Hysterectomy: The Basics

Dr. Cindy Hall, D.O. OB/GYN

A hysterectomy is surgery to remove the uterus, also known as the womb. Hysterectomy can treat symptoms like heavy periods, fibroids, pelvic organ prolapse and cancerous or pre-cancerous conditions. Women who have a hysterectomy will no longer have the ability to become pregnant.

There are three different kinds of surgery for hysterectomy:

•    Abdominal hysterectomy, performed through an incision in the belly. For an abdominal hysterectomy, the cervix can be removed or left in place.

•    Laparoscopic hysterectomy, performed by a tiny camera and tools through small openings in the belly. The uterus is removed a small portion at a time through one of these small incisions. The cervix can be left or removed, and in most cases women can be back to normal capacity after about two weeks of recovery time.

•    Vaginal hysterectomy, done via cuts inside the vagina. Vaginal hysterectomy leaves no visible scars and can be done laparoscopically. For a vaginal hysterectomy, the cervix must be removed.

During a hysterectomy, doctors sometimes also remove the ovaries, the organs that produce female hormones including estrogen and progesterone.  A subsequent supplemental hormone program is called for in this case. Removal of ovaries depends upon several variables for patients, including age and an assessment of how living without ovaries might affect you.

In women who have not been through menopause, having the ovaries removed can lead to hot flashes, bone loss, and other problems. In women of any age, having the ovaries removed can sometimes also reduce interest in sex. On the other hand, women who have health problems that get worse at certain times in the menstrual cycle sometimes feel better without their ovaries. Plus, in rare cases, the ovaries can develop cancer, so women sometimes choose to have them removed.  A qualified obstetrics and gynecology specialist can help you evaluate the pros and cons of ovary removal with hysterectomy. 

Studies show that women can have happy, full lives after a hysterectomy. Many women feel better after the surgery, because they no longer have the symptoms that previously impacted their quality of life.

Dr. Cindy Hall, D.O. OB/GYN
A Center for Women's Care, P.C.
970-384-2000
www.womens-carepc.com
Glenwood Springs

Mennorhagia: What it is, and why you don't have to live with it

Dr. Cindy Hall, D.O., OB/GYN

Menorrhagia, or excessive menstrual bleeding, can be painful, disruptive to lifestyle, and can impact health with iron deficiencies and other undesirable effects.

There are three main causes of menorrhagia, including anovulation (not ovulating once per month), having polyps or fibroids in the uterus, or having an overgrowth of the uterine lining (endometrial hypoplasia).  Sometimes it can also be due to an overall bleeding tendency in the body, for patients taking blood thinners like Coumadin or having a low platelet count.  Whatever the reason, a qualified physician can determine the cause with an examination and a variety of tests including an endometrial biopsy, which is standard before any surgery or procedure.

Patients with this condition should understand that memorrhagia is not something to endure and just "live with", and that medical science offers numerous effective treatments. The best treatment of heavy menstrual bleeding depends on:

•    The cause of your bleeding,
•    Your preferences for treatment,
•    The need to prevent pregnancy, and
•    Your desire to have children in the future.

Treatment with one or more medicines or hormonal birth control may be tried first. Antifibrinolytic medicines help the blood to clot, and antiinflammatory drugs such as ibuprofen and mefenamic acid (Ponstel), can reduce bleeding and cramps. Lysteda is a relatively new medication, which has been successfully and widely used in Europe to treat heavy bleeding, but is more costly than other available medications.

A minimally invasive surgical treatment might be an option for women with polyps or fibroids with a myomectomy, which can be performed in the office due to advances in minimally invasive surgical technology and laparoscopic pelvic surgery capabilities.

Other surgical treatments for menorrhagia include:

• Endometrial ablation, a treatment that removes most of the lining of the uterus. However, it is not a good option for women who might want to become pregnant in the future.  The treatment can be done in the office or as a day surgery. Most women can go back to work the following day.
• Hysterectomy,  a surgery that removes the uterus.  It is a permanent treatment that cures heavy menstrual bleeding. However, the surgery can have complications and requires up to six weeks for full recovery. Pregnancy is not possible after hysterectomy. There are new, less invasive techniques with laparoscopic surgery, for abdominal or vaginal hysterectomy than were previously available with traditional surgery.

Individuals who believe they may be suffering from memorrhagia should know that it can be diagnosed, and most importantly, treated, by a qualified obstetrics and gynecology specialist.

Dr. Cindy Hall, D.O. OB/GYN
A Center for Women's Care, P.C.
http://womens-carepc.com
Glenwood Springs
970-384-2000