I had one about 7 years ago and it was a complete hysterectomy, including cervix and ovaries. I have not had to be on HRT, I am almost 51. I have had occasional hot flashes, but most of my girlfriends who still have their reproductive organs are having them too.

Every person is different, so I don't really know what to recommend. My gyno told me that removing my ovaries would rule out ovarian cancer. Since I no longer have a cervix, I don't get pap smears, and there would really be no way to check for ovarian cancer.

I had huge fibroid tumors in my uterus and that is why I had the hysterectomy...had to have a blood tranfusion for the loss of blood just before the surgery! All I can say is that it definitely changed my life for the better.

There seem to be two very distinct schools of thought. Both are reasonable.
1. Do as little as possible. If it's not broken, etc.
2. Get 'em out to minimize future risk of cancer, etc.

I had a choice and had my ovaries and the cervix removed. I was 58. Had I been 25 or 35, I might very well have made a different decision about the ovaries.

1. I was already through menopause. (I never had hot flashes, etc. Mainly my skin got drier.) Some studies support the theory that even post-menopausal women may live a little longer if the ovaries stay. Just because you keep the ovaries doesn't always mean you're home free on the hormones. The ovaries can be slow to "wake up" after surgery. You can be on an emotional and physical roller coaster trying to regulate hormone dosages or waiting for your ovaries to settle down.

2. There isn't a reliable test for ovarian cancer yet. My surgery was because of non-stop bleeding due to fibroids and polyps, but any tendency to produce abnormal growths makes me nervous. As far as I know, there's no scientific data to support this. It's just what works for me.

3. I have some significant risk factors for surgery. I wanted to minimize the number of reasons for future surgeries.

I HATE taking medicine of any kind, so I'd have only taken hormones if I had gone completely nuts post-surgery. (I didn't.) My gynecologist said that there seem to be more problems in women who had been post-menopausal for awhile and then started hormones; fewer issues if hormones are started in peri-menopause.

I highly recommend a site called Hystersisters. The support and information are outstanding. Although hysterectomies are common, it's still major surgery. It's often accompanied by intense emotions. A lot of people just don't get that and are less than helpful. (No, it's not just like C-section. The uterus is a large blood-rich organ about the size of a heart. Yes, it's ok to grieve the loss of ability to have children - even if you're 70 and are child-free by choice. Yes, it's ok to be scared. Yes, a large number of us are emotional wrecks before surgery.) That said, my experience was surgery very positive. A little over a year later, I feel soooo much better!

Msrose, I'm sorry that you are having to face this option. Hang in there. If you have questions, please feel free to send me an e-mail via gardenweb.

Here is a link that might be useful: Hysterectomy Support

I had to have a complete hysterectomy when I was only 30 as I had stage 4 endometriosis and it invaded everywhere. I took Hrt until I was 57 at which time another of my sisters got estrogen positive breast cancer and with 2 sisters involved it was wise to pull me off the estrogen. I can tell you that the estrogen made me look younger than I was which was good and I never really had any problems with it but continued to have hot flashes to this day. I'm 70 and healthy and very active and no problems with bone loss. I never felt that having the ovaries removed impinged me in any way. I had my 3 children and the bonus was never to have a painful period again. Good luck to you.

I had one due to fibroid tumors. Bleeding excessively. Best thing I ever did was save my ovaries and have the surgery. I went in to menopause 2 yrs later. That is the usual way as your uterus secretes estrogen and when that is gone the ovaries wind down their efforts. I have taken a combo of testosterone/estrogen since then...about 13 yrs or so. I have had NO problems ever with the HRT. It has been a god send and I think it is why I am able to do what I do . I have terrific muscle power and balance and bones. It may or may not be the reason but I am glad I have cont. the therapy.

As to cancer..there is no link at all to any cancers when you have had your uterus removed. In fact more women die of osteoporosis and the effects than cancer from HRT ...if they have NO uterus. Now as to ovarian cancer there is very little known about it but it does have hereditary indications. I am not going to worry over it now. I have mine, they are withered and useless but there they are and it is too late to worry. I probably should have had them out and in retrospect I wish I had, I guess. But there is very very little evidence that I will get ovarian ca as no one in my family has ever had it. I would never be without HRT though...that is of course my choice made by me with my MD"s assistance. Everyone has to decide for themselves.

