hysterectomy skeletal changes Archives

Share Your Hysterectomy Experience

by WS

Published on December 4, 2018

4447 views

The hysterectomy and oophorectomy industry continues to flourish. There are over 600,000 hysterectomies every year. The oophorectomy rate is about 70% of the hysterectomy rate, some performed at the time of hysterectomy and others as separate surgeries. About 90% of these surgeries are for benign conditions (elective). These are merely estimates based on samples of inpatient data from short-term, acute-care, nonfederal hospitals along with hysterectomy and oophorectomy outpatient percentage estimates. According to the aforementioned publication, the rate of outpatient (ambulatory) hysterectomies increased from 14% in 2000 to 70% in 2014. Outpatient oophorectomies increased from 57% to 84% over the same time period. The Centers for Disease Control (CDC) reports only inpatient hysterectomies which is why hysterectomy rates are typically understated by the media. A 70% understatement is a gross misrepresentation and outpatient hysterectomies may now exceed 70%.

Hysterectomy is seen as panacea for a multitude of women’s health issues. Unfortunately, it is not, and yet, this perception that hysterectomy is a cure-all survives, largely because of false information from gynecologists, gynecologic oncologists, other medical professionals, hospitals, surgical centers, the media, and women who have had the surgery(ies).

The prevalence of hysterectomy and oophorectomy leads the public to mistakenly believe that a woman’s sex organs are disposable. In many cases, gynecologists fail to provide their patients with the necessary factual information to make an informed decision about these surgeries, leaving women and their partners to learn about the side effects after the fact. Some of the more commonly reported side effects include: bladder and bowel dysfunction, skeletal and figure changes, sexual dysfunction, emotional emptiness, and impaired ovarian function. Although some may believe these side effects are rare and thus rarely discussed pre-surgery, comments on these hysterectomy articles indicate they must be more common than many realize.

What makes these side effects even more troubling, is the fact these procedures are rarely needed. Women are coaxed into the surgery under the false pretense of cancer or pre-cancer or told it is their only or best option. Finally, many women’s organ(s) are removed despite having specifically told their surgeons that organ(s) should not be removed. Here is just one of those stories.

In light of the problems with hysterectomy, the HERS Foundation is collecting stories of post-hysterectomy problems. We are supporting that effort. If you would like to share your story, consider participating in the “In My Own Voice” project. To learn more, click here.

If you would like to share your story here on Hormones Matter, please contact us here.

Thank you in advance for sharing your hysterectomy experience.

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Adenomyosis

by Philippa Bridge-Cook, PhD

Published on January 9, 2014

69385 views

Adenomyosis is a common disease of the uterus, yet little is understood about the causes and risk factors, diagnosis is difficult, and there are few effective treatments besides hysterectomy. Adenomyosis can exist on its own, or in conjunction with other pelvic diseases such as endometriosis. The incidence of adenomyosis in the general population is not known, because estimates of incidence have only been done in populations of women undergoing hysterectomy.

Symptoms of adenomyosis may include:

Painful periods
Painful ovulation
Chronic pelvic pain (all month long)
Heavy and/or prolonged menstrual bleeding
Large blood clots
Pain in the thighs

Adenomyosis can sometimes be asymptomatic, and it is not known why some women can get debilitating pain and extremely heavy bleeding from adenomyosis, while others have no symptoms at all.

The medical definition of adenomyosis is when glandular tissue, normally only found in the endometrium ( the inner lining of the uterus), is found in the myometrium (the muscle wall of the uterus). Adenomyosis used to be commonly called endometriosis interna, or endometriosis of the uterus, because of the similarity to endometriosis, which occurs when tissue similar to the endometrium is found in the pelvis or elsewhere in the body.

The cause of adenomyosis is not known. There are some studies that associate c-sections, prior uterine surgeries, and/or miscarriages with a risk of adenomyosis, although other studies have found no associations. One theory is that invasion of cells from the surface endometrium into the deeper muscular layers of the uterus can result in adenomyosis. In addition, developmental origins have been proposed, where tissue laid down in the wrong place during formation of the embryo can result in adenomyosis later in life. This theory may be the most likely to be true, as there is some support for this theory in the development of endometriosis, and endometriosis and adenomyosis often occur together.

Diagnosis of adenomyosis is difficult, because there are no tests that can definitively confirm or rule out a diagnosis. In some cases, adenomyosis can be suspected from ultrasound results or MRI results, but normal ultrasound or MRI results do not rule out the presence of adenomyosis. Adenomyosis can also be suspected from pelvic exams, when the uterus is large or tender. Since the main symptoms of pelvic pain and heavy bleeding can result from many other causes, it is difficult to diagnose adenomyosis based on symptoms. Other conditions causing similar symptoms include endometriosis, fibroids, and hormonal imbalances.

Sometimes adenomyosis symptoms can be managed with medication. Pain relievers such as NSAIDs can be used to treat pain, and in some cases hormonal medications such as the birth control pill or a Mirena IUD can treat the symptoms by stopping periods. Medications to control heavy bleeding are often not used by gynecologists, but they can be effective and prevent the need for a hysterectomy if heavy bleeding is the only symptom. The most effective medication for heavy bleeding is Lysteda (tranexamic acid), but DDAVP (desmopressin) can also be used.

Endometrial ablation is sometimes a suggested treatment for the heavy bleeding caused by adenomyosis, but it can make adenomyosis pain worse. In addition, adenomyosis may confer a greater likelihood of endometrial ablation failure. Doctors will often say that “the ultimate cure” for adenomyosis is a hysterectomy. Although hysterectomy is obviously effective at curing uterine pain and heavy menstrual bleeding, it is a major surgery and sometimes has unwanted effects and complications . If we understood the causes of adenomyosis better, we might be able to develop more specific treatments for the underlying cause or causes, and avoid such extreme surgery.

