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Monday Medical News - Endometriosis After Hysterectomy

Posted Mar 22 2010 5:17am
As Endometriosis Awareness Month draws to a close, I just had to post an article related to endometriosis & hysterectomies. The past two weeks I have found myself doing A LOT of research for personal reasons as once again my endo symptoms have returned (even though I am almost 2 year post-hysterectomy). I knew that my hyst was not a cure and I knew there was a chance it would return. I was just really really hoping that I would be one of the lucky ones.  At the time, my hyst was unavoidable because of the amount of damage the endo had caused (my kidneys and bowels were involved as well as my left ovary being so diseased that it had swollen to the size of my uterus) but still there is that small part of me that wonders if I had held on a little longer could I have gotten pregnant?  Of course, I'm smacked in the face with the reality that even if I had gotten pregnant I would have never carried to term.  So therefore . . I guess I am glad that it happened when it did.  So back to the present, it's on to finding successful treatment for life with endo after a total hysterectomy.  Today's article comes from .

Endometriosis After Hysterectomy- Are Relapses Common?

Experiencing endometriosis after hysterectomy is a likely possibility, and is why treatments such as Mirena may still be needed.  This may come as a surprise to you, especially if you have been under the impression that a total hysterectomy (removal of the entire uterus, ovaries, and part or the entire cervix) can provide relief from the painful symptoms caused by endometriosis. 
Although it does sound logical that the removal of the organs infected by endometriosis would put a stop to the disease, this, unfortunately, is not the reality for a number of women.  In fact it is estimated that 10-15 percent of women with endometriosis, who undergo a hysterectomy, experience an endometriosis recurrence after 1 – 3 years following the procedure, and as many as 50 percent have a recurrence after 5 years.
How can the return of endometriosis after hysterectomy be possible?  First and foremost, there is no cure for endometriosis.  Secondly, it’s a known fact that implants (endometrial tissue) can be found outside of the uterus and ovaries, and can occur throughout the pelvic cavity and beyond (I.E. bowels, bladder and rectum).  Therefore, if implants occur in areas outside the uterus, a total hysterectomy will not remove all of the disease. 
That being said, there are surgeons that will attempt to remove any implants they find in other regions aside from the reproductive organs.  However, there is still a high possibility that some of the disease will be left behind, as some implants are microscopic and can go undetected.
Another problem that can cause endometriosis after hysterectomy is hormone replacement therapy.  If a woman undergoes a total hysterectomy, she has lost her ovaries, and is, therefore, in full blown menopause.  Although menopause can be beneficial in relieving endometriosis symptoms, because it stops the production of estrogen (the hormone that feeds the disease), the female body requires a certain level of estrogen in order to function properly. 
In other words, while endometriosis may no longer be a problem, unpleasant menopause symptoms due to lack of estrogen (I.E. hot flashes, headaches, vaginal dryness, bone loss, etc.) will be.   Hence, women who have undergone a total hysterectomy, and do not take hormone replacement therapy, may find relief from their endometriosis but not their menopausal symptoms, or vice versa.  These women often find themselves in a no win situation.
Are there ways to treat endometriosis after hysterectomy?  Yes.  The following are some treatment methods you may want to consider -

• Control your diet – Find out what foods you should avoid that can trigger endometriosis symptoms or make them worse.
• Medical therapies – There are different remedies such as oral contraceptives, and the drugs Progestin and Danazol, which help to prevent the growth of endometrial tissue.  You may also consider taking over-the-counter medication such as NSAIDs (nonsteroidal anti-inflammatory drugs – I.E. aspirin, ibuprofen) to help alleviate painful symptoms.
• Alternative remedies – non-drug therapies that may be useful include acupuncture, acupressure, aromatherapy, hypnosis, messages, herbal remedies, etc.

Essentially, when it comes to treatment, the best course of action you can take is to talk to your doctor about your options to find out which ones are right for you.
Finally, if you have endometriosis or know someone who does, and are thinking about having a total or partial hysterectomy, it is imperative that you explore other treatment options first.  The chance of a recurrence of endometriosis after hysterectomy is high enough that it shouldn’t be ignored.  There is no reason to put your body through the stress of such extreme surgery, when there are other options available to you.

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