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Radical hysterectomy effects
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I am going to have a "radical" hysterectomy. I know that then my body will go into menopause. What do I need to know, and look out for, what will it be like?  

If you are having your ovaries removed, which the term "radical" seems to imply, you will experience surgical menopause.  The part of the surgery which removes the ovaries is called surgical castration or bilateral oophorectomy.  You should have been informed by the surgeon if this is to be part of your surgery. "Radical" hysterectomy usually removes more of the surrounding tissue around the uterus than a plain hysterectomy and it is usually done when there is possible disease in the surrounding tissues such as for cancer or severe endometriosis.  

The term hysterectomy would imply that only the uterus is being removed.  
In a partial (or subtotal) hysterectomy the cervix and base of the uterus are left intact.  
In a total hysterectomy the entire uterus including the cervix is removed.  
A total hysterectomy with bilateral/oophorectomy removes the entire uterus, cervix, ovaries and fallopian tubes.  
A radical hysterectomy will include all of the above plus part of the vagina and some lymph nodes.  This is very serious surgery and your doctor should have told you exactly what to expect and exactly what he/she is planning to remove with diagrams. 

Surgical menopause can be made bearable with estrogen replacement therapy (ERT).  Unfortunately, many women who require radical surgery for cancer or endometriosis, cannot take estrogen as it feeds their disease (the reason the ovaries are removed in some cases, is to eliminate the source of estrogen).  These women must learn to adjust to the reduced levels of estrogen their bodies will have.  

If you have your ovaries removed and do not take estrogen replacement you can expect to experience any of the 34 signs of menopause to come crashing in on you all at once within a short time after your surgery.  Some women start to have the hot flashes as soon as they recover from the anesthetic.  Others don't have them until a few days later.  The major problem caused by this artificially lowered estrogen level is that it can cause your bones to become weak over time and you will be more susceptible to developing osteoporosis than the average woman.  For this reason, you will need to do some reading and find out what diet and exercise changes to make to preserve your bone mass after surgery. 

Many women have gone through this surgery before you and they have learned to live in their new bodies over time.  Initially, you will be very happy to have the disease removed from your body.  After the surgical pain subsides, you will be pain free, but if the ovaries are removed, you will have hot flashes and night sweats which may keep you from sleeping.  You may have problems with fuzzy thinking and volatile emotions and rages.  These will probably go on for a seemingly endless period of time (months) and you will look for anything (other than estrogen) to give you relief.  Your doctor may prescribe a blood pressure medication for the hot flashes which may help some.  You can try wearing all cotton night clothes and sheets and fan yourself and keep the temperature in your rooms very low.  You will be tempted to try herbs and supplements - anything to get relief. Unfortunately no one knows what the effects are of these substances on the disease which brought you to surgery.  Some women have found relief with the use of natural progesterone cream, but research has shown that there is a largely placebo effect with these creams.  

There are other side effects of surgical castration which you will undergo even if you take ERT.  You will possibly experience vaginal dryness which will be itchy and uncomfortable and make intercourse difficult to impossible.  There are lots of different lubricants to use to help this and you might try aloe vera gel to add moisture to these tissues.  Your doctor might let you use an estrogen cream or gel to replenish the vaginal tissue. 

I can't tell you how long it takes to get past the period of withdrawal from endogenous estrogen (this is the estrogen your ovaries produced).  I was able to take ERT after my surgery.  There are many others who know and should be able to tell you though. There is a hysterectomy e-mail list you may want to subscribe to.  Go to this web site and follow the directions there: 
http://www.2cowherd.net/findings/sans-uteri-list.html 

fiona  
 

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