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To Keep Ovaries or Not to Keep Ovaries? To Keep Ovaries or Not to Keep Ovaries?

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  #1  
Unread 12-13-2005, 03:05 PM
To Keep Ovaries or Not to Keep Ovaries?

I just found out, this morning, that I have to have a hysterectomy (for fibroids in my uterus). My doctor is giving me the option to keep my ovaries or remove them. The sonogram this morning showed the ovaries to be normal and healthy. I am 45 and have 3 children. My doc says it's up to me, but I don't have a clue how to make such a decision! Any advice?
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  #2  
Unread 12-13-2005, 03:57 PM
To Keep Ovaries or Not to Keep Ovaries?

I recommend the old adage: If it ain't broke, don't try to fix it.

If your ovaries are healthy and you are at an "average" risk for ovarian cancer there are those in the medical community that are saying you are statistically better off keeping them.

Some articles to help you understand the major issues involved.

1. The Rational for Ovarian Conservation by Donna Shoupe MD

2.Ovarian Conservation at the Time of Hysterectomy for Benign Disease

The following study is a summary of the above article.
It is from an article in the Harvard Women's Health Watch titled "Study questions ovary removal during hysterectomy." The article cites a study in Obstetrics and Gynecology Aug. 2005 which evaluates the risks and benefits of oophorectomy before the age of 65 among women at an average risk for ovarian cancer. The study uses long term data from various long term studies. Conclusions are: removing the ovaries increased the likelihood of heart disease and hip fractures and is associated with a 9% increased likelihood of dying before the age of 80. Taking ERT lowered the risks a bit but not as much as hysterectomy alone-with or without ERT. 9% is higher than the likelihood of getting ovarian cancer in one's lifetime!

3. Hormone Levels in Older Women after Hysterectomy, BSO, The Rancho Bernardo Studies

4. Drinking Tea

At the young age of 45 you are still around 6 years from a natural menopause. Natural menopause is a slow process. Surgical is abrupt. Look at the No hormones and Hormones forum as well as the Sexual Dysfuction to see some of the issues that women contend with. This is not intended to scare you but to acquaint you with real issues being dealt with by real women.

I personally think it is very poor patient teaching and informed consent that doctors who are aware of the major issues involved tell women that the decision is theirs and then do such a poor job informing women as to the consequences of the decision. At the age of 45 if you have your ovaries removed you will be faced with the sudden decision of weather or not to use hormone replacement to manage your more severe and sudden onset menopausal symptoms. Some women will find the replacement easy and are happy with it. Others say they never feel the same. There is no way to tell which camp you will be in prior to having your ovaries removed. This may be a calculated risk when disease is present--But why take this chance when nothing is wrong? Also, common complaint is brain fog after a BSO. This is a completely unacceptable risk of elective surgery!!! I am frequently shocked at the number of women who have this complaint and seem to laugh it off. Depression seems to be another common complaint. Is this an acceptable risk?? There are multiple studies that show an increased risk for osteoporosis and cardiovascular disease. Our risks are high enough without doing something to add to them.

Good luck on your quest for helpful information.
  #3  
Unread 12-13-2005, 04:43 PM
To Keep Ovaries or Not to Keep Ovaries?

Hi KimberlyK and

We're happy you joined the Hystersisters community! There's a ton of solid information on the site, and the members have unlimited hugs to dispense at all stages of your journey to good health!

I've heard it said here on the Hystersisters site that the concept of prophylactic oophorectomy (removing healthy ovaries to prevent ovarian cancer and other ovary disease) is outdated. I can't say if that's true or not, but I will say that even when it wasn't considered by some doctors to be outdated, I've read on various OB/GYN websites that age 45 was the recommended cut-off age where most doctors wouldn't remove them if a woman was younger than 45. So, at your age, you really are "on the cusp" whether you believe the old school or the new school of thought.

Hystersisters.com recommends keeping healthy organs, as explained in this short article from the Pre-Op Articles archive:

Keep Ovaries

I hope you make the decision that winds up being the best one for you!

Many s and Best Wishes,
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  #4  
Unread 12-13-2005, 06:41 PM
To Keep Ovaries or Not to Keep Ovaries?

If your ovaries are healthy, by all means keep them!!!! If you end up having more problems down the line that involve your ovaries, the operation to remove one or both of them is much easier than a full hysterectomy.

Surgical menopause is very sudden and can be quite a shock to your body, no matter what your age. There are a lot of posters in the hormone jungle who had their ovaries removed while in their 50's or 60's (already in menopause) and they still struggle with issues of hot flashes, mood swings, joint pain and body aches, headaches, fatigue, brain fog, vaginal atrophy, etc...Even when you enter menopause naturally your ovaries still produce a small amount of hormones. When they are removed, there is an even greater loss of hormones. And like the above posters said, your risks of cardiovascular disease and oseoporosis increases two fold. I personally wanted to preserve at least one ovary but my gyn took them both due to endometriosis on them. Still I am regreting this terribly. I would almost rather live with pain than deal with this surgical menopause! At least then I could take pain killers that helped some. Now I am struggling with HRT that doesn't seem to help no matter what the dose or what kind I have tried. And I can not undue what has been done.

