It's baaack -my period plus hysterectomy?

If you are young they actually prefer to go with a hysterectomy that leaves the ovaries over an Ooph for many medical situations but each person is different.

If you are going down that road... If at all possible go with laproscopic. It changes things drastically! Recovery is shorter, side effects tend to be lower... I'm nearly 2 years out from a laproscopic supracervical hysterectomy. 

Reality is there has been one thing I noticed as not the same for the bad and one for the good. 

Good: Positional limitations due to a "retroverted" uterus are gone. 

Bad: Sometimes if I eat food that is too starchy or cheese and not enough fiber I can pay the price for it. A touch more tender, and a touch harder to cope with as there is less in that area it seems to compress things before we get to the end game. That said mine was retroverted so that may not be the same for all.

I would talk to your Dr's and investigate ALL options. It is a big choice. Regardless of which way you go. Hell get a second opinion. Surf the hystersisters site... It's important to know before you do it.

Shell

Isn't the whole point of you needing an Ooph/hyster to get rid of Estrogen?  Cuter, taking the uterus and leaving the ovaries won't do that....

Leah, my Ob said the exact same thing...she pointed out that reproduction isn't the ONLY purpose of the uterus (structural integrity) and taking it can essentially exchange one problem for a whole new set. 

ShariBell-

I was on tamoxifen for 3.5 years after my first bc, and never went into menopause> Then last Dec. they diagnosed a second bc while I was still pre-menopausal and on tamox.  So, I had a BMX and a complete hysterectomy last January, in one massive, 6-hour surgery.  Here was my thinking, along with my docs:

I was 51, with my second primary, and still on treatment.  menopause was no where in sight.  So the ovaries had to go to reduce my recurrence rate by about 65%.  I also had benign ovarian cysts that popped from time to time.  Won't miss that! Your ovaries produce most of your body's estrogen, so that is why their removal can be important.

Next, I had been having bleeding issues while on tamoxifen: really heavy periods, that were making me iron deficient.  Those troubles resulted in us taking the rest.  If I had not had problems there, we would have left the uterus. As it turned out, it was full of fibroids and would have been a problem. So another good call.

Now I am on  anastrozole (arimidex), which is an aromatase inhibitor. While my ovaries are gone, your adrenal glands and brain produce aromatase, that can combine with other things to make estrogen. The anastrazole binds with that aromatase, similar to how the tamoxifen combined with the estroge, and further keeps your body from producing estrogen.  But you can't take an aromatase inhibitor (AI) unless you are in menopause, either naturally or surgically.  You should check out the hormonal therapy pages here for more details on that.

 Now, I am not a doctor, nor do i play one on TV, so this is very general, lay-person understanding. Hope it helps, and hope your docs and give you good answers to your questions.

Chris in NM

Thanks for the clarification Shell. 

The SE I mention, and the stats, are from surgeries that were 'done well.'  It doesn't seem to matter how well done the operation...they remove a corner stone and everything else shifts.  This may not cause an issue in some women, and in some, the issues don't come for a decade or more.

The reason I harp on this is simple.  No one told me anything when I was scheduled for my Hysterectomy.  Not a single medical professional said that some studies show up to 50% of women 10 years out have issues requiring MORE surgery, or suffer quality of life issues.  I had to research that all myself...

Sheri, you may want to go to youtube and watch the procedure. You can watch a surgeon perform what the machine does, or you may be able to find the actual DaVinci procedure. I watched and well, I'll let you make that decision. Yikes.

Also, the reason an Ooph is shorter recovery.....I had on stitch in my belly button..with hysterectomy you have hundreds of stitches on the fascia which is why it takes longer to heal.

I know this is a personal decision...but as I read I want to share what I've learned along the way...because I wish someone was there to warn me ....do you know how many woman (even in my own family) who have had hysterectomies and STILL don't know what their future may hold?

Crazy.

TonLee. Never had a Da Vinci. All Laproscopic and in a Dr's hands. I've been lucky to have great surgeons.

I said Hyster was Laproscopic, and Appendix when 15 years old was Laproscopically scoped prior to major incision. Appendix went from invistigative laproscopy to apendectomy in very short order. They cared more about closing my major incision then making sure my belly button scars were smooth.

To be clear... I only contributed to the thread because I have had a hysterectomy and the list of possible side effects can be daunting.I tried to keep personal opinions out of it outside of that but each time I come back I so want to say more so I shall.

I know a number of women who've had hysterectomies and to be honest... I don't know of any who've had complcations when they've gone the less invasive routes outside of feeling "too good, too soon" and possibly over doing it so being sore and needing to sleep a bit more. That was right after post-op.

Heck some of the issues mentioned... Prolapse... Incontinence... It can happen without a hysterectomy. Can and does. Infact one particular kind of prolapse causes incontinence. Bladder prolapse. Remarkably they often correct things with laproscopic surgery. It's entirely possible if you have a forward thinking surgeon to take steps to lessen the risks during the immediate procedure.

All options have some up sides and down sides. Reality is that there have been many issues that can arise after an Ooph for women, and many that can arise after a Hyster. I am so glad you are happy with your decision. It is always wonderful when our choices we make are right for us.

