA2 carriersprovided they do not have a personal history of cancer. In those in surgical menopause who have a Factor V Leiden mutation , the long-term protective effects of hormone therapy may often outweigh the risks posed by the use of hormones.

Nevertheless, if you are concerned about using estrogen due to a family history of estrogen-dependent cancers, blood clots, or other risks, it is wise to discuss this with your doctor to make sure that you are carefully dosed and monitored to avoid adverse effects of hormones in surgical menopause. Alternative medications can also be used in some extreme cases .

Estrogen therapy is the most effective way to prevent all of the symptoms and risks associated with surgical menopause. However, for those who absolutely cannot take estrogens, there are some alternative therapies available:

For osteoporosis, effective alternatives include biphosphenate medications and selective estrogen receptor modulators such as raloxifene, tamoxifen, or bazedoxifene+estrogen.

Hysterectomies That Save Ovaries Still Carry Health Risks Study Finds

Mood Swings After a Hysterectomy

Women who have had their uterus and ovaries removed need to be monitored for high blood pressure, weight changes and high cholesterol, a new study suggests. This photo is from a blood pressure check at the Centers for Disease Control and Prevention in 2005.

CLEVELAND, Ohio — For years, surgeons performing hysterectomies have opted to leave the patients’ ovaries in place, when possible, to reduce the risk of heart disease and other health problems.

But preserving ovaries may not help as much as was previously thought, a new study suggests.

A recently published 22-year-long study found increased risks of hypertension, obesity, heart disease and coronary artery disease, even when ovaries were left intact after a hysterectomy.

“That was a surprise,” said Dr. JoAnn Pinkerton, executive director of the North American Menopause Society, and professor of gynecology at the University of Virginia Health System. She spoke by phone from Charlottesville, Virginia.

Women who had hysterectomies – especially those women younger than 35 – faced increased health risks. The study also suggested that if women take estrogen until 51, the average age of menopause, their health risks dropped to average levels.

This study could help women who are considering a hysterectomy to make important health decisions, and to look for alternatives to the surgery, Pinkerton said.

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Are You Worried About Being Forced Into Surgical Menopause

Thats a valid concern. Even women who are of age and prepared to go through menopause naturally have concerns and go through a grieving process. For some women, the symptoms of a hormone imbalance can be intense and even debilitating.

As a result, just thinking of having a hysterectomy that adds to hormone changes in this way can bring with it fear and a real sense of losing some of your lifes richness.

But theres good news! Your symptoms are symptoms of a hormone imbalance. And a hormone imbalance can be treated with bio-identical hormone replacement therapy .

Natural Vs Synthetic Estrogens

There are two main types of estrogen therapy: synthetic and natural:

Synthetic estrogens are made in a laboratory and are not identical to the hormones produced by the body.

Natural estrogens, on the other hand, are derived from plant sources and are chemically identical to the hormones produced by the body. This is often termed bio-identical. The most common form of estrogen used for HRT is Estradiol.

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What You Can Do

If you are planning to have both ovaries removed during a hysterectomy, you may want to discuss hormone therapy with your medical professional. This treatment can help your body slowly adjust to the loss of estrogen so the signs and symptoms of menopause arent so sudden and severe.

In turn, hormone therapy can help reduce your risk of age-related health issues common in people with a hysterectomy and ovary removal, including bone loss and osteoporosis.

Some people may be able to take hormone therapy short term. Others may need to remain on it until they reach the age of natural menopause, or 45 to 55. The average age of menopause is 51.

Likewise, your healthcare professional may recommend lifestyle adjustments that can help prevent health issues related to early menopause and estrogen loss. Exercise and an improved diet may be helpful.

What Are The Different Types Of Hysterectomies

New Study Looks At Long-Term Effects Of Hysterectomies

To fully envision how your body may change after a hysterectomy, you need to know the different types of surgery. Dr. Macey may recommend one of three types of hysterectomies:

  • Partial or supracervical hysterectomy: Upper part of the uterus is removed, while the cervix is left in place
  • Total hysterectomy: Entire uterus and cervix are removed

Although a hysterectomy doesnt include your ovaries or fallopian tubes, they may also be removed depending on the reason for your surgery. When one or both ovaries are removed, the procedure is called an oophorectomy. Removal of your fallopian tubes is called a salpingectomy.

