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Hysterectomy: Pros? Cons?

Cervical Cancer research and treatment discussions

Hysterectomy: Pros? Cons?

Postby lee » Fri Aug 12, 2011 3:57 pm

I've been threatening to look into getting a hysterectomy for a while now, and I've finally done it. I'm only twenty, don't have cancer, am not transgendered, and don't really have any necessary medical reasons for getting one. I have found a doctor who will make it "medically necessary" for me to have one, thus ensuring that it's covered by medical somehow, but I'm terrified of doctors and would rather get as much information as I can before having to go see him.

My reasons for getting one would be that: I don't ever want children, menstruation in itself thoroughly grosses me out, I have very painful periods and being out of commission for at least one day a month because I can't move is extremely detrimental to my productivity (I'm a student, a writer, and live a very fast-paced lifestyle in which I have to pack a lot into one day), and I have severe anxieties which keep me from going in to get pelvic exams, even though I should have been having them for a few years now.

There are some things I understand from my own research, the different possible surgeries and such. What I don't understand are the pros and cons involved with the removal of the cervix. My understanding is that, if left in, there is still a significantly lowered possibility of getting cervical cancer, and outside of that there isn't much that it changes. As well, I've read that a hysterectomy involves the removal of some of the vaginal tissue, thus shortening the vagina. If the cervix is left in, does this negate the removal of said tissue? Or do they just disconnect the cervix, remove tissue, and reconnect it? That seems a bit redundant to me, but I couldn't find any answers to that.

Also, as far as removal of the ovaries goes, I understand that it's not recommended unless necessary; and I don't really feel like taking hormones for the rest of my life so I'd rather leave them if they're still going to function in that regard - the side effects involved with their removal don't seem very happy. As far as just a uteral removal goes, though, would the hormone balance be at all affected? Would I still get hot flashes, or is that connected to the ovaries? I don't really understand how this part works.
I guess what I really want to know, if someone can tell me, is what side-effects I'd be facing, just having the uterus removed; and whether or not I should deal with the cervix.
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Hysterectomy: Pros? Cons?

Postby armon » Fri Aug 12, 2011 3:58 pm

This is an horrifically bad idea. The reason it's so hard to find a doctor who will remove the healthy uterus of a 20 year old is that it's such a bad idea. That means that most docs who would do such a surgery aren't very good ones.

Other reasons why this is bad: you think you're solving a problem by getting your uterus removed, but what you're doing is giving yourself some new, possibly worse, problems. For example, the cervix and uterus play a role in sexual pleasure and orgasm. Remove them, and you may be causing yourself to have problems reaching orgasm, or making your orgasms less intense. The uterus also is attached to a lot of internal muscles, meaning that after you get it removed you might have some problems with abdominal strength and with incontinence. Maybe you won't have those problems--no way to know until after surgery, and at that point it's too late, you can't go back.

If you were to get your ovaries removed, you'd sign yourself up for a shortened lifespan. Women who have had their ovaries removed before age 40 have an average of 8 years shorter lifespan, according to the Harvard Nurse's Study, and also experienced increased mortality and increased problems like osteoporosis and Parkinson's. Yes, you can take hormones to help to combat that, but you have a naive attitude about hormones--they're not as good as the real thing, and it can take months or years to get them as you'd like, if that is possible--I know young women who have gone through surgical menopause who never have been able to get their hormones right, which affects their quality of life, 24/7/365. If you leave your ovaries in but get your uterus removed, then some women go into menopause only shortly after the hysterectomy. Then yes, you'd have hot flashes, night sweats, and, here's the really bad thing they just don't tell you about but that has been well-documented: your VERBAL MEMORY is negatively affected. That is, estrogen, made by the ovaries, is very important as a neurotransmitter in your brain. It helps your language abilities. If your ovaries are affected by the surgery, then you will have problems with language--something that should terrify anyone wanting to be a writer. I say this from personal experience. I went through surgical menopause at a young age, and the immediate effect on my language skills was very obvious to me. They'll often say to women that it's just because they're getting older. But I was young, so such an explanation doesn't work. When I say problems with language, I don't mean you won't be able to speak or something like that. Rather, the sharpness of your verbal abilities may end up blunted. It's not something that would necessarily bother your average woman. But for a writer, you need to keep your rapier wit at its sharpest. You don't want to sit there puzzled, unable to think of a word. Before surgery, having a word on the tip of your tongue is an uncommon occurrence. Post surgery, it will be common.

