Sensational headlines might be a bit off but the conversation is worthwhile

Posted by on 29 October, 2012

This might be worth explaining. No I'm not booked in for hysterectomy regardless of symptoms on my 50th birthday. But if I need one, I'm running to the doctor and adding my name to the list.

I see lots of women who have shocking bleeding and discomfort from problems with the uterus that start around the perimenopause. If I so much as mention the word hysterectomy, they go white and say they'll do anything but that!

So here's a word in favour of the hysterectomy for people who have issues with fibroids, adenomyosis, recurrent CIN and even heavy bleeding simply from not ovulating;

First it isn't the major surgical procedure that left your grandma bed ridden for months and never the same again. It's done by keyhole surgery and the recovery is very quick. They leave in your tubes and ovaries. Of all the surgical procedures my patients have, this one would most often get the "best thing I ever did" verdict. When needed, a hysterectomy can be life saving.

Hysterectomy lowers your risk of ovarian cancer and eliminates your risk of uterine, endometrial and cervical cancer. It permanently solves your bleeding issues. And finally it puts oestrogen only HRT on the table if you need it for the devastating symptoms of menopause. And 70 per cent of women have at least one symptom of menopause- be it hot flashes, mood swings, insomnia, sexual problems, feeling vague....

Usually with HRT you need both oestrogen and progesterone (combined HRT). That's because despite the fact that it's oestrogen that does all the heavy lifting in terms of your symptoms, if you give oestrogen without progesterone, you risk endometrial cancer. The problem with adding in progesterone is that you do see this tiny increase in breast cancer and heart disease. That came out in the Womens Health Initiative in 2002. Oestrogen only therapy LOWERS the risk of both (unless you're in your 70s when the heart disease risk becomes problematic but few women need HRT for hot flashes by the time they hit 70).

Even with a uterus in, I'm going for HRT if I hit menopause with a bang. I've seen too many beautiful women have their lives made uncomfortable by hot flashes and the other symptoms of menopause but deny themselves the very best treatment available because they're worried about the breast cancer risk of HRT. The increased risk from being on HRT is smaller than from having a glass of wine a night or from being overweight.

We use small doses and start as soon as possible after the start of your symptoms and we wouldn't leave you on it for ever. But HRT works and more women should put it back on the table as an option. It seems several peak bodies agree and this year the North American Menopause Society, the Endocrine Society, and the American Society of Reproductive Medicine, all put out a statement saying HRT is safe and effective and the statement was then endorsed by another 12 top medical societies in the United States, Canada, and Mexico.

My story is not meant to generate titillating headlines but get women talking about menopause and  having more options to deal with it and less guilt and fear. Watch the Sunrise segment HERE and read the herald article by Jo Cassamento HERE