I realize my opinion is biased because I am struggling so much, but I just think doctors are too quick to take away our reproductive organs without considering the long term effects. You are smart to get as many opinions as possible and do your research. Good for you! My hysterectomy was only two weeks after the subject was brought up and that is my worst regret, not taking the time to understand my body, my illness, and what the consequences would be after this surgery. I wish you the best whatever you decide!
  #5  
Unread 12-13-2005, 08:43 PM
To Keep Ovaries or Not to Keep Ovaries?

Well, here's what happened to me, for what it's worth: I was 44 when I had hysterectomy recommended to me for fibroids, hyperplasia, and an enlarged and boggy uterus.

I said I wanted to keep my ovaries if I could. Doc said at my age (I was 44) that I had at least 10 solid years of good estrogen production ahead of me and that there would be no problem keeping them if they were healthy. They were healthy, and the ovaries stayed. So far, everything's working OK.

Even if you keep your ovaries, there is a chance that they will "go to sleep" after your surgery, although they will likely "wake up" again. Also, it's possible that one or both ovaries will fail after surgery.

I guess what really clued me into the fact that I had made the right decision for me (which is what this is all about, after all) was that my roommate in the castle was a woman who had her hysterectomy when she was about 40, but was just having her ovaries removed at the age of 74. Those ovaries served her well for over three decades after her surgery.

Only you and your doctor can make this decision together. We're here no matter what you decide.
  #6  
Unread 12-13-2005, 09:15 PM
To Keep Ovaries or Not to Keep Ovaries?

I had my TAH, kept ovaries, 6 years ago at age 44. The reason for my TAH was an enlarged uterus, mulitple fibroids and heavy bleeding. I am now 50 and my ovaries seem to still be working. My doctor wouldn't remove any healthy parts she said. While some women say they feel better on HRT, please consider keeping your natural parts. -Melanie
  #7  
Unread 12-13-2005, 09:38 PM
To Keep Ovaries or Not to Keep Ovaries?

Kimberly,
I kept one overy and I am glad. I wouldnt want to go thru menopause at 40! I hear it stinks!
  #8  
Unread 12-13-2005, 10:32 PM
To Keep Ovaries or Not to Keep Ovaries?

It took me well over 2 months to come to a decision I was comfortable with. I told the doctor to keep the ovaries if they were healthy. I read lots of posts and articles. The ovaries are not just an egg producer, but they aid in heart disease prevention and ostepreosis.

Turned out, my ovaries were healthy and I got to keep both of them. There was a cyst on my right ovary that was removed.

I had to use prometrium (PMS in a bottle)for 10 days prior to surgery. If that was any indication as to what HRT was like, I didn't want any part of it.

So are, I'm glad that I was able to keep my ovaries.
  #9  
Unread 12-14-2005, 07:18 AM
Thank You to All of You !

Thanks so much for ALL of your posts and information links! I had NO idea that the ovaries played such an important role in our bodies! I have read & printed out most all of the articles that you all have shared with me here. At this point, it seems pretty obvious to me that the best choice is to keep the ovaries, if possible! Thanks again!!
  #10  
Unread 12-15-2005, 12:03 PM
To Keep Ovaries or Not to Keep Ovaries?

Kimberly K,

I am 49, and had a TAH December 7, 2005 for the same reason you are having yours. I also had the option of keeping or having my doc take my ovaries. He tried his best to talk me into having him take them... because I am so close to the average age most women start menopause anyway (51-52). He assured me that he would put me on estrogen, and most women are fine. Another argument was that by taking them I would never have to worry about ovarian cancer, and with no technology available to diagnose it... he wanted to remove them. I have no risk factors for ovarian cancer, so that puts my risk of getting it at less than 1%. I opted to keep my ovaries, even though he tried his best to talk me into letting him take them (of course he would have taken them if they had not been healthy).

I am a little over a week post-op, and feeling great. I am very happy with my decision to keep them. All the women I know who have had a hysterectomy kept their ovaries if they could, and were happy with the result.

From the research I read, after a hysterectomy the ovaries can quit working as well... but that's OK with me. What ever hormones they are able to produce for me, I'll take. I'll go through menopause when my body is ready.

Hope this helps! Good luck with your decision. You will make the right one for you.

Lena23

  Quote:
Originally Posted by KimberlyK.
I just found out, this morning, that I have to have a hysterectomy (for fibroids in my uterus). My doctor is giving me the option to keep my ovaries or remove them. The sonogram this morning showed the ovaries to be normal and healthy. I am 45 and have 3 children. My doc says it's up to me, but I don't have a clue how to make such a decision! Any advice?
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