Sure hope you post back and let us know what you decide and how you are feeling. (( )) to you and good luck ! c

I think I have mentioned this here before and I quickly want to mention it again. Even with a complete hysterectomy, it is possible to get ovarian cancer. I don't exactly know how, but it happened to my own mother. So even with ovaries removed, it can happen.

Another (very strong) vote for hystersisters (and not just for hysterectomy, they cover other female related issues).

I had a total abdominal 9 years ago, but opted to leave my one healthy ovary. I didn't want to take HRT. I still see my surgeon annually, it was semi-annually for years, with an ultrasound, but since I'm doing ok he changed it to once a year unless a problem comes up. He is a well known & respected gynecological oncologist in my area, love him to pieces, he's wonderful. Anyway, we talked a lot about HRT, he is out of a university hospital and was involved in some studies, and at that time he was of the 'use nature first' mindset, if possible. I don't know if his stance on that has changed, I don't follow studies, refuse to take HRT. My own hormones made me wacko, taking BCPs was never an option, they made me even more wacko, so bad I didn't want to even think about trying HRT. I feel better than I've felt in years. Only issues I've had (which I'd hit naturally anyway) are mild hot flashes sometimes at night, sometimes daytime (I stick to lightweight cottons, that helps a lot), being forgetful (mostly with misplacing small things, like keys, or getting ready to run errands and making at least one trip back into the house for something I knew I needed, thought I grabbed but didn't). I never used to lose things, including losing my train of thought, lol. The worst for me is sleep issues. But I'll absolutely take this over the way it was pre-op. Lost count of how many laparascope procedures I had done by my regular gyn. I was miserable every month for years. And now I'm not :)

Seriously, go sign up at hystersisters, anything you need to know, any support you need, you'll find it there.

I had it all removed and I've been lucky that I don't need any HRTs. They did put a patch on me during surgery that I left on for a few weeks.

I do want to say, if you have any kind of surgery, make sure you have some Milk of Magnesia when you get home. :)

I have not had a hysterectomy and am 60 years old. I went through early menopause at 37. I did use HRT for several years and it helped, but I chose not to take them too long term.

If I had ever been faced with the choice of a hysterectomy and ovary removal, my decision would be based on my age. If I were in my 50's I would probably choose to have them removed; if not, I would keep them because there is not a man-made pill out there that is the same as natural hormone production for the ovary.

Wise words Tuesday. I'm 51, still on bc, so of course no surgery and no menopause yet. Had my hormone levels checked last August and will again at this year's physical. I believe I read now that the advice from doctors is if you are 45 or over, go ahead and remove the ovaries.

Also, I would think twice about removal of the cervix. It CAN alter sexual response, etc.

tina

Thank you so much for sharing your stories with me. It sounds like fibroids are pretty common. That's what I have, but my doctor is doing a uterine biopsy next week just to rule out uterine cancer since my mother had it. I'm 48 and done having kids, so I'm not worried about losing my ovaries. I'm kind of a health nut, so I just hate the thought of taking hormones, but I would if I felt bad without it. I will definitely check out the website. I want to read everything I can to help me make my decision.

I also have to decide what type of hysterectomy I want. My doctor only does the open hysterectomy (bikini line), but she recommended another doctor if I'd like a robotic hysterectomy. A part of me would like the robotic, but I've been going to my doctor for 22 years and I'm comfortable with her. For those of you that had an open hysterectomy, do you remember how long it took you to recover? I'm worried about how much time I will have to miss from work. I work from home, so I don't have to be able to drive, but I do have to be able to sit at a desk all day.

oakleyok - I'm terrified about that. When I had surgery in December, the Milk of Magnesia didn't work after I got home and I actually had to go back to the ER. It was terrible.