It is commonly stated on medical websites that adenomyosis goes away after menopause. However, it was often said that endometriosis goes away after menopause, and now it is known that for at least some women, maybe most, it does not. We don’t really know the incidence of endometriosis post-menopause because women who complain of pelvic pain after menopause are usually told that the pain cannot be endometriosis, and are not investigated for endometriosis, even if they have a previous history of it. It may be a similar fallacy to believe that adenomyosis goes away after menopause.

It is also often said that adenomyosis is more common in women over 35. The idea that it is more common in older women may come from the fact that it can only definitively be diagnosed by pathology studies post-hysterectomy. Older women with pelvic pain and/or heavy menstrual bleeding may be more willing to have a hysterectomy to solve the problem than younger women, who may want to keep their uterus for child-bearing. Therefore, adenomyosis ends up getting diagnosed more often in the older age group, but may be just as common in younger women. In fact, adenomyosis is starting to be diagnosed more often in younger women, using better imaging techniques.

There are many unanswered questions about adenomyosis and more research is needed in many areas of this disease. Better methods for diagnosis would be extremely helpful, as at the moment adenomyosis can only be confirmed by hysterectomy. Answers about why some women have such severe symptoms while others have none, what causes adenomyosis in the first place, whether it really can persist after menopause, and more, may help lead to less invasive and more effective treatments for this disease.

Post Hysterectomy Skeletal and Anatomical Changes

by WS

Published on April 23, 2013

339355 views

I wonder if so many women would “choose” hysterectomy if they knew how it would affect their figure and internal anatomy. I know I would have told my once respected gynecologist “no way” and left never to return if I’d known just a smidgen of what I now know. Here are some of the anatomical and skeletal changes that occur post hysterectomy.

Ligament and Skeletal Changes Post Hysterectomy

An intact woman’s figure has space between the rib cage and the hip bones commonly known as the waist. The waist gives her the curve in her lower back, the natural sway in her hips, her “elongated” torso that’s proportionate to her extremities. This all changes after hysterectomy.

Four sets of ligaments hold the uterus in place. These ligaments are the “scaffolding” or support structures for the core (midsection). When the ligaments are severed to remove the uterus, the spine compresses causing the rib cage to gradually fall toward the hip bones and the hip bones to widen. This causes a shortened, thickened midsection, protruding belly, and loss of the curve in the lower back, giving the appearance of a flat derriere. In some women, these changes cause those hated rolls of fat (weight gain or not). In others, it looks more like a pregnant belly. This can be particularly distressing for women whose hysterectomies denied them the chance to have (more) children.

As if an unattractive figure isn’t devastating enough, these skeletal changes lead to chronic back, hip, and rib cage pain as well as tingling and loss of sensation in legs and feet. It also explains why, even absent osteoporosis, hysterectomized women lose height. With all these changes to the skeletal structure, I wonder if hysterectomy can also cause spinal stenosis. It would certainly seem plausible.

Evidence of my spine compressing started 12 to 18 months post-op. A crease started forming about two inches above my navel. It gradually lengthened over the next 6 months to a year until it became visible all across my midsection. I’ve always been thin (underweight) with flat, toned abs and prominent hip bones. And contrary to what most women experience after hysterectomy, I lost weight. As my spine compressed, my flat abs became “fat” and flabby. My hip bones became less prominent in the front (as my belly pooched out) and more prominent in the back since my rib cage had fallen onto my hip bones. And I now have intermittent back, hip, and rib cage pain as well as tingling in feet. My sacrum / tailbone has also looked bruised since not long after my hysterectomy.

Internal Organs Post Hysterectomy

And how does the body change on the inside? Well for one, it affects the bladder and bowel. The uterus separates the bladder and bowel and holds them in their rightful positions. Removal of the uterus causes these organs to fall impeding function. When the bladder or bowel is full, there can be a feeling of discomfort or even outright pain (exactly what I’m feeling at this moment – constant pain that increases by just walking). Complete emptying can be problematic as can incontinence. Bowels may alternate between constipation and diarrhea. Adhesions can further hamper bowel function even to the point of a life threatening obstruction. I’ve had serious bowel problems ever since my surgery 7 years ago. Chances of bladder, bowel, and vaginal prolapse and fistula also increase leading to more loss of quality of life and future risky surgeries. Hysterectomy has even been shown to increase risk of renal cell (kidney) cancer likely caused by damage to ureters. I have to wonder if functions of other organs may also be affected as our organs don’t work in isolation and may be further affected by the anatomical changes.

Nerves and Sex Post Hysterectomy

And what about sensation after all those nerves and blood vessels are severed? What’s it like having a shortened vagina that’s not connected to anything? Well, it’s no wonder sex isn’t the same! How can it be? And if you enjoyed uterine orgasms, those are obviously a pleasure of the past. Even nipple sensation can be lost because nerve endings are found all along the spine. The severing of nerves as well as scar tissue formation can cause a problem worse than loss of sensation – nerve entrapment which can be quite painful.

I’m not sure which is worse – the hormonal adverse effects or the anatomical and skeletal adverse effects. There’s no doubt though that my body has been drastically altered since the unwarranted removal of my vital female organs.

The adverse effects to a woman’s figure, as well as the many other adverse effects of female organ removal, are detailed in the video “Female Anatomy: the Functions of the Female Organs.” Priceless!

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