C. W. Randolph, M.D.
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 Approximately one in every four American women will enter an abrupt, artificial menopause as the result of a hysterectomy. If you are a woman who has had a partial hysterectomy—that is, removal of the uterus only—you can still be estrogen dominant because your ovaries will continue to produce some estrogen and even less progesterone.
If you are a woman who has had a complete hysterectomy—that is, removal of the entire reproductive tract (the uterus, fallopian tubes, and ovaries), you can still be estrogen dominant. |
Bottom Line Health
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| In the past, abnormal uterine bleeding was treated by a complete hysterectomy.
Alternatives to hysterectomy...
•Endometrial ablation. This approach, requires no incision and is performed on an outpatient basis. It stops uterine bleeding in up to 80% of women.
How it works: A hysteroscope(a thin, lighted telescope) is inserted through the vagina and cervix into the uterus. An electric current or laser is then used to heat and destroy the endometrium. Scar tissue may develop, which is likely to impair a woman's ability to become pregnant. |
J. Douglas Bremner
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 Studies of women with hysterectomy and bilateral oopherectomy (removal of uterus and ovaries) initially showed an improvement in memory function with HRT, although these studies were uncontrolled. However, the Women's Health Initiative (WHI) study showed that estrogen alone in women with hysterectomy was associated with a decline in cognition as measured with the Mini Mental Status Exam.
In terms of benefits, HRT does reduce the loss of bone-mineral density that occurs with normal aging and reduces the risk of osteoporotic fracture. There is also minimal evidence that it improves sleep. |
Mike Adams, the Health Ranger
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 Note that the words hysteria and hysterectomy (the surgical removal of the uterus) have the same word roots. That's because a hysterectomy was a procedure originally developed by men and used as a surgical weapon to make women "less hysterical." It was long believed that the uterus was an organ that caused insanity! In reality, the organ that no doubt causes the most insanity is the penis, but that's another story... notice that you don't see male doctors recommending penisectomies as a cure for male insanity. |
Gerald E. Markle and Frances B. McCrea
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 One researcher has shown that a hysterectomy in an otherwise healthy forty-year-old woman increases her life expectancy by some four months, a gain is entirely explained by the 1.3% women who are destined to die of endometrial cancer. For other women, there is no gain in life expectancy; in fact, there may be a decline, given that among women with hysterectomies, there are higher rates of cardiovascular disease.
There are no universally accepted set of criteria regarding appropriate indications for a hysterectomy. |
| Radical hysterectomy (including the ovaries) may result in nerve destruction, leading to the inability to control bladder function. In premenopausal women, it also necessitates hormone replacement therapy.
One researcher has shown that a hysterectomy in an otherwise healthy forty-year-old woman increases her life expectancy by some four months, a gain is entirely explained by the 1.3% women who are destined to die of endometrial cancer. |
| The most common presenting symptom for a hysterectomy is severe menstrual bleeding. Complications from surgery are common: half of all women develop postsurgical kidney or bladder infections, some of which require additional surgery. Radical hysterectomy (including the ovaries) may result in nerve destruction, leading to the inability to control bladder function. In premenopausal women, it also necessitates hormone replacement therapy. |
Andreas Moritz
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 This means that more than half of all American women will have had a hysterectomy by the time they reach the age of 65. Many of these women will suffer from post-operative syndromes such as depression, anxiety and increased susceptibility to stress. I have seen in my own practice that most women who have had a hysterectomy developed ovary problems, breast lumps, digestive disorders or breast cancer 1-5 years after the operation.
An investigation carried out in six New York hospitals found that 43 percent of all uterus operations were unjustified. |
| Thousands of women every year have a full hysterectomy (including the removal of the ovaries), but have not given their consent prior to the surgery. Only a few of them make use of the law to seek compensation, but money cannot return a woman's uterus, which is symbolic of womanhood.
Even from a surgical perspective, a woman has less invasive and traumatic options. First, there is the less invasive nryomectomy, which preserves fertility by removing just the fibroid, but keeps the rest of the reproductive system intact. However, nryomectomy can be just as traumatic as having a hysterectomy. |
Shannon Brownlee
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 Two procedures in particular stood out: the hysterectomy, in which a surgeon removes a woman's uterus and sometimes her ovaries and cervix, and the prostatectomy, or removal of a man's prostate gland, which sits at the base of the penis and helps produce seminal fluid. Hysterectomies were performed for a variety of reasons: to get rid of fibroid tumors, a noncancerous type of growth on the uterus that can cause bleeding and cramps; to reduce premenstrual symptoms; to cure the pain from another abnormal growth called endometriosis; and sometimes as an expensive form of birth control. |
Tori Hudson, N.D.