I avoided a hysterectomy (recommended by my first doctor) by having my fibroids removed via hysteroscopic resection. There was no incision made and my recovery was very quick. I still had some bleeding issues, and had an endometrial ablation about a year later. Until I went through menopause at 50 I had periods that required nothing more than one or two "junior" tampons per day. I was about 44-45 when I had both procedures. I am happy to still have all my parts.

Mine was an open due to the massive size of the tumors. Dr said my uterus was at a size equivalent of a 5th month pregnancy. Was pretty bad!

Recovery did take the full six weeks, but mainly because I was so tired. I was very anemic. I think if you're in good health before the surgery, a couple weeks is realistic, and if you don't have to drive anywhere and can work at your own pace, it wouldn't even be that long. The one thing you HAVE to remember is to do no lifting (even grocery bags) or vacuuming till your Dr gives the ok. Trust me, you dont want to chance it!

I had a laparoscopic hysterectomy when I was 58 (6 years ago). My surgery took fives hours because of the size of the fibroids. I did have the ovaries removed because of history of breast cancer in the family.

If I hadn't gone on the treadmill five days after the surgery, the recovery would have been a piece of cake!

I never went on hormones and really the only thing I've noticed which is on the negative side is that my skin has really aged.

As others have said, each person is so different. I never felt bad during my recovery but I know some have.

Go with robotic. I've had abdominal surgery; everyone heals different depending on what needs to be moved when you're open. I had pain for over a year. Never again.

There is a huge post on city-data; I'll grab the link later if you want it. Glad I don't need to make this decision; but at one time; I was prepared & decided I was leaving them in had I needed it.

Have to say that the flow has gotten better since taking the over the counter Estroven PM. I now only have 1 heavy day

Due to my age at the time of my vaginal hysterectomy, I opted to keep my ovaries. My mother and aunt are also estrogen positive breast cancer survivors. Both had taken HRT and this upped my reasoning for keeping my ovaries. Before hysterectomy I was severely anemic due to heavy bleeding. Pathology report determined I had adenymosis and also determined the other options for treating the heavy bleeding would of ineffective.

Get differing opinion on need of a pap smear since my cervix was removed. I opted to have one every other year. I did notice a little dryness due to removal of cervix, but a little lubrication goes a long way.

Good luck, and another vote for Hystersisters.

I can't find the exact one I'm looking for

Anyone had a hysterectomy?
Necrotic Ovarian Cysts After Full Hysterectomy
Fibroids and Hysterectomy
Questions about fibroids
Your thoughts on hormone replacement therapy HRT

How do you know if you've gone thru menopause or not? I had a hysterectomy when I was 32. I kept my ovaries. I'm now 45 and haven't felt any symptoms (I haven't had a menstruation since my hysterectomy).

I had a hysterectomy last summer due to a HUGE fibroid, too huge for laparoscopic. When I asked my Dr. (who is known as the best in our state, I had to travel to see him) about robotic, he said he could definately refer me, be he didn't do robotic, and has just never got past trusting a machine that could malfunction. He has seen it happen, where the machine cut the stomach (I think) in error and so I was happy to do otherwise. I know Drs. aren't perfect either, but, I just felt better with him doing the surgery. I had also called one Dr. before mine, and found out the robotic machine was getting fixed, so that didn't make me feel good.

I just turned 50, and my Dr. talked me into keeping my ovaries, and definately my cervix, since my cervix was very well intact, especially due to not having any children. Since there is no history of ovarian or cervical cancer in my family, that quality of life is important also, and I would be very happy I kept them as long as I could. If I had to have them removed later, the surgery is no way as bad as the hysterectomy.

Hystersisters helped me a lot. BUT, remember, a lot on there are people who had problems, most people do not. I had NO problems, but did what I was suppose to do and not lift things or drive until I was suppose to. If you read Hystersisters, you will see that if you do, you could tear all the stitches out INSIDE your body, which takes much longer to heal than the outside of your body. I really paid attention to that. Hardest part to me was not having sex-HA!! (I know, TMI)

Afterwards, he has put me on Progesterone (pills) and Testosterone cream. They work well for me. I never got night sweats, since my body produced so much estrogen anyway, which is why I got the huge fibroid anyway. Too little estrogen gives you hot flashes, apparently. No HRT for me! I know too many people who have taken them, and have gotten cancer.

