Hysterectomy for Endometriosis

Newspaper Column Ad Appearing 7-30-03

Endometriosis, after fibroids, is the second most common reason for a hysterectomy. Endometriosis is a condition whereby tissue which usually lines the uterus (endometrium) is found elsewhere in the abdomen and sometimes in distant locations. These misplaced endometriotic lesions can cause pain and abnormal bleeding usually during or immediately after the menstrual period. Women with endometriosis may also have symptoms from other affected organs, such as urinary bladder or bowel, and typically have difficulties conceiving. Treatment options range from drugs to surgery to remove or destroy the lesions. A woman with severe endometriosis may have her ovaries and uterus removed as well. The hysterectomy brings about a "surgical menopause" that helps relieve pain by virtue of the absence of estrogen produced by the ovaries. This brings a cessation of both menstruation and swelling of the lesions that cause symptoms. However, hysterectomy is a "definitive surgery" - it terminates a woman’s reproductive function and should be reserved only for those who have completed their families. New treatment options delay this procedure and allow most women to have a family. Low-dose hormone replacement therapy (HRT) may be used after definitive surgery to reestablish estrogen’s protective effects. It is important in such cases to use the bio-identical hormones in the doses that prevent premature menopause yet are not high enough to cause endometriosis recurrence.

Generally speaking, in all but severe cases of endometriosis, doctors try conservative treatments before resorting to hysterectomy. If you suffer from this condition, discuss your various treatment options with your gynecologist. There are uterus-sparing procedures and other treatments now available that may help some women forestall hysterectomy so that they may have children. For additional information on this subject or to schedule an appointment, please call OAK BROOK FERTILITY CENTER, a medical practice devoted to reproductive endocrinology, infertility, and assisted reproductive technology. New patients are welcome.

P.S. Premature menopause can increase the risk of osteoporosis and possibly heart disease which are the price of losing the protective effects of estrogen at an early age.

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