Myomectomy or Hysterectomy > July 2005 Archives
July 4, 2005
Early Menopause for Hysterectomies
This is the first study I've been able to find on this subject.
There's been lots of info flying around about what happens to ovaries after hysterectomy if you keep them.
And finally someone's done an actual scientific study on the subject. Though the study group is not that large, I think it confirms a lot of anectdotal evidence and surveys that show that hysterectomy affects ovarian function in the long run.
The article does not detail the ages of the women and reasons for hysterectomy which I think might have something to do with ovarian function. I can only guess that a less invasive procedure would do less damage to the ovarian function. However, little is known even to this day about how the ovaries and uterus interact when a woman is not pregnant.
However, the article showed that only 21% of the women who'd had hysterectomies went into early menopause while 7% of the women who had not had a hysterectomy. Of course the women chosen for the control group had normal periods ... I'm not sure if my ovaries would have been very happy if I'd left my already 4 month uterus continue growing. The left one was already getting mushed out of position.
Anyway, it's clear that hysterectomy has long-ranging effects on overall health. Though early menopause confers lower risk for breast and ovarian cancer, it carries higher risk for osteoporosis and cardiovascular disease. Uterine conservation may be as important as ovarian conservation for women at high risk for cardiovascular disease.
Posted by Elizabeth M. at 11:55 AM
July 7, 2005
Androgen Levels lowest in women with Oophorectomy
The Journal of Clinical Endocrinology & Metabolism published a report recently about androgen levels in a large survey of women.
The cross-section was otherwise healthy women aged 18-75. Some were pre-menopausal, some post-menopausal and some had surgically induced menopause.
"We report that serum androgen levels decline steeply in the early reproductive years and do not vary because a consequence of natural menopause and that the postmenopausal ovary appears to be an ongoing site of testosterone production. These significant variations in androgens with age must be taken into account when normal ranges are reported and in studies of the role of androgens in women."
What this seems to indicate to me is that ovaries are important to the female endocrine system and function far beyond the fertile years. What these androgens do, precicely, is not completely understood, but I'd guess that we need them.
There was further news as well that serum testosterone levels apparently have little correlation with women's libido. Though the report concedes that testosterone may still be integral to sex drive, the levels detected in the blood may have little to do with it.
This may put a lot of this research back to square one and should alert women that there is certainly no pill or patch at this time that can take the place of ovaries.
Posted by Elizabeth M. at 6:42 PM
July 16, 2005
Diffuse Abdominal Pain
I'm not quite sure what it is these past few months. I've been having trouble sleeping since the beginning of the year. Part of it, I think, is a change in bedding. My doctor wanted to be more aggresive with my allergies and suggested that I get rid of all of our featherbedding. I had just purchased a new down comforter last fall, but he said it had to go (even though I keep it in a duvet that get's washed twice a month). So, now I have a new fiberfill comforter and the weight is just not right.
My bedroom is very bright at night, I think they changed the streetlight outside. And of course the sun rises earlier now.
Anyway, the poor sleep seems to leave me a little achy during the day. I've really ramped up my activity, what with the vigorous vacation, lots of heavy work in the yard and of course my regular household stuff like laundry which requires taking baskets of stuff from the second floor to the basement.
I've had a diffuse sort of pain in my abdomen for a while. I don't know if it's related to the heavy yard work or the terrible diarrhea I had earlier this week (maybe a combo of both).
Anyway, I'd like to just sleep in one of these days, but it seems like I wake up at 7:30 on weekends and can't go back to sleep. I'll try again tomorrow.
I've overdue for my yearly gyno appointment. I'll try to remember to call next week. Of course if it isn't an emergency it'll take another two months to get an appointment so I'd better call sooner rather than later.
Posted by Elizabeth M. at 4:31 PM
July 17, 2005
Blue Cross/Blue Shield of Vermont stops covering some HRT
I try to keep up on my reading about the latest on fibroids, hysterectomy and ovarian cancer. One of the easiest ways to do this is to set up a Google News Alert, where Google will email you a list of links to stories that fit your search.