Msrose, it was 4 days after my surgery when I had a BM, and I had my dh go get some MOM. (no one told me about the gas pains which were far worse than the surgery). I took a double dose, and it worked great. heh.

My pharmacist said double dosing on meds like that are okay (not tylenol, etc.) because prescription meds are just a stronger dose.

I don't know if endometriosis can be found in robotic surgery, but when they cut me open, they found some already growing.

It took a good week before I could sit comfortably in a hard chair. Extra pillows to rest your tummy on is a must if you're a side sleeper.

The only side-effect I have since surgery and this could be totally unrelated, is I don't have the energy I once had.

I had two blood transfusions before surgery and almost had to have another, so of course I was anemic and had to keep taking iron pills for six months afterwards.

Skin and hair are fine. I have no regrets though. I was SO glad to get rid of Aunt Bessie who decided not to leave! lol

The pain meds are usually what causes bathroom problems. Drink LOTS of water and that really helps.

If you have the laproscopic and they use the gas to blow your belly up (blow it out? LOL), make sure you ask for a rocking chair and use it. I had that when I had my gallbladder out. It truly helps with the gas.

I'm thinking Allison had the robotic surgery, so maybe she'll chime in.

The Davinci robotic surgery is used here in my area and quite popular. I found this on-line:

The daVinci� surgical system provides surgeons with enhanced true 3-D vision, ergonomic comfort of surgical manipulation and unprecedented precision of tissue handling. Utilizing the EndoWrist� instruments of the daVinci Surgical system, the surgeon is capable of performing precise, fine-tuned movements of robotic arms with "7 degrees of freedom," eliminating tremor and allowing for instrument manipulation that would be impossible in conventional laparoscopy.

These are the few of the benefits of the robotic hysterectomy:

Decreased blood loss
Faster recovery time
Greatly reduced post-operative pain
Quicker return to daily activities

Good luck!

I am a Charge RN in a Women's Center but I don't provide direct patient care to the gyn pts. I do know a fair amount about their recoveries and length of stays though.

The DaVinci procedures last 2+ hours depending upon the experience of the surgeon and fibroids, etc. These patients are up out of bed shortly after surgery and require minimal pain meds (Therefore, minimal interference with elimination IYKWIM?) Much shorter recovery time in general. Check with insurance because with use of the DaViinci and longer in surgery time this may cost more. The cost may be offset with shorter hospitalization though. Just heard this around the unit--not sure if it is true or not.

Abdominal hysters require an abdominal incision, more pain meds, perhaps a period with no food intake, and a longer recovery period.

Lap assisted hysters fall somewhere in the middle with no abd incisons other than the "bullet holes" from the lap trochars. Vaginal hysters also have similar recoveries.

HTH

No - haven't had one. I had a large (10cm) fibroid and had it treated with uterine fibroid embolization so no need to have anything removed.

If the reason you're considering a hysterectomy is because of fibroids, be sure you consider all treatment options. Your gynecologist may not be a proponent of some of them, such as UFE, because the procedure is done by an interventional radiologist, not a gyn. In fact some gyns don't even tell you there are options other than a hysterectomy.

You can obviously get cancer in lots of body parts besides your ovaries - doesn't mean you have those parts preventatively removed unless you are at high risk for that particular type of cancer. In my opinion the more involved the surgery the greater the risk.

Thanks for posting that information gibby. I was researching UFE for my fibroid treatment, and found the doctor who did my resection by working backwards. My first doctor was a "take everything out" kind of guy, and I wanted to know all of my options. I contacted the only facility in my state that did UFE at the time (10 years ago), and asked them for names of doctors who referred to them from my area. Fortunately, my fibroid was totally inside the uterus and was able to be resected. I learned that the ones inside cause the most bleeding problems.

