WOMENS-HEALTH Messages for August, 2000: Re: necessity of total hysterectomy

Re: necessity of total hysterectomy

From: R. Daniel Braun, MD (anonymous@obgyn.net)
Thu, 31 Aug 2000 19:28:09 -0500 (CDT)

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In reply to: Pat: "necessity of total hysterectomy"

At Thu, 31 Aug 2000, Pat wrote: >
>I have an enlarged uterus, fibroid tumors, excessive bleeding and
>extreme anemia. My ob/gyn wants to do a total hysterectomy. From what
>I read I feel that if my ovaries and cervix are healthy she should leave
>them behind. She disagrees. I do not want homone replacement therapy.
>I had a bad reaction to provera. What would be effective for me?

After a hysterectomy, we give estrogen replacement therapy not Hormone replacement therapy. After the hyst there is no need for the provera. If pap smears have never been abnormal and the patient desires to have the cervix left behind, I have no problem with it. The patient has to understand the need for continuing pap smears etc. Usually, the age of the patient or the pathology determines whether or not I recommend removing the ovaries. Ovarian cancer (1%of all women will get it) is a devastating form of cancer to get. Cure rates are very low. The risk of cancer versus the need to take a hormone pill a day is what needs to help you make the decision. If you want to keep your ovaries and cervix, your physician can't make you have them out.

RDB

--
R. Daniel Braun, MD FACOG  FOG

This is for educational purposes only, and is not intended to be replacement or substitute for consultation and examination by an appropriate medical professional.  Due to time constraints, private e-mails cannot be answered.

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In reply to: Pat: "necessity of total hysterectomy"

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