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 Women who have had a hysterectomy but still retain one or both ovaries will go through menopause more naturally most of the time, although sometimes earlier than they would have otherwise. Without the uterus and the monthly bleeding, it may be harder to know when menopause arrives. All the typical symptoms can occur, though. If you are fortunate to not have any of the overt menopausal symptoms, you can estimate that you'll have gone through menopause somewhere between ages 48 and 53. The FSH blood test may be used to determine menopausal status. |
Thomson Healthcare, Inc.
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 Cimicifuga racemosa was as effective as the estrogen products in decreasing menopausal symptoms in young patients who have undergone a hysterectomy (Lehmann-Willenbrock, 1988).
Eighty percent of women experiencing menopausal symptoms improved or resolved in a multicenter study of 629 patients (mean age 51 years) who were treated with Black Cohosh. Patients tolerated the black cohosh well with mild gastrointestinal complaints recorded in 7% of the patients studied. (Stolze, 1982). |
| Homeopathic Arnica preparations had no effect on surgically induced trauma after total abdominal hysterectomy or bilateral oral surgery.
Retinopathy, Diabetic
Two clinical studies demonstrated beneficial effects of homeopathic Arnica therapy in the treatment of diabetic retinopathy (Zicari et al, 1998; Zicari, 1997). |
| Nausea and Vomiting, Postoperative
In a double-blind, placebo-controlled study, postoperative nausea and vomiting occurred with lower frequency in women undergoing abdominal hysterectomy who were treated with a capsaicin-containing plaster than in those treated with an unmedicated plaster (Kim et al, 2002).
Neurogenic Bladder
Excellent or satisfactory improvement in urinary incontinence occurred in about 80% of patients treated with intravesical capsaicin. |
Tori Hudson, N.D.
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| Bladder sympathetic innervation may be interrupted by injury to peripheral nerves from prior UTIs, hysterectomy, or childbirth. This may lead to an increased transmission of pain impulses from the bladder and reduced circulation, facilitating inflammatory cell infiltration and leading to bladder ulceration, fibrosis, and atrophy.
Each of these theories has supportive and detractive evidence. As stated earlier, the cause of IC may vary in different people, or multiple factors may be in operation. |
Shannon Brownlee
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| The side effects of both surgeries could be huge, even life-altering: The hysterectomy was major surgery, and some women died. Others suffered a sudden and complete loss of interest in sex. For men, a prostatectomy might make urinating easier, but it could also leave them so incontinent they needed adult diapers, or impotent, or both. Wennberg wondered how many men and women would actually submit to the surgery if they were made aware of the potential consequences and the uncertainty about its supposed benefits. Such questions weren't welcomed by surgeons. |
Thomson Healthcare, Inc.
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| In a double-blind, placebo-controlled study of 80 postmenopausal women, between the ages of 45 and 59, who were diagnosed as having DSM-III-R major depressive disorder or dysthymia between 6 and 36 months following either natural menopause or hysterectomy, underwent 1 week of single-blind placebo washout, followed by 30 days of double-blind treatment with either SAMe 1,600 mg/day or placebo. There was a significantly greater improvement in depressive symptoms in the group treated with SAMe compared to the placebo group from day 10 of the study. |
Shannon Brownlee
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| In the latter part of the twentieth century, dozens of common treatments, including the tonsillectomy, the hysterectomy, the frontal lobotomy the radical mastectomy, arthroscopic knee surgery for arthritis, X-ray screening for lung cancer, proton pump inhibitors for ulcers, hormone replacement therapy for menopause, and high-dose chemotherapy for breast cancer, to name just a few, have ultimately been shown to be unnecessary, ineffective, more dangerous than imagined, or sometimes more deadly than the diseases they were intended to treat. |
Tori Hudson, N.D.
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| The exception is women who have had a hysterectomy; they do not need to take progesterone or progestins. However, there are times when adding natural progesterone rather than increasing the dose of the estrogen, even in women without a uterus, may alleviate some menopausal symptoms. Some women's insomnia, fatigue, mood swings, and other menopause symptoms may be more responsive to progesterone than to estrogen.
It is important to note that all progestins (the synthetic progestogen) can have undesired side effects. |
| There are basically three surgical options that may be considered in individual cases: dilation and curettage (D&C), endometrial ablation, or hysterectomy.
1. Dilation and curettage (D&C) can be both diagnostic and therapeutic. A D&C is the quickest way to stop bleeding; therefore, it is a treatment of choice in women with DUB who suffer from anemia due to heavy menstrual blood loss or who are acutely unstable. The problem with a D&C is that it is only temporary in most cases and does not cure the problem the majority of the time. |
Bill Sardi
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 New England Journal Med 293: 1164-67, 1975; International J Gynecology 12: 496-500, 2002] Some physicians suggest women undergo a complete hysterectomy before they start on the drug to eliminate the risk of endometrial cancer.