I just wanted to say that my SIL had the UFE treatment as well. It was very successful, Her OBGYN wanted to do surgery but she researched and discovered the UFE option.
Yes, as Gibby said - look into all options.

Olliesmom - You mentioned one of my fears. Could something go wrong with the machine? I know it's probably a rare occurence, but it's still a possibilty. You said you were on Progesterone (pills) and Testosterone cream, but no HRT. I haven't researched any of this yet, so I don't know the difference. Is Progesterone and Testosterone not HRT?

oakleyok - I was reading on Hystersisters that you do a bowel cleanse the night before surgery. It's strange that you do that for a hysterectomy, but I didn't have to do that when I had part of my small intestine removed. That's was part of the problem for me. This may be TMI, but the food I ate the day before surgery had been sitting in my digestive system for a whole week since I had an ileus following surgery. I think it will help if everything gets cleaned out prior to surgery.

tinam61 - I forgot about the pain meds. I did take alot after my last surgery. I'd like to say I won't take as many this time, but I know I will if I'm in major pain again.

rnmomof2 - Thank you for chiming in. Hoping you can answer a few technical questions for me. I actually started watching a DaVinci hysterectomy on you tube, but it was so long I didn't finish. Do they remove the uterus vaginally or through a small incision? Are the holes from the DaVinci surgery about the same size as the holes from the lap assisted or would they be smaller? I wondered why I wasn't give the choice of a lap assisted and if I should consider that also. Of course, we're still going to have a more thorough conversation later and she may bring it up then.

I think it's very smart to consider other options, but I feel like I just want it out. My mother had uterine cancer and I had small instestine cancer last year, so I'm cancer paranoid.

roselvr - Thanks for the links!

msrose, as far as the machine goes, they do have to be repaired, but I am sure it is rare. I just know, my gyno said he has seen it "accidentally" cut through the stomach and that's a whole new ballgame. Maybe someone on here knows more about that? I have had a number of girlfriends though use the robotic and was just fine, so I am sure it's rare, but can happen. My fibroid was so big, he probably just felt better about doing it himself. Mine was abdominal instead of vaginal, and I was glad. I didn't realize they STUFFED you with gauze vaginally and it is suppose to be uncomfortable, and plus you still bleed for awhile. I had NO vaginal bleeding at all after surgery. Now I do have a scar, but, I don't wear bikini's anymore, so I wasn't worried about that.

Progesterone and Testosterone are not HRT's. Your body produces these things naturally, just not at the rate you did when you were younger. Dr. also had me take Omega 3 to help with moods and they all seem to be working fine.

Does your gyno know much about bioidenticals? Because, if you don't want to take an HRT, you may need to seek out a doctor who is on board with that, if you are interested. They are becoming much more popular than they use to be. A lot of doctors are more knowledgeable about them now.

When your body stops producing hormones naturally and you supplement them with pills that is by definition Hormone Replacement Therapy. Also so called 'bioidentical' hormones are rather controversial.

Had only my uterus taken out less then 2 years ago.

I did a ton of research and delayed getting it until I couldn't take it mentally or physically.

I wish I could remember the exact numbers but even after menopause, your ovaries produce a significant amount of hormones and are NOT useless. Yes, you have the potential of getting ovarian cancer but you don't remove your breast because you have a 10% or more chance of getting breast cancer do you?

I take no hormones and at almost 54, I assume I would have gone through menopause. I asked the physician if I should take the test to see if I have, and with no negative symptoms she said there really wasn't a need to.

There's a wealth of information out there. Good luck with your decision.

Here is a link that might be useful: Post Menopausal Ovarian Production

teriks, HRT's are synthetic and a foreign substance put into your body, bio-identicals are natural (from plants, etc.) and match exactly what we lose as we get older. So, they are NOT the same.

You didn't read the article that I linked to.

