Marianne is a bright, professional 45 year-old woman who was talked into having a hysterectomy by her gynecologist. Suffering with irregular and occasionally heavy periods, Marianne had two surgeons’ opinions. They both recommended hysterectomies. The diagnosis requiring the surgery was Grade I endometriosis and a fibroid.Before the surgery, Marianne asked her physician about side-effects and any problems she may have to face after the surgery. The doctor she had chosen, a woman, assured her the surgery was a pip and Marianne had nothing to worry about, she would have her ovaries left behind to continue producing hormones thus not a worry in the world.

Happy and reassured, Marianne had her surgery.

In the recovery room she had her first hot flash. Upon arriving home, Marianne felt even worse. She felt no longer female, no longer sexual, no longer alive. Her 6 week post operative visit was an even bigger disappointment. The erstwhile friendly and reassuring doctor spent 5 minutes looking at Marianne’s scar and telling her she was healing well. When Marianne told the doctor she was depressed, was having hot flashes and lost her sex drive, the doctor discarded the symptoms’ importance and recommended an antidepressant if Marianne felt she was having a hard time coping with the fact that she felt she had been gorged. As for the hot flashes, well those were nothing much but would get better in time or she could take some Premarin (a synthetic hormone) if she really could not bear it.

Marianne’s story is not unique, and it’s important to understand the effects of surgical menopause, as they’re not often discussed by doctors and those in the medical industry:

“Instead of following the normal decline in hormonal output, at some point we undergo surgery and cut off the ovarian contribution to our total hormone levels entirely. When we have our surgery, at the time the surgeon snips our ovaries free from our bodies is our time of menopause. Wherever we may have been on the natural menopausal timeline of ovarian decline before surgery, we depart from it dramatically and totally at the moment.” (From Survivor’s Guide to Surgical Menopause)

Hysterectomies are the second most common major surgery among women in the United States. Each year, more than 600,000 hysterectomies are done. About one third of women in the United States have had a hysterectomy by age 60. It is a staggering number with far reaching implications. The need for so many hysterectomies occasionally makes it into the public consciousness but rapidly gets swept under the rug by conventional medicine.

I will try to offer a modicum of logical insight into what happens after the hysterectomy and how best to use natural hormones to forestall the devastating effects women experience even as they wake up in the recovery room after the surgery.

Let’s look at what happens to your hormones while the doctors are taking out your uterus in the operating room. The ovaries and uterus are the organs that define us as women and also make the bulk of the hormones we desperately need to feel good. Taking out the uterus alone sends the ovaries into immediate shock and that leads to an abrupt stoppage of estrogen and progesterone production. Taking out both the uterus and the ovaries, removes the very source of estrogen and progesterone production.

During any surgical procedure, the amount of stress hormones (cortisol) generated is immense. In the case of the hysterectomy, stress and removal of the organs that actually make the estrogen and progesterone create what is known in medical terms as “surgical menopause”. The symptoms we experience in the recovery room are those of severe, acute menopause. Hot flashes, profuse sweating, palpitations, nausea and a sense of doom are all connected to the sudden shut down of hormone production by the ovaries as a direct consequence of the hysterectomy procedure.

How do you prevent this horrible experience from happening? Of course the ideal situation is to prevent the hysterectomy. In those cases when it cannot be avoided, natural hormones and the following tips will diminish the trauma of the transition, limit the symptoms and keep you feeling like yourself.

1. Four weeks before surgery eliminate soda (all including diet and low carb), coffee (limit to a maximum of one cup a day) and alcohol (all).
2. Three weeks before surgery minimize the amount of fats, fatty meats and preserved meats you eat
3. Two weeks before surgery start taking supplements to improve your immune system function ( Colostrum 400 mg twice a day, L-Carnitine 500 mg twice a day, Coenzyme Q-10 60 mg twice a day and Vitamin C 1000 mg twice a day). Increase your water intake to 10 glasses of water and increase green tea to 3 glasses a day.
4. Two weeks before surgery start natural/bioidentical hormones- I prefer to use a combination of estradiol and micronized progesterone in cream form.
5. One week before surgery make sure you get a minimum of 7 hours of sleep a night.
6. Three days before surgery, try to take off from work and take time for yourself. Read, get your nails and hair done, have a massage, take a few yoga classes, relax and meditate.

After the surgery, continue the natural hormones, they will serve you well:

“Death rates rise when women under 45 years old undergo bilateral ovariectomy — surgical removal of both ovaries — and do not receive proper hormone replacement therapy, according to a new Mayo Clinic study to be published in the October 1 issue of The Lancet Oncology. Mortality from all causes increased.” (From Dealing with Menopause)

Do not take synthetic hormones or only estrogen. Your body needs the progesterone as well. It is incorrect to think that all you need progesterone for, is to protect the lining of the uterus from cancer. Without a uterus, every cell in your body, every organ continues to need progesterone to balance the estrogen and keep you from getting old before your time and feeling out of balance.

For a FREE e-Book by Dr. Hotze on Natural Hormone Replacement Therapy CLICK HERE.

This entry was posted on Thursday, October 5th, 2006 at 2:19 pm and is filed under Dr. Erika Schwartz. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.