If I was to go back and do any of it over the only thing I would want before hand is the BRCA Gene testing first. Right now I have my fallopian tubes andfor those with the gene there iss a slightly increased risk of fallopian tube cancer as well.

Now... Something you might want to be sure about as this is a major decision. Nothing I have seen indicates removal of ones ovaries gives 100% certainty against ovarian cancer. In fact the numbers I found said 80-90% less likely so if a woman had a 30% chance, and we go with 80% reduction to risk there is still 6% risk.

If it was ME... My personal choice in the matter would be to seriously weigh my own numbers and odds. Would I consider an 80% chance of risk reduction worth it? Possibly. Would I consider a 30% chance worth it? No probably not. If we went with the same numbers as above and a woman had a 30% chance, and we used 30% reduction to risk there is still a 21% chance. I'd probably enter the why bother mind set. The bone thining, and increased heart risk might not be worth that little for me. not to mention the increased risk of memory loss and dementia.

Just an FYIhaving a Hyster without an Ooph can reduce your risk by about 36% for Ovarian cancer. That was a bonus for me. I didn't and don't have heart risk issues but if I did I would have factored that in. For me the reason I kept my ovaries is I had turned 30 years old 2 1/2 weeks prior. 

Some info that I went with when looking things up:

http://www.ncbi.nlm.nih.gov/pubmed/9185694 Tubal sterilisation, hysterectomy and decreased risk of ovarian cancer. Survey of Women's Health Study Group.

http://www.anapsid.org/cnd/hormones/hysterectomy.html  Keeping Ovaries After Hysterectomy Boosts Survival

We can bombard poor SheriBell with information but at the end of the day without knowing some of these other factors... We're flying blind here and offering no more than our personal opinions, and information we've stumbled across in our search.

To be honest I mentioned HysterSisters before but I will say it again... It is an invaluable place.

So... Good luck SheriBell. Do what is right for you but ask questions till you are blue in the face. I didn't arrive at the concept of a hysterectomy over night and tried other options prior to having one done. For me it was medically required as I was hemmoraging basically. 

Shell

I had a hyster a month ago, because I did not want tamox (family history of ovarian and endometrial cancer). So instead I had the hyster and femara. So far, I feel just fine, better even since they cleaned out a bunch of nasty scar tissue along with the uterus etc.

SheriBell... What kind if Cyst? Simple (the kind a woman gets every month when releasing eggs), complex (the kind they worry about)? Just asking... Cyst is a very ambiguous term as I am sure we have all learend with our breasts.

Fair enough. I just looked it up.

Yes it needs to be removed. If you WANT an Ooph then go for it, but talk to a surgeon who removes dermoid cysts regularly and they may offer removal without a bi-lateral Ooph. Not saying this to sway you. I'm saying this to give you information in case it comes up.

Sounds like you have some choices to make SheriBell... I think I'd want multiple opinions on this. Just a personal choice though. Good luck!

Shell

Nora,

That flies in the face of basic anatomy.  The lining of the uterus, the endometrium, thickens in response to estrogen stimulation. In a pre-menopausal woman, the endometrium thickens in response to rising estrogen levels during the menstrual cycle, then sheds at the times of menses. In a woman who is past menopause, the endometrial thickness does not vary much from month to month, since there is no longer a monthly cycle of rising and falling estrogen levels.

My OB told me that an "orphaned" uterus does not thicken.  Plus you will no longer be on Tamox (likely)....so that is also removed from the equation.

Because of Tamox I also had a thickened lining from my baseline before starting it, and she offered to D & C it, but I declined because I've read the lining will thin with time on its own. 

Guess what?

It's gone.  6-7 weeks out of Ooph and my thickened lining (not as thick as yours!) has "resolved."

She assured me 99% of uterine problems are from estrogen (including fibroids!) and once the source is removed, the uterus shrinks and goes "dormant."

I'm not sure what a separated uterus is...but I'd ask if it really matters once it shrinks....separated from what exactly?  I dunno about that....

Not seperated... septated.

A uterine septum is a form of a congenital malformation where the uterine cavity is partitioned by a longitudinal septum; the outside of the uterus has a normal typical shape. The wedge-like partition may involve only the superior part of the cavity resulting in an incomplete septum or a subseptate uterus, or less frequently the total length of the cavity (complete septum) and the cervix resulting in a double cervix. The septation may also continue caudally into the vagina resulting in a "double vagina". 

And thank you for sharing that SelenaWolf... That is in line with some reading I had done.

Oh ouch! I had an anotomically great one that was prone to craptacular cell growth for the cervix... *sigh* Followed by the Texas Chainsaw Massacre look alike contest... I was and am glad mine is gone. ;-)

I am glad they got the biopsy... that sounds awful painful... Trust me. They don't give you anything or tell you to take anything unless you get your hands ona  nurse. The Dr's forget.

Shell

Wow Nora....that's some mighty strong estrogen!  lol

Removing the ovaries will stop the thickening.  I'm in the school of thought that if it ain't broke, don't remove it! 

Good luck with your decision!