"Natural" is a meaningless term with respect to BHT. All bioidentical hormones are manufactured using wild yams or soy as the starting ingredient, and all undergo chemical conversion in a laboratory to be synthesized to the final ingredient. [1] [3] There are no bioidentical hormones that do no undergo some sort of laboratory manipulation. Consequently there are no truly "natural" bioidentical hormones.

terriks, we could go back and forth all day, and it doesn't matter to me what other people do, BUT, HRT and bio-identicals are NOT the same. Many doctors are using HRT's as a last resort now, as there are definately concerns with them causing cancer.

There are also cancer risks with the "bioidenticals" and if you don't believe that you are only fooling yourself.

Would love to have more info on that, terriks! Have never heard that at all, but I am not close-minded enough that I would like to see some articles on that. I will google also, but, like I said, that is news to me!

It's funny, but I saw Suzanne Somers on Rachael Ray a couple of weeks ago and she mentioned a website if you were interested in bioidenticals. That was before I knew I had fibroids and would need a hysterectomy. For some odd reason, I went to the website and requested info on a physician in my area that uses them. I think they got an overwhelming response from the publicity, because I've received two emails letting me know that haven't forgotten about me and would get me a name as soon as possible. I'm planning to research those and medications.

My belief is that bioidentical hormones have the same risks as synthetic hormones such as Premarin and Prempro but may have better side effect profiles. In this context, "natural" doesn't mean risk-free. And because these and other hormones have powerful, general effects, I believe they should be regulated as drugs, not dietary supplements.

Andrew Weil, M.D.

source: have enough hormones?

Here is a link that might be useful: Dr. Weil on bioidentical hormones

msrose, Here is a good website on Uterine Fibroids and treatment options. Hysterectomy is not the only treatment, though many women choose that option.

Here is a link that might be useful: National Uterine Fibroid Foundation

Tina, you're right. Pain meds do cause constipation, especially if they're taken 24/7. So when we get out of the hospital we're so high on Morphine, then take hydrocodone at home, well, let's just say, "My poor tummy!"

About HRTs. My BFF is a health nut. She's also a vegetarian. But she cannot live without HRTs. She's been on them for the past 10 years and she's now 60. If she stops, her world goes topsy turvy. So some women have to take them.

If it were me, to heck with it and I'd get it all out and see what happens hormonally. Ovarian cancer used to scare me to death. All cancer does, but especially that one.

All I know is I'm SO glad I don't have to worry about "down there" anymore and I feel free as a bird!

I had a total hysterectomy at the age of 36 due to an ovarian cycst the size of a grapefruit. (It had become that large in a matter of 3 weeks). They had prepared us for it being cancerous but luckily it was not. When they opened me up, I also had endometrosis everywhere. They literally had to scrape all my internal organs and even removed my appendix. I had already had uteral surgery to help me get pregnant and a C-section with the smiley shaped incision but they had to do a huge incision that goes from above my belly button all the way down to you know what! It kinda looks like an anchor with both incisions. Let me say this was way back in 1986 so alot has changed since then. I took estrogen and progestone for a few years then dropped it to just estrogen. I stoppped that about 10 years ago now and my biggest complaint is that everything on me is dry. I have tried the creams and stuff but nothing seems to work. Hot flashes come and go but overall that isn't my main issue. I still have paps done every three years - its actually more of the lining of course but you should still be checked for endometrial cancer.

The estrogen threat is not just for the ovarian cancer but also breast. It was actually my husband who suggested I talk with my doctor about stopping the estrogen as it was being discussed among the doctors at the cancer center where he works in Radiation Therapy. As I said that was 10 years ago or more.

So much depends on your age - I was so young at the time, the hormones were basically a necessity but now I am glad I have stopped them.

Dr Phi;'s wife Robin wrote a book on bio-identical hormones. I did research on them years ago. Thankfully Estroven PM has been helping my issues; so I don't need to worry about it yet Robin's web site I posted a lot of info about it here

Dr Phil show page What's Hormones Got to Do with It?

To save others from looking for Suzanne Somers info-

Resource List opens in a pdf file

She has been treated by one we used when hub had cancer. I'm not sure if she originally used him for the hormones.

Body Logic MD

Here is a link that might be useful: Suzanne Somers on RR