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[Micky]

 I am awaiting an apt to have my ovaries removed due to cysts & at age 52 they are pretty much redundant now anyway...In the meantime my the Gynaecologist said it was my decision if I opted for a hysterectomy also ...Part of me just thinks just get rid of it all, so that I can dispense with any potential future worry/probs etc ..But part of me thinks is it really necessary to go the whole hog ( as it were) - aside from some recent brown discharge, my periods have pretty much stopped...I was never able to conceive and have children, so psychologically I had to come to terms with/accept that years ago - so I don't think I will have any issue on an mental level...I am just unsure as I don't want to totally lose my sex drive & have read that having the works may affect all this - and I am don't want to go on Hrt .....Can any ladies here that have had a hysterectomy or are thinking of it - help..
Thank you

[Joyce]

I had hysterectomy over 20 years ago in my mid 30s. 10 years later I started having ovarian problems in my left ovary. Pain constantly. So went in to get it removed, however night before op surgeon explained, with my history,  that my right one be removed also as I was likely to develop same problems with it. So I did. My left ovary was tied up with adhesions, so was quite glad I'd saved myself further problems.

I know its not quite the same, but would suggest you ask your consultant to explain his reasoning.

[Dancinggirl]

Hi Micky
Why are you against HRT?
I haven't had a hysterectomy so can't speak from experience but loss of libido tends to come with the loss of oestrogen(& testosterone) at menopause anyway.  I believe the ovaries will still produce some oestrogen even after menopause and the oestrogen level drops gradually over about 2 years after your last period. I think it's the loss of the ovaries not the uterus that has an effect on the libido - I hope ladies who have had a hysterectomy will be along soon to advice about this. You may find your hormone levels drop quite quickly after your operation and so this could effect your sex drive. Many women who have a hysterectomy opt to keep their ovaries to help maintain their hormone levels for as long as possible.
I believe there is a slightly higher risk of a bladder prolapse in the future after a hysterectomy but as you haven't had a baby this may not apply to you - you should discuss this with your gynae. 
The plus of having the full hysterectomy would be that you could just use Oestrogen - you only need to use progesterone if you still have a uterus; progesterone is the part of HRT that can cause the problems. I believe studies have shown that using oestrogen after a hysterectomy can actually reduce the risk of breast cancer, so it has a protective effect.  Oestrogen will also protect your heart and bones. It's the combined HRT that contains oestrogen and progesterone that carries the slightly higher risk of breast cancer after the age of 60. You could consider using some oestrogen that could prevent vaginal atrophy & therefore maintain your vaginal area so this could help the sex life. In fact, if might be worth using some systemic oestrogen and some local oestrogen to help keep the 'lady bits' healthy - again ask your gynae about this. 
I know some women see a gynae privately to get some testosterone to help with libido - this won't be available on the NHS.
I had a premature menopause so had to use HRT for many years - I am now 58 and have been off HRT for a year - my vaginal atrophy is really causing problems and my libido has disappeared (poor hubby). I am seriously considering going back on HRT to help these meno problems but I'm dreading the progesterone part - if I was offered a hysterectomy, so I could just use oestrogen, I would jump at it. 
I do hope other ladies who have had hysterectomies will be along soon with their personal experiences.
Do try to discuss this with your gynae.  DG x

[Micky]

Dancing Girl

Thank you for your reply - I don't mind admitting that I am totally ignorant when it comes to the full implications, and for and against of hysterectomies and having ovaries removed etc ....For many years I had a degree of endometriosis & endured crippling periods for two days of every month - aside from ( the small area of endo shown on a laparoscopy) the specialist at the time said they couldn't find any other reason why I shouldn't be able to conceive and have children ...However I suffered with crippling period pain for two days of every month for years and the only advice was to go back on the pill ( which I didn't want to do as hoped to have kids) so I was prescribed pain relief...I never conceived and had one ivf treatment many years ago now & thankfully the period pain finally started to abate in my late forties ...Now I am having probs with ovarian cysts and some brown discharge and at times major anxiety .....Hence gynae suggested removal of both ovaries & uterus also if that's what I prefer ?? - In my ignorance I really have no idea what to do for the best - but at the very least feel I need to address the cyst issues and they are causing me discomfort, I am due to go back to the hospital for result of blood test, so hopefully I can gain a better understanding.. The Gynae that I saw on the NHS was male and maybe they are not so informative as a female gynae would be ....Its not of much relevance here, but have just gone thru an unexpected/unwanted ( on my part) divorce & therefore am alone with all this - emotionally I am not in the greatest place and now anx about all these meno /physical issues ....The reason I am reluctant to go on HRT is because I have read about increased risk of breast cancer, and I guess that causes me some anx too ..

