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Rethinking the ovaries Rethinking the ovaries

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  #1  
Unread 01-19-2012, 02:44 AM
Rethinking the ovaries

Here in Europe, when a woman around my age (48) has a hyst for any reason, Dr.s routinely remove the ovaries. I have questioned my Dr. about this and he said "You really don't need them...they've performed their duty and are not doing much for you at this point." I know that the thinking is MUCH different in the states, and I'm feeling very torn.

I like my ovaries. We've had an excellent relationship and they've never given me a problem. One of them (I'm not sure which) provided me with a truly awesome child and I'm very grateful. They continue to give me periods that I can set a clock to, which, despite being tired of that, is atleast nice that I know when to expect it. I have aged beautifully - no wrinkles, crows feet or sags yet. It seems harsh to just toss them.

On the other hand, Cancer in the family, and a lot of it. In spite of that genetic proclivity, there is no osteo, dementia, or heart disease; might genetics play a role in this as well? If I'm in otherwise good health and NOT predisposed to a lot of the "no ovary" concerns, might the estrogen do as good a job as the ovary did?

I've put in a call to my American GYN to talk to him, but wanted to get your take as well. I've got 20 days to fiigure this out.

Thanks!
--Fish
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  #2  
Unread 01-19-2012, 08:02 AM
Re: Rethinking the ovaries

I went back and forth with this as well. I am 50 and was menstruating very regularly. My surgery was due to multiple prolapse. I requested my surgeon take a look and if they looked healthy to leave them, and that is what happened. I still have my little girls in there doing the best job they can for me! Heart disease and osteoporosis runs in my family whereas there is really no record of any family members with cancer. I am comfortable with my decision and I guess can always get them out later if needed. I had headaches and night sweats for about 10 days post but that has resolved. I am now tracking my basal temp daily to try and see if I am ovulating. It will take a couple months to look for the pattern but I also did this to help timing when I was having a difficult time getting pregnant in my 20's. Good luck with your decision - there are arguments both ways!
  #3  
Unread 01-19-2012, 08:06 AM
Re: Rethinking the ovaries

I really don't know how much help I can be because I'm in a very different age catagory (only 31). I was supposed to have my ovaries removed for endometriosis but ended up going to a specialist who was able to keep them. It's obviously very important for me to keep them at my age to prevent cardiovascular and bone problems. That being said, I was told by a doctor here that, even after menopause, ovaries still produce a small amount of estrogen and serve other functions. That doctor told me that estrogen supplement can never match what the body would have done naturally and that he always saves healthy ovaries regardless of the age of the woman. I'll be interested to hear what the other ladies have to say. I don't know if that kind of thinking is the norm or not. Best wishes to you!
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  #4  
Unread 01-19-2012, 08:43 AM
Re: Rethinking the ovaries

Fish,

I'm sorry you need to make this decision. I decided, after going back and forth hundreds of times, to have my healthy ovaries removed. I was 55 at the time but still struggled with it.

Today, four years later, I'm glad I did because I feel much better on the 'fake' hormones I take than I did for many years on what my ovaries gave me.

That said, I know I need estrogen to be healthy. My body has made that very clear to me. I take estrogen replacement and plan to continue for a long time. Older ovaries don't stop
making hormones after menopause, they just slow down. They continue making small amounts of hormones your body needs.

You mention cancer in your family. What type of cancer. Estrogen can be beneficial in some types of cancer and has not been proven to cause breast cancer. It isn't necessarily all good, you need to talk to your doc. If he just wants to remove your ovaries because of your age, talking to other docs about it is a good idea.


There are good reasons to remove ovaries, age isn't necessarily one of them.
HRT can be very difficult to get right, it can be expensive and some women don't do well with it.

I didn't like my ovaries, they gave me PMS, headaches, bloating...I could go on and on. If you and yours get along well, consider keeping them.


and
  #5  
Unread 01-19-2012, 08:50 AM
Re: Rethinking the ovaries

thanks ladies!

I've been in peri for an EXHAUSTING six years with no real end in sight, so I have to admit that, in addition to getting rid of the cancer in my cervix, a jump-start into menopause would be a total relief. I have horrible, debilitating symptoms - not only night sweats and hot flashes (omg, the hot flashes), but also migraines, fainting spells and a complete lack of energy because I'm getting so little sleep. SO NOT ME!! I used to be a very energetic person with tons of stamina and I hate this whiney, blob-person I've become. This is a big plus on the "take them out" side for me.
  #6  
Unread 01-19-2012, 09:00 AM
Re: Rethinking the ovaries