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Impact On Mental Health

In addition to physical changes, a person who undergoes a hysterectomy may also experience changes in their mental health.

Hysterectomies mean a person can no longer get pregnant. For some, this causes grief and sadness, particularly if they had hoped to have more children.

A person will also not have periods anymore, which can make a female feel they have lost part of their identity or womanhood.

For others, losing their periods can be a relief. If someone has a painful or difficult health condition, their symptoms may improve, along with their quality of life.

People who do not want children may also feel relieved that they cannot become pregnant.

A study of females who underwent hysterectomies without ovary removal from 19802002 found that they had a 6.6% higher risk for new depression diagnoses and a 4.7% higher risk for anxiety diagnoses in the 20 years following their surgery.

The researchers are not sure why this occurred, so scientists need to carry out more research to understand this trend.

Hysterectomies are not reversible, so it is a good idea for people to ask for as much information as they need to feel confident with their decision.

Questions to ask could include:

According to Dana-Farber Cancer Institute, a person should contact their doctor or healthcare provider if they experience any of the following symptoms after their surgery:

  • heavy vaginal bleeding that soaks a pad in less than 1 hour
  • foul vaginal odor

Getting Estrogen Therapy After Hysterectomy

If youve had both your uterus and ovaries removed, estrogen replacement therapy with estrogen alone is the most common medical intervention. However, according to WebMD, if youve had your ovaries but not your uterus removed, you may need both estrogen and progestin. This is because just getting estrogen hormone replacement alone can increase the risk of cancer in the uterus. Progestin balances out the estrogen to remove the cancer risk.

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Okay Good To Know But What Does This Have To Do With A Hysterectomy

If your healthcare team deems it necessary to remove both of your ovaries during the hysterectomy, your body will experience a quick drop in hormones which will lead to something called early menopause. The sudden loss of estrogen can trigger those notorious hot flashes, as well as several other symptoms:

  • Vaginal dryness
  • Painful intercourse
  • Lost libido

The ovaries also produce hormones that help prevent various health complications such as osteoporosis, heart disease, and aging skin . Unfortunately, there’s growing evidence to suggest that unnecessary ovary removal may be linked to increased risk for heart disease and stroke and other age-related diseases.

Whats more, results from the Mayo Clinic Cohort Study of Oophorectomy and Aging found that people who have both ovaries removed before natural menopause may be more likely to experience cognitive impairment however, more research is needed to prove causation.

Hormone Replacement Therapy After Hysterectomy Can Help You Restore Balance

Pin on The Heat is On

Billie struggled with painful periods throughout her adult years. She felt at the mercy of her monthly cycles, which were irregular, heavy, and came with crippling cramps. At age 23 her doctor finally put a name on her discomfort: endometriosis. But even with an accurate diagnosis, she struggled for years to find the right treatment. Relief only came after her second pregnancy when doctors urged her toward surgery to finally address her painful symptoms thanks to a radical hysterectomy, Billies life changed forever. But while the hysterectomy brought welcome relief from her pain, it also introduced new complications.

Like many women, Billie was shocked to experience the changes brought on by surgical menopause. The mood swings, hot flashes, and sleep disturbances made her question her decision to have surgery, and she felt lost as she faced her new reality. Meanwhile, the increased risk of osteoporosis and cardiovascular disease introduced by hysterectomy began to worry her. So when her doctor suggested hormone replacement therapy to address her most uncomfortable symptoms and potentially protect her health, Billie jumped at the chance to make her life normal again.

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What Other Symptoms Can You Experience After A Hysterectomy

The most obvious symptom of a hysterectomy is actually lack thereof: no more menstrual cycle! For many people, a hysterectomy symbolizes an improved quality of life however, others might experience grief over the loss of fertility or a disinterest in sex.

Dr. van Dis shares that for women whose menstruation or fibroids were interfering signifcantly with their quality of life, they may experience great joy after recovering from a hysterectomy. She elaborates, They may feel free to have more sex, if sex was painful. They may decide to perform exercise that before caused bladder leakage or pain. In short, she says, The majority of women who have hysterectomy experience marked improvement in their quality of life.

