The role a woman’s ovaries play after menopause
What role does a woman’s ovaries play in her overall health, and what use are they after menopause?
Menopause is tough enough to deal with when it occurs naturally, but when we enter menopause in our 20s, 30s or 40s due to surgery, these changes are sudden and can therefore be quite distressing.
Women who go through natural menopause often have hot flashes and night sweats caused by the drop in estrogen production, but they usually don’t have the extreme symptoms that come with the abrupt surgical menopause (sudden onset of menopause after removal of the ovaries).
When it’s happening naturally, women see a more gradual decline in estrogen production than those who go through the immediate version.
A woman’s ovaries produce the lion’s share of estrogen and testosterone, so estrogen and testosterone levels crash after removal of her ovaries in surgery.
Pre-menopausal women who have a hysterectomy with bi-lateral oophorectomy will undergo an ?instant? menopause, due to the loss of hormones produced by the ovaries. This includes her ability to produce progesterone [that occurs at ovulation].
After removal of her ovaries, a woman’s cholesterol, particularly the bad LDL cholesterol, rises and she is at increased risk for suffering a heart attack. Other side effects include depression, osteoporosis, and the drop in testosterone causes loss of assertiveness, muscle strength and interest in making love.
Recent studies show that the symptoms of surgical menopause are more severe and prolonged compared to symptoms during natural menopause (when ovarian function gradually diminishes).
The aging ovaries continue to produce certain amounts of estrogen and androgens for at least ten years after the start of menopause. Androgen deficiency affects bone loss, libido, muscular and fat distribution, the sense of well being, energy, and appetite.
Preservation of the ovarian production of estrogen and androgen, albeit reduced compared to the reproductive years, may contribute significantly to a woman’s health.
This is another rationale for preserving the genital organs even after menses have ceased.
Does removing women?s healthy ovaries at hysterectomy really prevent ovarian cancer? A review of the evidence
Today, the debate centres on the removal of a woman’s healthy ovaries during abdominal hysterectomy on the basis of such a removal’s prophylactic - or preventative - effect. Oophorectomy, some claim, prevents the development of ovarian cancer.
But does it really? In fact, no conclusive medical evidence exists to support this belief. Rather, the medical research on this question presents a confused picture, with a few studies claiming prophylactic oophorectomy prevents ovarian cancer, but the majority refuting this claim.
If the ovaries are normal, the chance of cancer later in life appears to be around 0.25%.
There is a 5% chance of reoperation for cysts when the ovaries are saved. However, reoperation for endometriosis may be high as 47% if the ovaries are preserved.
The benefits for women at either a high or low risk for ovarian cancer of prophylactic oophorectomy are unproven.
Women who have been informed they need a hysterectomy are urged to hang on to their ovaries unless life-threatening.
Even though a hysterectomy will interfere with the blood supply resulting in complete dysfunction of your ovaries over time, leaving them where they are will benefit your overall hormonal health … providing they are healthy.
The medical term for the removal of your ovaries during a hysterectomy is castration!
At the end of the day, women should recognise the real role of the hormonal output of their ovaries in their bodies - both before and after menopause - and insist that their practitioners demonstrate the benefit to them of oophorectomy at hysterectomy before seeking their express consent to perform the procedure.
