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GYNECOLOGY 101: DOES A HYSTERECTOMY CAUSE YOU TO GO INTO MENOPAUSE?

by Ngozi Osuagwu, MD | August 14th, 2016

GYNECOLOGY 101: DOES A HYSTERECTOMY CAUSE YOU TO GO INTO MENOPAUSE?

The short answer is no. However, it seems that it is common for many people to think that it can.  It is removal of the ovaries that causes you to go into menopause.

A hysterectomy is removal of the uterus. A total hysterectomy is removal of the uterus including the mouth of the uterus (the cervix). A supracervical or subtotal hysterectomy is removal of the body of the uterus and not removing the cervix.

To go into menopause, you have to remove the ovaries, also known as an oophorectomy. The ovaries produce the hormone – estrogen among other hormones. When you have the ovaries removed before you reach the age of menopause, you will go into surgical menopause and will have all the symptoms that a woman who has gone through natural menopause will have.

Typically, when you decide to have a hysterectomy, your physician will talk to you about the other organs next to your uterus which include the tubes and the ovaries. We are now removing the tubes also called a salpingectomy because we are finding out that it may reduce the risk of getting ovarian cancer. The research has shown that the origin of some cancer of the ovaries may start at the fallopian tubes. The fallopian tubes serve no purpose once the uterus is removed.

The ovaries are a different story. The ovaries are important. The ovaries produce many hormones like estrogen, progesterone and testosterone. Yes, women do produce a little testosterone and that helps with our libido. By leaving the ovaries in place, we can decrease our risk of having menopausal symptoms like hot flushes, vaginal dryness, skin dryness, and urinary problems. The ovaries help with bone health and also help in decreasing the risk of heart disease.  The decision to leave the ovaries or take the ovaries out will depend on your age, your personal medical history and your family history of breast or ovarian cancer. Please know that if you decide not to take your ovaries out at the time of the hysterectomy,  you are at risk of ovarian cancer like all other women who still have their ovaries.

There are many ways a hysterectomy can be done. It can be done vaginally (taking out through your vagina without any scars on your abdomen) and abdominally. With abdominal hysterectomy, you can have it done with small incisions or cuts on your belly – laparoscopically or with a robot. You can also have a large cut on your abdomen to have the uterus removed. Your physician will discuss your options and help you make the best decision.

Deciding to get a hysterectomy is not easy and should be made with a full understanding of your risks and benefits. There are times when you may not have a choice, for example when you are having it done because of cancer or if you are bleeding excessively at the time of delivery and it is a life and death situation. Majority of the time, you do have a choice and you should be offered other options. If in doubt, you can get a second opinion. If you decided that a hysterectomy is your best option, then make sure it is your decision. Please know that once the uterus is removed, you will not be able to have children.

Take home message: Removing the uterus also known as a hysterectomy does not put you into menopause. Removal of the ovaries puts you into menopause. You can have a hysterectomy with or without removing the ovaries. If you choose to have a hysterectomy, get your tubes removed at the same time.

 

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The book discusses common gynecological and women’s health issues in a series of witty and entertaining letters. These letters, all educational, offer suggestions on what approaches to take in tackling the medical problems that typically bring women to an ob/gynecologist. The letters are spiced with art, a poem and quotes. Although its emphasis is on gynecology and women’s health, it touches on some other medical issues that make women visit their doctors.

The second half of the book briefly discusses the most common gynecological conditions and also provides an overview of sexually transmitted infections. A list of annotated websites dealing with the different topics in the book is provided for the reader who wants to pursue each subject in depth.




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