I am surprised to see few comments. I was advised to have a hysterectomy at age 64 for cancer prevention because I was told that my condition of endometrial hyperplasia doubled my risk of cancer. This is a scary assertion. But I did some research and the normal lifetime risk of endometrial cancer is 4% . Another writer here said 3%. I demurred because I think that a more than 90% probability of not getting cancer is high enough for my comfort level.
The hyperplasia was controlled with a D and C and then a lifetime prescription for progesterone. I am very glad not to have had what felt to me to be a distressing, life changing alteration in my bodily integrity and my sexual functioning.
And I had had all of my children 30 years prior.
I have since learned that there is a connection between hysterectomies and cardiac disease in older women.
It isn't just about mental health. My uterine fibroids were discovered when I was in my 40's. Since I had no symptoms (no pain or bleeding) my doctor advised that I wait as menopause would probably shrink the fibroids. After he retired my new Gynecologist strongly advised that I have a complete hysterectomy. I went to another doctor for a second opinion and was given the same advice because "you might need one later." Glad I didn't listen. I'm now 70 and have had no difficulties. Physicians are way to quick to push this procedure.
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@Kathleen Kourian Agree!
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My hysterectomy three years ago due to severe endometriosis (which had kept me from ever bearing a child) indeed sent me into a depressive tailspin. I’m doing better now, but still wonder if the depression resulted from the sudden hormonal changes, or of the finality of knowing I would never be able to give birth. Maybe both.
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It is particularly troubling that 45% of U.S. women end up having a hysterectomy despite the fact that less than 8% are done for a cancer diagnosis. And the oophorectomy (castration) rate is 73% of the hysterectomy rate. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804006/
Since the uterus and ovaries have lifelong functions, many studies have shown that female organ removal does more harm than good.
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Isn’t one of the great benefits of a hysterectomy that you no longer have to worry about uterine and cervical cancer? Those were benefits that helped me make the choice to have a hysterectomy for fibroids when I was 47. I’d rather deal with depression than cancer. Prozac has kept me feeling good.
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@Teresa Uterine and cervical cancers are rare. Endometrial has a less than 3% lifetime risk and cervical less than 1% lifetime risk. Hysterectomy does more harm than good when done for benign conditions because of the anatomical changes, sexual dysfunction and increased risk of heart disease (#1 killer of women) and metabolic morbidity.
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I had an open myomectomy at age 50 after years of suffering with fibroids. I did not want a hysterectomy. I did not have cancer so I had my uterus repaired, not removed. There is little research on the long term impact of uterine organ removal on women’s health. Hysterectomy can lead to other problems.
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Hysterectomy for benign fibroids is completely unnecessary. I have been performing Uterine Fibroid Embolization (UFE) for almost 25 years, yet most women never hear of this outstanding, life changing procedure. It's outpatient and nonsurgical and not performed by Gynecologists, but rather a different specialty doctor (Interventional Radiologist). Our patients go home on the same day as the UFE procedure with just a bandaid AND importantly their uterus. It treats all of the fibroids and is covered by all insurances. This article is just one of many reasons why women need to keep their uterus. There are other consequences for women that lose their uterus for benign fibroids: sexual dysfunction, psychological issues, urinary leaking, even increased cardiovascular disease. Learn more about UFE and fibroids at ATLii.com. Women are entitled to know all of their options for fibroids, not just the surgical ones. John Lipman, MD, FSIR Founder & Medical Director Atlanta Fibroid Center
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Thank you! I had an open myomectomy at age 50 and had 24 fibroids removed. I saw no benefit to having a hysterectomy. I My doctor was Dr. SHIRA VARON at UCSD.
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@John C. Lipman, MD, FSIR I was told that UFE was not an option based upon previous myomectomy, c-sections, tummy tuck, hence the fear of scar tissue impeding that process. So I had a partial hysterectomy, cervix left. What are your thoughts on this?
I was terrified of surgery but after years of fibroids and heavy bleeding, I realized I really had no other options. Having a hysterectomy at age 50 was the best decision I ever made. I remember the first time, post-surgery, I walked past the tampon/sanitary pads and felt a surge of joy that I didn't have to stand there for half an hour trying decide which sizes of everything I needed.
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There are many other options for fibroid treatment other than complete removal in an organ. It’s unfortunate you did not have a more skillful surgeon available to treat you
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@Jackie
When I was having my hysterectomy, I was content. I have 3 beautiful children and with a history of fibroids that were reoccurring and causing heavy bleeding, @ 52 yo, I was okay with this choice AND I trust my Gynecologist who delivered two of my children, and performed the myomectomy in 2000.
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Years ago, My sister had a hysterectomy, and she took antidepressants for about 2 years as part of her treatment. She is doing well now. One of my best friends refuses to have ANY surgical procedure that may help her with her fibroids. And I have seen how she can't have a life because she can start bleeding, she's in pain or she's too weak. I have not been able to convince her, surgery is a powerful choice that could bring her strength, energy back. Congratulations to all the women out there who decided to have the procedure and live life.
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@Ying Yang Until you have the surgery and realize how very limited and exhausted your life had become, it's not imaginable. I hope your friend gets some help.
