By Teri Borseti
If you've been advised that you need a hysterectomy, you're far from alone. Hysterectomies are the second most frequently performed surgical procedures for US women, right behind Caesarean sections. Every year 600,000 hysterectomies are performed and an estimated 20 million women in America have had the operation, whether because of fibroids (benign tumors of the uterus), endometriosis (cells from the uterine lining growing outside the uterus), pelvic inflammatory disease, or a diagnosis of a gynecological cancer, among other disorders.
The three types of hysterectomies are:
Partial or subtotalRemoval of the uterus.
Complete or totalRemoval of the uterus and the cervix but not the ovaries and the fallopian tubes.
RadicalRemoval of the uterus, the upper part of the vagina, the cervix, supporting tissues, one or both ovaries, and the fallopian tubes.
If you were still of childbearing age, of course, the prospect of losing your uterus could be devastating. But since you're a post-50 woman, you may find that being free of symptoms such as heavy bleeding and pain is a tremendous relief. Also if you don't have a gynecological cancer, you may not need a radical hysterectomy. Remember that even after natural menopause, your ovaries continue to make estrogen and testosterone that are vital for your well-being, and If you keep your ovaries you won't go into instant "surgical menopause."
Although some women (and their doctors) do feel that the most prudent decision is to remove all the reproductive organs rather than court the possibility of cancer down the road, removing your ovaries does not unequivocally guarantee that you won’t get cancer. The cancer can come from cells throughout the peritoneal cavity.
Obviously, the decision about which type of hysterectomy to have – or whether to have the surgery at all -- is a very personal one that you should discuss with your doctor, and even get a second or third opinion. Unless you have cancer, you may choose to try conservative treatments first, such as hormones to shrink fibroids, an endometrial ablation (removal of the uterine lining) to stop heavy bleeding, or a lapraoscopic or abdominal myomectomy to remove fibroids. In the end though, the only sure way to cure the conditions that would prompt a recommendation for a hysterectomy is some version of that operation.
If you do have your ovaries removed and experience surgical menopause, there are treatment options for dealing with night sweats, mood swings, anxiety, decreased libido, vaginal dryness, and irritability. Some doctors recommend starting hormone therapy before you are wheeled into the operating room so that you won't have a drastic and sudden drop in hormone levels.
Not every woman chooses hormone therapy but those who do can opt for the Vivelle-Dot patch instead of taking pills that make the liver work harder. The small transdermal (through the skin) patch replaces estrogen with estradiol, a hormone that’s bio-identical to the ones produced naturally. The patch not only helps control menopausal symptoms but may also aid in preventing osteoporosis.
Finally, some advice no matter which type of hysterectomy you have: You need to give yourself ample time – about six weeks – to recuperate. Go easy on the physical activity so you won't have adhesions and be sure to get plenty of rest and eat a healthy diet. In addition, if your cervix hasn’t been removed, you'll still need to have annual pap smears.
Nobody wants to undergo major surgery, but this one can vastly improve your quality of life – and even save it. That thought should make the prospect seem a lot less daunting! Line up some tag team post-surgical help from family and friends and you'll not only get through this just fine but you'll surely look back and realize that you're grateful for the advances of Western medicine that have made your recovery possible.
Teri Borseti has been a freelance writer for over 20 years. Her byline has appeared in numerous publications including The Boston Globe, Ocean Home Magazine, Boston- Common Magazine. She is also the author of “Memories of Maverick”. Please visit http://www.teriborseti.com/