Are hysterectomies always necessary?

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by Dr. Angela DeRosa

azfamily.com

Posted on September 30, 2013 at 3:10 PM

Updated Tuesday, Oct 1 at 9:36 AM

PHOENIX  --  Hysterectomies are the second most common surgery among women in the United States, according to the Centers for Disease Control. A third of American women will have one by the time they're 60. The procedure involves surgical removal of the uterus.

So why the increase in this procedure? Dr. Angela DeRosa says the most common reason for a hysterectomy is uterine bleeding. "They get painful periods," she says. "And that's often due to uterine fibroids."

Another reason is uterine prolapse, and the third most common reason is endometriosis. But DeRosa recommends always getting a second opinion, because there are non-surgical options to treating all of those conditions. "Some doctors are more apt to want to take your uterus and not understand the consequences," says DeRosa.

There are risks to hysterectomies, including changes in hormones. Within a month of having a hysterectomy, many women start having menopausal symptoms, despite still having their ovaries.

Most women will experience a 100 percent drop in testosterone production, which leads to symptoms of fatigue, low libido, mood disorders, and loss of muscle energy drop.

Most women will also encounter a 30-to-50 percent decline in estrogen, so they start to have estrogen deficiency symptoms as well.

Dr. DeRosa says if you're younger, there are benefits to leaving the ovaries. But she has different advice for older women. "If you hit the age of 40 or above, take the ovaries out," she says. "You're going to take that huge hormonal decline anyway. I can give you back your hormones." Leaving the ovaries can increase risk for ovarian cancer.

Dr. DeRosa says women need to know and understand all of these risks and side effects before they consent to their surgery so they are prepared for what will happen.

There are approximately 600,000 hysterectomies performed annually, and it’s estimated that 20 million American women have had a hysterectomy. 

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