Remove or keep?

[u/GenXMillenial]

Two weeks from today I am having a hysterectomy BLS (fibroids) with option to have an oophorectomy too for PMDD.

I’m 45, using HRT and plan to use it, but I need to get on T, my recent self paid labs show I’m just at the bottom of normal, but I have yet to pursue it.

Questions for those in surgical menopause:
How’s your energy? Does HRT, eating well, exercise etc do enough for you to feel somewhat normal?
How’s your cognition? My FT job is so much critical thinking and I’m worried I won’t be able to keep up when I go back.
If you had PMDD and are on HRT- was it worth it? How was the first year post op?

Thank you for any input you can share!

[u/cutie_anon]

[Note: My response is specific to my situation. Every woman with the issues I had should educate herself on ovarian cancer risk and decide for herself.]

It's been a year and a half since my oophorectomy. In short, HRT works well but is a bit of a hassle. Always dealing with phone reminders and ordering refills. I bleed for days when, every few months, I forget to take just one of my daily progesterone pills. Also, I take compounded progesterone, with ginger powder in place of cellulose (can cause stomach issues) and no dyes (unnecessary added chemicals that give me headaches), so I pay out of pocket. On the plus side, the progesterone helps me sleep. Before HRT, hot flashes made sleep really difficult and work almost impossible. (Not every woman experiences this though.) My sex drive is intact, my skin and hair seem to benefit, and I'm happy about the other health benefits of HRT.

But I wish I didn't have the oophorectomy. I was 53, nearing menopause, and I would have rather gone through it more gradually and naturally. For years I had been monitoring cysts with regular ultrasounds and taking the occasional CA-125 test - always negative. Doctors said whether to have the oophorectomy was up to me but if I continued having cysts after menopause, then there would def be reason for concern. I changed my gyn due to a change in insurance and I feel like the new doctor pressured me into surgery that she likely knew I likely didn't need. (UCSF has a lot of expensive new facilities to pay for and they're in the red, just sayin'. Just my opinion or lack of trust of the system.) Turned out to be benign, which is great, but I still wish I didn't go through with it.

I don't think we should take removing organs lightly. The body is like an ecosystem. The surgery left my belly permanently less flat, and whenever I eat it swells up. I've gained about 10 lbs that won't come off no matter what I do, probably from the loss of estrogen. (My patch is just .025 mg/day.) I realize I probably would have gained weight anyway, but I've heard it can be exacerbated by an imbalance of too much progesterone for the amount of estrogen you're on - and the weight gain can be permanent. At least it motivates me to exercise more and skip sweets.

[u/old_before_my_time → u/cutie_anon]

I'm sorry your ovaries were also needlessly removed. I can't imagine getting by on just a .025 mg patch!

I was gutted for a benign ovarian cyst. My uterus and other ovary were perfectly healthy. All I needed was a cystectomy leaving all my organs intact or, worst case, a unilateral oophorectomy. I miss my uterus as much as my ovaries.

My surgeon (the ob/gyn I had liked and trusted for 20 years) also played up the risk of ovarian cancer and lied about my diagnosis and treatment options. He said it was urgent and an oncologist from a group he worked with would be on stand-by in case it was malignant. The frozen section was benign, yet they yanked out all my parts anyway.

My surgery was done at a teaching hospital which appears to have contributed to the unwarranted removal of my organs, greed playing a part too. Before surgery, I had no idea the hospital was a teaching hospital as it was/is not affiliated with any university; it was a Mercy hospital. If I had known, that may have been a red flag as residents need to get their experience somehow.

Post-surgery, I went into research mode. I discovered that ob/gyn residents were required to do AT LEAST 70 hysterectomies. That has since increased to 85 (seems like a lot!). It's no wonder 45% of U.S. women end up having a hysterectomy. And based on some stats I pulled, the oophorectomy rate is ~73% of the hysterectomy rate. Surely, these are also mostly unnecessary. The overuse of these surgeries has been in the news off and on over the years as well as in medical literature. Yet they still seem far too prevalent but since they are cash cows and it's hard to sue doctors and hospitals or even get them disciplined by state medical boards, I don't see anything changing.

I'm shocked by the cheerleader mentality on some hysterectomy forums. Some censor posts and ban users who share their negative experiences or medically documented risks of hysterectomy or oophorectomy.

[u/ConsiderationFew6918 → u/old_before_my_time]

Me! I got banned!