That's how I found this article in the Times Argus: Insurer pulls plug on drug for menopause. It's about a woman in Vermont who had an oophorectomy at 29 and has been on HRT ever since but after years of trial and error finally found that Estriol actually worked for her. But her insurance is now refusing to cover it because it's "natural estrogen" and not approved by the FDA.
I'm posting about this because all of us have to be vigilant about erosions in our health care system. It's fine to have surgery and think that a pill is going to solve our problems later on, but it's another thing entirely to find out that we have to bear the cost entirely by ourselves. Not only is it unfair that a proven but unapproved treatment is denied under the coverage, it also squeezes out these small pharmacies that seek to give their clients personalized care instead of the huge mail-order pharmacies that most of us have been forced to use in the past few years.
The article talks about defending women against a lack of options for controlling menopause symptoms, but another major factor is women who've had oophorectomy for such conditions as endometriosis and polycystic ovarian syndrome being denied a treatment option that can protect their hearts, cardiovascular system, bones and teeth. It seems extremely short-sighted on the part of the insurance companies. I wish there were a tick box on my insurance when I sign up for coverage where I can say, "I'd like all prescriptions that my doctor deems necessary to be covered, not just the ones you think are cost-effective."
Posted by Elizabeth M. at 12:31 PM | Comments (2)
July 24, 2005
Another Step Closer to Ovarian Cancer Detection
Tampa Bay Online reports that there is a promising new test for ovarian cancer that just got approval for
This week, the National Cancer Institute awarded a $3.5 million grant to H. Lee Moffitt Cancer Center & Research Institute at the University of South Florida to expand its search for telltale signs of the disease that can be found in a blood sample.The test is promising and has already been shown to be 93% effective, whereas the current test, CA125 is only 50% and has a high level of false positives. Read the article here.
Posted by Elizabeth M. at 10:07 PM
July 31, 2005
Keeping Ovaries, Keeping Bones
Again, I'm on the kick to keep ovaries as healthy as possible and in the body as long as possible. Of course there has been a change with the medical colleges no longer recommending oophorectomy to pre-menopausal women over 45 (though a great number of doctors still remove healthy ovaries in women with no ovarian cancer risk factors by habit). But many doctors still remove ovaries in post-menopausal women during abdominal surgery because they think that if ovaries aren't putting out eggs, they're of no use and possibly a threat.
First, there's osteoporosis. Yes, pre-menopausal ovaries keep women's bones strong. But the post-menopausal ovary still puts out estrogen, and for many women that's enough to keep them strong enough as they age.
Look at this:
Over 1 million people break their hip every year in the United States alone, the vast majority of those are post-menopausal women.
50% of those people will never regain their independence - they will end up in hospitals and rest homes.
25% of those women who have a hip fracture will not survive the year, usually because the loss of mobility allows other pre-existing conditions to take greater hold of their lives. Lack of exercise and mobility means bad nutrition, lower immmunity (pneumonia being a big killer after hip fractures), depression, heart disease, strokes and additional falls.
If you're still in your 20s or 30s, you're still in your prime bone-building years. Good nutrition and weight bearing exercise will serve you well as you age. If you're over 40, it's not too late, you can still keep the bones you have with the same regimen of healthy living. Avoid sodas and smoking, as both are shown to leach minerals from the bone or keep you from absorbing minerals from the foods you eat, respectively.
Last, if you're having a hysterectomy for any reason other than cancer and have no documented cancer risk factors (first generation relatives, a positive matching on the BRCA1/BRCA2 markers, preexisting cancer) or an estrogen fed disease (endometriosis), it's important to evaluate the full effect of removing healthy ovaries. As I've posted here before, while the estrogen and progesterone levels drop as we go through menopause, the androgen levels don't. Though estrogen gets a lot of credit for helping us maintain our bone density, androgens such as testosterone may help us keep our muscle mass. Keeping muscle can be just as important to mobility as we age as bones.
Other articles and resources where this information was gleaned - Bone Health, Planning Now, Prophylactic Oophorectomy (Mayo Clinic, be sure to read down to the bottom about the risks)
Posted by Elizabeth M. at 10:18 AM