I struggled with this question/decision also. I'm 5 weeks post op tomorrow. I decided in the pre-surgery holding area two things: he can take my cervix ( prev told him I MUST keep it, though once he got in there it had to be removed anyway as it was a mess) but I insisted he leave it until this point in pre-op. #2: I also insisted to him I keep my right ovary (left was all my troubles) but I told him now also to go ahead and take it all, as I realized waiting to get wheeled in that I NEVER wanted to go through anymore surgeries for any of this again-that is what changed my mind and I have no regrets and I am so happy with my decision-if I knew there was 1% chance I would ever need another proceedure I'd be so sad/depressed/worried forever, now I know I am REALLY done for good with these surgeries. (I had many, many laproscopic surgeries to clean up endo, scar tissues, etc. before hysterectomy so I am just done with anymore)

Good luck, pray on it and decide what you feel is best for you-no one knows but you what is the right thing to do.
  #7  
Unread 01-19-2012, 09:23 AM
Re: Rethinking the ovaries

This is something I too have to consider. My gyn said he has to do an abdominal hysterectomy as my ?fibroid is so big. Hw also mentioned removing the ovaries, but will discuss with me. He said they are 'coming to the end of their use'. I have terrible night sweats, that I hate, and hot flashes that are constant. I'm interested to hear though, what benefits, if any, there would be to me not having them removed. He said I will have to have estrogen anyway.
  #8  
Unread 01-19-2012, 11:57 AM
Re: Rethinking the ovaries

Ok - well, that settles it for me, I guess.

Just had a great, long email from Dr. in the states and he feels that with the extensive family history of cancer (esp. uterine and colon), and considering my age and that ovarian cancer is so hard to detect early, that he would probably take out the ovaries if he were doing the surgery.

I'm glad I asked. I feel like I can move ahead with the original plan and rest easy that all will be well, that I will live a happy, hormonally balanced life with HRT, better diet and regular exercise.


--Fish
  #9  
Unread 01-19-2012, 12:14 PM
Re: Rethinking the ovaries

I think there are always benefits to keeping them provided they are not diseased nor a source of your problems.

Having said that, I unexpectedly had to have my one remaining ovary removed due to complications with my TAH. I was not happy about it (due to a family history of early heart disease) and decided to really, really understand what it means to have no ovaries.

To that end, I have read every medical study and journal I could get my hands on in the last two weeks. I will pass on what I have learned in hopes that it adds to others knowledge base when making their own decisions:

1) If you have your ovaries removed before the age of 45-50 and you don't use estrogen replacement until at least the age of natural menopause (average age 51) you are at higher risk for heart disease and other issues.

2) If you use estrogen replacement, your risks are the same or even slightly lower than someone who doesn't use hormone replacement therapy (HRT).

3) In the Women's Health Initiative Study (WHI) that showed an increase in breast cancer and heart disease in women on HRT, it was only in those women who used estrogen plus progesterone. The women who had hysterectomies and used estrogen only actually showed a decrease in both breast cancer and heart disease over women who had never used HRT. This finding has been shown in quite a few other studies prior to the WHI study. There is, however, a slight increase in stroke with estrogen only but that can be reduced by using patches, creams or gels instead of pills.

4) The WHI studied women who started taking HRT in their 60's, a decade after natural menopause. There is a theory that if you start taking HRT during peri-menopause or immediately after menopause, the risk of breast cancer doesn't go up. This is currently a hypothesis only. There is a clinical trial (the KEEPS study) currently underway that tests this hypothesis and also tests various forms of HRT (including bio-identicals). The results of that study will be released in 2012 and 2013. This will hopefully clear up a lot of lingering questions about the WHI.

5) The one thing I'm not clear on is since they are starting to believe that the ovaries do continue to put out small amounts of hormones even past menopause and they may confer some health benefits, whether it makes sense for someone without ovaries to continue on small amounts of estrogen indefinitely.

It can be a difficult decision with pros and cons going both ways. For me the pros for not having my ovaries include never having to worry about ovarian cancer nor having to have another gyn surgery (fours enough, thank you) and I know for a fact I am now in menopause and that my symptoms can be treated with estrogen. I actually feel a lot better (mentally and physically) since going on an estrogen patch. I believe, in my case, having lost one ovary at age 19 that I have probably been suffering from an estrogen deficiency for a long time.

All women go through menopause. Many women have distressing symptoms whether they keep their ovaries or not and some have almost no symptoms. Some women choose to use HRT with great success, some choose not to for very legitimate reasons and some have problems taking hormones. It's a roll of the dice, there's no way of knowing who will end up in which situation.

Anyway, hope this helps. I don't profess to be a expert on this. I would strongly encourage women to do their own research on these issues as well as consult their physicians.
  #10  
Unread 01-19-2012, 01:16 PM
Re: Rethinking the ovaries

Dear Debbie:
Thanks so much for the informative response. There is so much information out there - it's easy to get confused and lose track of the big picture!
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