Estrogen blockers like Tamoxifen eventually lead to a dead-end street. Due to what is called " Tamoxifen resistance," the drug inevitably turns on every woman within five years. Tamoxifen must be stopped after five years when cellular resistance materializes and turns this drug into a cancer-promoter. |
Shannon Brownlee
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| At thirty-one, she underwent a total hysterectomy for symptoms of endometriosis. Besides the fainting spells, Dawes suffered from nausea, vomiting, exhaustion, dizziness, blinding headaches, depression, and anxiety. Her symptoms left her unable to work, and she spent most of her time in bed or on the sofa. With no primary care physician, Dawes had made more than two hundred visits to emergency departments over the years and had referred herself to a string of specialists whenever one symptom or another grew intolerable. |
Thomson Healthcare, Inc.
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| Capsicum plaster at the Korean hand acupuncture point reduces postoperative nausea and vomiting after abdominal hysterectomy. Anesth Analg; 95:1103-1107. 2002
Kohane D, Kuang Y, Lu N et al. Vanilloid receptor agonists potentiate the in vivo local anesthetic activity of percutaneously injected site 1 sodium channel blockers. Anesthesiology Feb; 90(2):524-34. 1999
Kreymeier J, Rheumatherapie mit Phytopharmaka. In: DAZ 137(8):611-613. 1997
Lopez-Carrillo L, Hernandez Avila M & Dubrow R. Chili pepper consumption and gastric cancer in Mexic;: a case-control study. Am J Epidemiol; 139(3):263-271. |
Bill Sardi
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| International Journal Cancer 78: 720, 1998]
Growth Years
Years of Fertility
Change of Life
Males
High iron needs
Markedly lower iron needs
Lower iron needs
Females
High iron needs
High iron needs (unless hysterectomy)
Markedly lower iron needs
Iron and breast cancer
The injection of iron into breast tissue exposed to a toxic carcinogen doubles the frequency of tumors observed in rats. Tumors in iron-injected rats were also larger. [Carcinogenesis 18: 1757, 1997]
Japanese researchers have found that progesterone increases the serum iron levels among breast cancer patients. |
Andreas Moritz
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| Having a hysterectomy, on the other hand, is not without risks. The mortality rate is 1 in 1,000 procedures, and serious complications occur 15 times more frequently than that. Side effects can occur in more than 40 percent of operations; they include urinary retention or incontinence, significant reduction in sexual response, early ovarian failure, risk of a fatal blood clot and bowel problems.
Induction, Cutting and Caesarean Section
Pregnant women are generally treated with respect and special care, but the methods of delivery used today can have an adverse effect on mother and baby alike. |
| Risk of requiring a hysterectomy after a caesarian was four times higher than after vaginal birth.
In addition to the harm done to mothers, babies who are delivered by Caesarean section are exposed to the danger of developing serious lung damage, which causes a shortage of breath previously found only in prematurely born babies. In naturally born babies (which includes not clamping the umbilical cord before it stops throbbing; see lotusbirth.com), the uterine contractions press out all the accumulated secretions in the baby's chest and lungs and eliminate them through its mouth. |
| I have seen in my own practice that most women who have had a hysterectomy developed ovary problems, breast lumps, digestive disorders or breast cancer 1-5 years after the operation.
An investigation carried out in six New York hospitals found that 43 percent of all uterus operations were unjustified. Other research shows that only 10 percent of hysterectomies are warranted. Fifteen percent of hysterectomies are carried out to remove cancerous tumors, and are thus considered necessary. |
Gerald E. Markle and Frances B. McCrea
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| There are no universally accepted set of criteria regarding appropriate indications for a hysterectomy. Most are done for fibroid tumors that present no immediate problems, inflamation or bleeding, or are associated with abortion or sterilization. One study found that in half of all hysterectomies reviewed, accuracy of the preoperative diagnosis could not be evaluated.13 Some suggest that a "majority of hysterectomies performed for menorrhagia (excessive bleeding from menstruation) are unnecessary," advocating instead less invasive procedures. |
| In the 1970s, the probability of a woman undergoing a hysterectomy in Middlebury was about one-quarter by age 75, whereas in nearby Lewistown, seven of ten women had the surgery. In 1982, carotid endarterectomies were twice as common in Boston than they were in New Haven, but the rates for coronary bypass were the reverse. Hysterectomies were more common for New Haven women, but hip replacements were performed at a higher rate in Boston.
What accounts for these variations in adjacent towns? |
| Just as every woman with a uterus was seen as a candidate for a hysterectomy, so was every child with a throat a tonsillectomy waiting to happen. Sore throat? Take out the tonsils. No great loss, thought most surgeons. Tonsils don't seem to do anything very important. At the time I lost mine, tonsillectomy was the third most common surgery done in the United States. Today it is understood that these little organs in our throat contribute significantly to the immune response.43
The very notion of "unnecessary" often involves cultural as well as medical judgments. |
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