Also, some who get a hysterectomy but keep ovaries may have a period for a few years then the ovaries conk out and they have menopause, while others will just go through menopause a few years early. I'd be fearful of the quality of the surgeon, who would remove a 20 year old's healthy uterus, so in that case you are up for more complications, potentially. Surgery is not a magic cure-all, which is why responsible docs look at it as a last resort rather than as a way to work around anxiety issues and deal with menstrual pain that could be dealt with in far less invasive ways, such as via continuous birth control to stop periods plus anti-anxiety meds, which are reversible and not dangerous, unlike major surgery. It's also fraud for a doc to claim something is necessary when it's not. So it might not be a good sign of their integrity that they'd be willing to do that.

When you have a hysterectomy, there's no reason to remove your cervix, really. If they leave the cervix in, then no, your vagina will not be shortened. They wouldn't do the thing you describe--shorten the vagina then reconnect the cervix. Cervical cancer is mostly caused by HPV, so if you've had the Gardasil shot, then that will for the most part protect you. But if your ovaries conk out as described above, then if you have a cervix, you'll need to take progesterone pills in addition to estrogen. If no cervix, then you only have to take estrogen--an important issue as exogenous progesterone potentially comes with a lot of nasty side effects.

Anyway, please think about what I've said here. Check out the website www.hystersisters.com, a website devoted to support and info for women who have had hysterectomies, because there are so many complications and problems that an entire website is needed to deal with it. You owe it to yourself and your health to try some other methods of dealing with your problems than surgery to remove body parts.
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Hysterectomy: Pros? Cons?

Postby berthold100 » Fri Aug 12, 2011 4:02 pm

Pros: Never having periods. Reduced risk of some types of cancers, like uterine and cervical.

Cons: The surgery itself is VERY painful, and requires weeks of rest afterwards. You still should have a yearly pelvic exam, even if your cervix is removed, including a yearly pap smear.

I had my cervix removed, and I don't notice a significant difference in the "length" of the vaginal opening. In fact, I find sex to be more enjoyable, because my husband doesn't hit my cervix when he has intercourse with me. My doctor recommended that I have my cervix removed to remove all possibility of getting cervical cancer, and I'm glad that I followed his recommendation. My doctor sewed the end of the vaginal opening shut after removing my cervix.

As far as the ovaries go, I had to have mine removed, because they were producing large cysts each month. When your ovary produces an egg, a cyst forms around it, which then ruptures and releases the egg. The source of my pain was that the cyst forming around it was extremely large, and the only way to get rid of the pain I was experiencing with my menstrual cycle was to remove the ovaries. Unfortunately, I had my hysterectomy at 30, and am now, at only age 40, suffering from osteopenia, because of the hormonal imbalance created by losing my ovaries.

I guess what I'm saying is, keeping your ovaries my mean that you experience problems even after having a hysterectomy, and having them removed may mean that you develop osteopenia or osteoporosis at a very young age.

I would not recommend getting a hysterectomy to anyone. I wish I could have solved my female problems another way. They found out, when they went to do my hysterectomy, that I had fibroids, and I wish I had tried a fibroid removal prior to the hysterectomy, to see if that cured my issue.
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Hysterectomy: Pros? Cons?

Postby graent » Fri Aug 12, 2011 4:10 pm

Much of your information sounds incorrect. At your age without any health concerns, if this is something you are sure about, you would just want to have your uterus removed and the cervix comes with it. As long as your ovaries are left in tact, and they absolutely should be left alone, your hormone levels will be normal. Your body will go through an adjustment period due to the cessation of your cycle, but your body will continue to make the necessary hormones. Eventually, you will go through menopause and there is no way to predict your symptoms. Some women have minimal symptoms and others are more severe, but you won't know until menopause age. Other than losing the ability to have children, there are no real side effects. You could achieve sterilization with a tubal ligation, but you would, of course, continue to have your monthly cycle. The tubal could be reversed at a later time. Removing your uterus is a permanent solution. There is no great change to the vaginal canal and vaginal tissue.
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