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menopause Jun 03, 2022

Don’t let the pictures below fool you, a Hysterectomy is when the uterus has been removed not the ovaries (oopherectomy). The ovaries are the hormone power houses and responsible for most of the menopausal symptoms we feel. It’s called a hysterectomy because back in the old days, a doctor found that manually stimulating women to the point of orgasm helped them to relax, therefore the uterus was the source of all of the hysteria… No wonder this doctor didn’t own a uterus themselves…

What Is A Hysterectomy?

Hysterectomies are the second most common female surgery behind Caesareans with 1 in 5 Australian women having had a hysterectomy. There are 3 types of hysterectomies; 

  • Partial- The uterus is surgically removed and the cervix, ovaries and vagina is left in place. 
  • Complete/Total- The uterus and cervix are removed leaving the ovaries and vagina.
  • Complete/Total + Oophorectomy- The uterus, cervix and ovaries are removed and the vagina is left in place.
Which type of hysterectomy you receive is based on a combination of your symptoms, age and future desire to have biological children. 

Reasons For A Hysterectomy?

  1. Heavy Bleeding- Heavy bleeding can be due to a couple of causes; Usually in Peri-menopause it is from the new imbalance of high oestrogen to progesterone due to the reduction in ovulation. Higher oestrogen means everything that has the potential for change in the uterus grows. This includes the growth of fibroids and a thickening of the uterine lining (endometrium). Too much bleeding whilst incredibly annoying can cause iron deficiency anaemia which can be dangerous and make you feel breathless, and fatigued all the time. Basically your body is starving of oxygen. Not great for all of your important organs (all of them). 
  2. Pelvic pain- The most common cause of pelvic pain in peri-menopausal and menopausal women are polyps/fibroids. This is due to the imbalance in hormones, contributing the the growth of lesions in the uterus. Pelvic pain can also be caused by chronic pelvic inflammatory disease, chronic infection, UTIs and endometriosis/adenomyosis. In these cases it is important to address the underlying cause before resorting to removing the uterus.
  3. Prolapse- In peri-menopause and menopause we can have the combination of a heavier uterus most commonly due to fibroids or polyps, thicker endometrial lining due to hormonal imbalances and a weakening of the pelvic floor, due to child birth, years of our pelvic floor fighting gravity and loss of muscle tone due to hormonal shifts. This leads to our internal organs shifting down causing lower abdominal pain, back pain, pain during sex, increased urinary frequency and a general feeling of unease (to say the least). There are non surgical options like pelvic floor physio and insertion of a pessary which acts to hold the organs up. Depending on your specific case these may be your first port of call, or you may need to skip straight to surgery. 
  4. Cancer- Rarely the cells in your reproductive tract, either endometrial, uterine, vaginal, cervical or ovarian can change and grow out of control, this is what we call cancer and there are many different sub-types. If you experience any bleeding after a 12 month period of no bleeding, speak to your GP pronto. Other signs can be loss of appetite, weight loss without any changes to life style and night sweats (of concern if accompanied by any of the other symptoms listen above). If you are experiencing any of these or are concerned about any out of the ordinary feelings, talk to your doctor. 

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