Its All About Balance

Testosterone therapy for women is one option in a range of hormone replacement strategies to manage negative symptoms associated with aging and hormone imbalance. The benefits of hormone therapy can be enhanced with nutraceutical therapy, aimed at achieving optimal nutrient balance in your body. With ideal hormonal and nutrient balance, women and men can build more lean muscle, improve energy, feel more positive, and counteract hot flashes and more associated with imbalances common with age.

Call the biostation today at 888-754-1852 or contact us online to schedule your private, personal consultation.

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Inducing The Menopause What Are The Risks

The risks of artificially and prematurely inducing the menopause include osteoporosis, along with the side effects of the menopause resulting from low oestrogen levels that include hot flushes, night sweats, skin dryness and insomnia.

Osteoporosis is the thinning of the bone density that increases a womans risk of fractures. Our bone strength and density is reliant on calcium that is constantly in balance between blood calcium forming bone and calcium released from bone to maintain blood levels. Oestrogen reduces the amount of calcium released from the bone, and this prevents thinning and reduces the risk of osteoporosis and fractures.

Menopausal side effects can be debilitating and are associated with hot flushes and reduced emotional wellbeing. These symptoms are often more severe with abrupt surgical removal of the ovaries compared to the natural menopause, with these symptoms lasting up to ten years. For this group of women who go through the menopause naturally, Hormone Therapy , formerly hormone replacement therapy, may be an option if the menopause occurs early or if symptoms are very severe. This combination of oestrogen and progesterone protect women from osteoporosis and the symptoms of low oestrogen.

Total Hysterectomy With Bilateral Salpingo

Should I keep my ovaries when I have a hysterectomy? Dr. Melissa Pendergrass

In a total hysterectomy with bilateral salpingo-oophorectomy, the surgeon removes the uterus and the fallopian tubes plus either one ovary or two ovaries . As a result of removing the ovaries, the risk of ovarian cancer developing disappears .

However, the ovaries are the primary producers of estrogen. So this type of surgery will affect your hormone levels. On the other hand, if you still have one remaining ovary, it will continue to produce estrogen and testosterone but not at optimal levels. If the surgeon removes both, you can expect to go into surgical menopause .

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How To Lose Weight After A Hysterectomy

So youve noticed your waistline has expanded and now youre desperate to lose weight after your hysterectomy. Thats understandable. No one wants to add a second problem to the first. Well show you what to do about it.

Or perhaps youre a woman who will soon have a hysterectomy? Heres what you need to know about how your upcoming procedure could affect your weight and how you can lose weight after your hysterectomy.

The good news is there are multiple ways to start losing that weight, and well show you how.

Bowel And/or Bladder Issues

Many women notice a change in their bowel or bladder function directly after the procedure. Some may develop urinary tract infections, others constipation, and yet others experience both. Fortunately, these issues are relatively easy to address and may ease up after a while. In the meantime, you should drink plenty of water, and increase your fiber intake, especially from fresh, organic fruits and vegetables.

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Findings Clearly Very Reassuring

For the latest study, which is published in The Lancet Oncology, researchers kept tabs on more than 7,600 women who took part in the estrogen-only treatment arm of the trial.

The women assigned to get estrogen took that hormone for about six years before they stopped. They have now been followed for nearly five years beyond their estrogen use.

Compared to women taking a placebo, women who took estrogen had a 23% reduced risk of invasive breast cancer. That means 151 women got breast cancer in the estrogen group compared to 199 women assigned to the placebo.

Women taking estrogen also had a 63% reduced risk of dying from breast cancer compared to women on the placebo. Overall, there were six deaths in the estrogen group compared to 16 in the placebo group.

In an email, Anthony Howell, MD, a professor of medical oncology at the University of Manchester in the U.K., says the study findings are âclearly very reassuring for women.â

âHowever, they have to be counselled concerning the very small increased risk of deep vein thrombosis and pulmonary embolism , which is seen with any hormones such as the oral contraceptive pill,â says Howell, who wrote a comment on the findings but was not involved in the research.

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