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I had a very successful open myomectomy at age 50 after i exhausted all other options and suffered for years with the fibroids. I am so grateful I preserved my uterus and did not have a hysterectomy
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@Skoosh Kudos! You never need a hysterectomy for fibroids unless you have the wrong doctor.
Hysterectomy is removal of the female sex organs. Watch the Female Anatomy: the life long functions of the female organs at hersfoundation.org.
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Having had a hysterectomy at 35 because of extensive endometriosis, I can say it was the best move I made medically. I had three kids by then, so fertility wasn't an issue. But being rid of the debilitating periods that took over my life was an amazing relief and I felt better than I had in years. I don't minimize the fact that I've been using bioidentical estrogen for over 30 years, but the relief I felt was beyond any anxiety I felt over the years. I will say if I stop using the estrogen patches, I feel a bit of the "blue dog" biting my bum.
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I had a laparoscopic hysterectomy when I was 35 because of an extremely large fibroid, keeping my ovaries. It was the best decision I ever made. I finally felt like I had control over my own body. I had been asking to have my tubes tied since I was 23 because I did not want any children and all I kept hearing from various doctors was that one day I would want children. Nope. I married at 27 and my husband and I decide prior to marriage that there would be no children. No regrets and I am 48.
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I'm a physician who trained with the assumption that hysterectomy was the only option for large fibroids. However, in the past five or so years, my outlook has changed as my patients' demands and society as a whole has changed. We now perform primarily minimally invasive outpatient fibroid procedures on patients to shrink fibroids (radiofrequency ablation) as opposed to total hysterectomies. My patients have never been happier, and often seek me out because I don't assume everyone needs a hysterectomy simply because they have fibroids.
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@DrNick Some women have very few options. I had pedunculated fibroids, which made me a bad candidate for other procedures. I tried everything, including continuous hormones, which helped for about a minute.
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Surgery is a big deal, recovery takes months and, depending on the reason for surgery, anxiety lasts a long time. Why not?
Contemplating mortality is a big deal.
Just the other day, I was thinking: My parents are dead, best friends have died, and even Dvorak and Brahms are dead. My favorite authors are long dead. Bette Davis is dead. Who am I to live forever?
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This is neither new nor surprising. It became a major issue for women in the 1970s, for feminists - and for all women concerned about paternalistic health care.
The number of hysterectomies had increased, without medical justification. Depression was a reported symptom of some women. One source of information from the 1980 National Women's Health Network guide #2, Hysterectomy, is available at http://bcrw.barnard.edu/archive/sexualhealth/Hysterectomy-Guide2.pdf. Quoting from this source:
A prevailing notion at them time among ob/gyns: 'Dr. R.C. Wright, writing in Obstetrics and Gynecology, the journal of the American College of Obstetrics and Gynecology, in 1969 promoted what have come to be called "birthday hysterectomies": "The uterus has but one function: reproduction. After the last planned pregnancy the uterus becomes a useless, symptom-producing, potentially cancer bearing organ and therefore should be removed.'
Regarding depression, the guide notes: " A 1973 English study, for example, found that one-third of the women within three years of undergoing surgery were treated for depression."
Among friends and relatives who have needed hysterectomies, their doctors have been exceedingly conservative in the right way -reluctant to perform surgery unless it is necessary, and will contribute to health. But even when needed, where the woman has made an informed decision, it is a major alteration of the body, and a loss to those who were stopped from bearing children.
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@cheryl Unfortunately, nothing's changed. The gyn specialty still views the uterus as disposable after childbearing. Why else would Graduate Medical Education mandate that each resident do 85 hysterectomies (recently increased from 70) and 0 myomectomies (removal of fibroids that preserves the uterus and its lifelong functions)? And they continue to remove ovaries / female gonads (castrate) women during over half of hysterectomies and also as separate surgeries. The ovary removal rate is 73% of the hysterectomy rate. Surgeons would NEVER consider removing a man's gonads (testicles) for any reason other than cancer.
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This is a no-brainer. If you have cancer, remove the cancer. But my generation (I'm 62) knows women who used hysterectomy as a form of contraception, or were deluded into believing fibroids were a reason for losing your uterus.
http://www.thecriticalmom.blogspot.com
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It may be the case that the reason for the diseased uterus was an imbalance of ovarian hormones. Removing the uterus doesn’t fix that, so a woman is left with terrible PMS or other problems.
I never read about studies to determine what “normal” hormone levels are for women. Why do some women “naturally” have very heavy periods and others not? What is the source of disabling PMS? With better understanding of the joint roles of the uterus and ovaries, some of these women might have benefitted from ovary removal as well followed by hormone therapy.
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Four to 6 percent is a fairly small percentage. I suspect that, like me, a large number were darn happy about it
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Some notes about possible causation would be welcome here. Does the uterus supply hormones or precursors to neurotransmitters that affect mood? Are there other explanations?
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I had a hysterectomy at 19 and I’m happy because I never wanted kids.
I think there’s a risk of post-op depression and anxiety with any surgery, but it makes sense that those feelings would be amplified if the surgery takes away something you had wanted, like the ability to have children.
If you have certain conditions that require getting a hysto, then you probably couldn’t have kids anyway- but the hysterectomy makes that feel a lot more “real”.
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I had mine at 23 I'd say I was relieved (not happy) but I was still scared, depressed, became repressed/shy. But still relieved.
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