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I think taking your ovaries out is a good idea. Often ovaries become sporatic producers of hormones within a few months of a partial hysterectomy because some of their blood supply must be tied off when the uterus is removed. This can cause bad pms in some women due to unpredictably fluctuating hormone levels. It is the beginning of menopause and can happen even several years earlier than it would have if the surgery had not been necessary. I took mine out and haven’t looked back since. Best thing I ever did.

The above article arguing for leaving the ovaries is accurate except that there is no mention of replacing the estrogen and testosterone if the ovaries do come out. I disagree that ovaries mostly should be left intact for the reason the author stated because their function can simply be taken over by another source. It is vital to provide the hormones the ovaries were producing to remain “even” in mood and prevent heart and bone problems. I am surprised the article didn’t even give hormone replacement a nod. Shame on the author. There is a lot of scaremongering out there so all of us have to read intelligently and do what is best for our own bodies.

Drugs like Premarin have gotten a bad reputation and rightly so because they contain horse estrogen which is not native to the human body. Drugs like Vivelle Dot and Estrogel have been painted with the same negative brush and don’t deserve it. They are bio-idential and are created to exactly mimic the human form of estrogen. Not in the same league at all as the horse derived kind. I am on Vivelle Dot and love it. Some women have trouble with Vivelle’s delivery method and are on various other forms of bio-identical estrogen. Luckily there are several to choose from so you can experiment and find what works best for your body.

The endometiosis makes adding estrogen tricky. You may do ok without it, but if you find life becomes unbearable, you will need to explore your options. I have talked to many many women who just NEED estrogen for their brains and nervous systems to work right. Mood crashes are not healthy so if you start to have them, get some hormone replacement.

My doctor has written several books on women and hormones and I recommend checking them out if you find you need some help. She treats women with endometiosis and PCOS and she puts them on estrogen after hysterectomy. Her books are reasonably priced and available from amazon. Look up Dr. Elizabeth Vliet.

“If it’s not broken, don’t fix it!” Should the cervix be removed during hysterectomy?
Posted on 08/19/2009 by Andrew Brill M.D.

Since the cervix does not cause most gynecologic conditions leading to conventional or laparoscopic hysterectomy, a growing number of physicians now recommend that it can be spared. Possible advantages of cervical preservation include better sexuality, less uterine prolapse and urinary incontinence, and reduced surgical complications.

When both the cervix and fundus are removed, the operation is called a total hysterectomy. When the cervix is spared, it is called sub-total or supracervical hysterectomy. Removing the uterus through the vagina, called vaginal hysterectomy, does not provide the option for sparing the cervix.

So why do most gynecologists still routinely remove the entire uterus during hysterectomy? For these physicians, the decision to perform a total hysterectomy is commonly based on personal custom and their residency training. The recommendation that removing the cervix removes the risk of cervical cancer is outdated, as modern screening and treatment methods for HPV and abnormal Pap smears have evolved.

Several recent studies conducted here and abroad have shed some light on the role of the cervix after hysterectomy:

Comparing women after total or sub-total hysterectomy:

There is no difference in sexual arousal including orgasm

There is no difference in urinary complaints or incontinence

Some women continue to have spotting after sub-total hysterectomy

There is too little information to comment on complications

Follow-up is insufficient to comment on uterine prolapse

In my practice, hysterectomy is routinely performed as an outpatient using advanced laparoscopic techniques – without the use of a robot. Many of my patients undergo laparoscopic supracervical hysterectomy with preservation of both ovaries and tubes. This combination treats all benign uterine conditions while permitting the choice to retain what is normal and potentially vital for personal and physical well-being. Moreover, since the vagina is not opened during supracervical hysterectomy, return to normal sexual activity is very fast. And, I strongly believe that the potential complications associated with hysterectomy are significantly less when the cervix is not removed.

If you have been recommended to undergo a hysterectomy, make sure to discuss with your doctor the pros and cons about whether you can preserve your cervix!

Women Should Keep Their Ovaries at The Time of Hysterectomy!

Affecting more than 300,000 women annually, physicians commonly recommend removal of the ovaries along with hysterectomy for benign disease in order to decrease the risk of ovarian cancer. In a recently published study questioning the validity of this recommendation, William Parker MD and colleagues clearly demonstrated that women younger than 65 years of age clearly benefit from ovarian conservation, and at no age is there a clear benefit from removing the ovaries.

For women younger than 65 at the time of surgery, removing the ovaries increases the risk of dying from coronary heart disease. After age 65, increased mortality is primarily from hip fracture. Importantly, at no age is there higher mortality for those choosing to conserve their ovaries, because the risk of dying from ovarian cancer is overshadowed by the risks from cardiovascular disease and hip fracture. Removal of the ovaries increases the risk of cardiovascular disease, the major cause of death for women. In fact, it has been determined that removing the ovaries between ages 40 and 44 years doubles the risk of heart attack compared with women with intact ovaries. Moreover, removing the ovaries before menopause causes an immediate and significant loss of ovarian hormones. Still misunderstood, postmenopausal ovaries continue to make small amounts of estrogen for years as well as significant levels of androgens (male hormones) which are converted in the body to estrogen. Since estrogens and androgens inhibit bone resorption and androgens increase bone formation, women who are postmenopausal at the time of removing their ovaries have 54% more bone fractures from osteoporosis than women with intact ovaries. And, removal before menopause leads to the sudden onset of hot flushes and mood disturbances including a decline in a sense of wellbeing, higher brain function, sleep quality, mood, and sexual desire.

Bottom line – when facing the decision to undergo hysterectomy for a benign reason before age 65, engage your physician in active discussion to insure that your are able to keep your ovaries unless their removal is otherwise indicated by a particular condition.

For women undergoing hysterectomy for benign reasons, removal of the ovaries should not be performed under the age of 65.