Hysterectomy: How to Choose the Best Procedure for You

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You have choices and options when deciding to have your Hysterectomy.

Dr. Maupin spent almost thirty years as a Gynecologist, and performed many hysterectomies. This week she is going to explain the three-different hysterectomy types a woman can have.

How old you are at the time of your hysterectomy is very important. It is really about whether you are pre-menopausal or postmenopausal. The removal of the ovaries means a loss of estradiol, progesterone, and testosterone. The younger you are the more you will be symptomatic without your ovaries, the higher your risk of heart disease and osteoporosis, and the more severe your symptoms will be. If you are pre-menopausal then you should ask why they must be taken out. The reasons are really important pieces of information for deciding what course of action to take.

If you have ovarian cancer, uterine cancer, advanced cervical cancer, or often even breast cancer, then there is usually no choice to make, you must take the ovaries to save your life!

When you and your physician are discussing having a hysterectomy there are three questions you should ask before you make the decision.

  1. Should I take my ovaries out?
  2. Which type of surgery is best for you? Should you have an abdominal or vaginal hysterectomy?
  3. Do you want to keep your cervix?

These are decisions that your doctor should discuss with you before the procedure because once you have the operation there is no going back.

Endometriosis is the most common reason, besides cancer, to remove the ovaries.

If it is physically safe it is preferable to leave one or both of the ovaries because of the hormones that you will need as you age. If you need to take them both out, then you will need to consider hormone replacement therapy after your hysterectomy.

Women can have reasons to take out the uterus. They also can need to take out only the ovaries. If there is only a need to take out the uterus doctors will usually go ahead and take out the uterus because if they leave it there will still be bleeding complications as the woman tries to get her hormones balanced as she ages.  If she decides to have a vaginal hysterectomy she will also loose her cervix as part of the procedure.  This is what doctors used to do, but now they have learned that there are reasons to leave the cervix if it can be done safely. The primary reason to leave the cervix is that a woman can have an orgasm from the cervix. If it is removed it will eliminate one of the ways that women can achieve orgasm. If they have historically had cervical orgasms they will lose the ability to have a satisfying sexual relationship. It would be desirable to leave the cervix so that a hysterectomy doesn’t destroy the ability to have a full and satisfying sexual life.

There are two other focal points from which women can have orgasms, but we believe it helps to maximize the potential experience for a woman and her partner if we can. The best way to do that is to leave the cervix.

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author. www.BioBalanceHealth.com.

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