[Dancinggirl]

Oh Micky - you are having a tough time.  We're here to listen and support you though this.
I suffered terrible period pain when I was young and the Pill was the only way I could have a  career - I really understand what you have been through.  Not being able to have kids must have been tough to come to terms with - it took me 18 months to get pregnant the first time and my period pains were much better after I had my daughter.  My period pains did return in my late 40s when I had increased my HRT dose - I don't know whether my periods pain, when young or later, were related to endometriosis.
I don't think seeing a male gynae makes much difference as we have heard some stories on MM about female doctors not being particularly sensitive or clued up.
Do read up all the info to the left of this page to get really clued up.
The slight increased risk of breast cancer when using HRT only really kicks in after the age of 60 so do keep an open mind about HRT. If you do have endometriosis and wish to try HRT, then many doctors like you to still use combined HRT after a full hysterectomy to prevent continuing problems. There are some really good HRT preparations/combinations out there now and it's usually about finding something that suit you.  Many women find HRT really helpful but you can consider that choice later after your operation.
Maybe you should do an email consultation with Dr. Currie - I've done this and she is really helpful. It costs £25 - I think details are on the home page.
You have a tough decision to make so the more info you can get the better. Sadly most doctors in the NHS have such tight schedules there isn't enough time to discuss things as we would like. Keep posting.  DG x

[Micky]

Dear Dancinggirl
Thank you once again for your kind and helpful reply..
Nothing and no one prepares us for all this - I seem to have become very health anxious & never sure whats normal and what isn't, and then mind goes into overdrive at every symptom ....Thank you re suggesting Dr Currie on this site - that may at least help me to understand better whats best and what is not for me..

Many thanks 

[tiger74]

Hi Micky,

I haven't had a hysterectomy and I don't take HRT so can't comment on those  aspects of your query. (I have had my ovaries and fallopian tubes removed laparoscopically and, for me, the procedure and recovery were an absolute piece of cake, so I hope that's also the case for you should you go this route).

Maybe I can help with a few general points about hospital consultations...
 
It sounds like you're due to go back for a hospital appointment fairly soon and that  you still have a lot of discuss with the specialist.  I always go armed with a list of questions and take someone with me who also has a copy of the same list of questions.  That way I can concentrate on asking the questions and asking follow-up questions depending on the answers, my companion can write down the answers and prompt me if I forget or miss anything.  On several occasions it has been very helpful to refer back to the written record later.  Would this strategy be worth considering?

I agree with Dancinggirl, I don't think the gender of the specialist makes any difference. OK, so men don't have ovaries or a womb or functioning breasts but I've seen male and female gynae specialists, male and female breast specialists - they're all different, some are more knowledgeable and have better communication skills than others.  It seems you felt that the gynae you saw was not as informative as you'd hoped?  Perhaps next time around, if you arm yourself with the information you're gleaning here (and elsewhere?) and some questions you may find that he is more forthcoming?  Alternatively, would you feel able to inform the hospital that you wish to see someone else? (You have the choice, something that patients often forget). 

Please don't be hurried at consultations.  I don't know what the nominal allocated time is for a specialist consultation at my local NHS trust and, frankly, I don't care.  I take as long as I need - sometimes this is a few minutes, sometimes it is much much longer.  I have NEVER experienced any problems with taking the time I need in a consultation and have found that most consultants react well to a well-informed, empowered, inquisitive patient. 

It sounds like you are gathering information to make a reasoned decision on the best way forward for you.  I wish you luck with this. 

[peegeetip]

Just to point out that more recent studies show that those taking Estrogen post hysterectomy have a reduced chance of getting breast cancer (not an increase!). 

Also I agree with Tiger, take as long as you like to decide.
One thing to remember is that there are many options in the surgery your considering.
Removal of ovaries is actually an oophorectomy.

But the hysterectomy can be more defined on what is removed.
It might be wise to review whether on not to keep your cervix with your doctor.

I'm sure I saw someone post that there is another site/forum for Hysterectomy too.

Hope all goes well with your decision.

 

[tiger74]

Just to point out that more recent studies show that those taking Estrogen post hysterectomy have a reduced chance of getting breast cancer (not an increase!). 

Thank you peegeetip.  I hadn't heard about these studies and would be interested in reading the research if you'd be so kind as to post the details.  It is a subject I'm interested in having had oestrogen positive breast cancer.
   

[peegeetip]

Hi Tiger

this estrogen only reduction was known about at the height of the HRT scares.
The information was not widely reported at the time as it did not make such good press imho.

More recent long term studies have shown similar results.

Here are some links that reported it more recently.

http://www.webmd.com/breast-cancer/news/20120306/estrogen-after-hysterectomy-lowers-cancer-risk

http://www.womens-health-concern.org/help/factsheets/fs_hrtrisksbenefits.html

search for in a surprising turnabout in the link as it mentions the danish study also.

The only thing to remember is a lot of doctors aren't aware of this study.
So if your looking to rush in and get this then be prepared for a possible Eye Rolling session from your doc

All the best and have a good weekend out there

 

[tiger74]

Thanks for the links peegeetip - I shall read them with interest.

I am however, not about to rush off to my doctor and ask for HRT as my breast cancer was quite strongly oestrogen-positive and high grade.  So, despite the effect of menopausal symptoms on my life, I see no logic in taking an aromatase inhibitor (which works by stopping the conversion of androgens into oestrogen, reducing the amount of oestrogen circulating in the body) plus being careful about avoiding phytoestrogens and then taking other medication which puts oestrogen into my body. 

I am, however, a member of a support group for people affected by breast cancer some of whom would consider HRT so any 'ammunition' is always useful to share. 

Hope you have good weekend too.  I'm just off to work but have the weekend off so am looking forward to spending time outdoors in some lovely autumnal weather (I love this time of year).