The Brilliant Conductor of a Finely Tuned Symphony ~ Our Ovaries
Before you remove your ovaries (or uterus) read this.
As a woman who lost her ovaries, it has brought me great joy to research these essential, finely-tuned organs and share with others the profound magnitude of natural healing and balance they bring to a woman’s body. To understand why you may want to ‘save’ your ovaries, read on.
The power of our ovaries should not be overlooked or minimized; rather, these organs should be revered, cherished and cared for. The ovaries are like the cocoon of a caterpillar, without its protection a butterfly would never form and without the beautifully orchestrated complex hormonal symphony that is largely managed by a woman’s ovaries, we would not exist.
Throughout this century, several misconceptions about our ovaries have been allowed to shape our present gynecological practices. I’ve heard everything from “The ovaries shut down at menopause” to “the main function of the ovaries is to bear children,” says Dr. Cutler who did her postdoctoral work at Stanford, where she established the Stanford Menopause Study.
Over the past century, these false beliefs have resulted in the philosophy that the preventative removal of the ovaries is justified because it decreases the risk of cancer.
This conclusion, based on erroneous beliefs (I’m not talking about BRCA genes), has led to the removal of healthy ovaries – and has become a standard medical practice for women over 40 when they undergo a hysterectomy. As a result, it is reported that 52% of all hysterectomized women lose their ovaries. And this dramatically increases to 76% for those between ages 45 and 54, leaving millions of women attempting to function without these essential organs.* And needless to say, adjusting to living with some dramatic body changes as a result.
If you’re facing a hysterectomy and considering ovary removal, you deserve to be as informed as possible. So, let’s take a look at some of the most common misconceptions around ovaries and the truth of what these organs do for our bodies.
Misconception #1: Your ovaries stop working after menopause
Women who have been led to believe that their ovaries will stop working have been urged to give up these critical organs when faced with surgical choices. In reality, however, a woman’s ovaries continue to work after menopause on critical funtions for the overall body, such as being the main contributing source of estoadiol (estrogen) and testosterone in all postmenopausal women.
In 1955, Hollenbeck published that ovaries contribute to a woman’s feeling of well-being. “The common experience of gynecologic surgeons reporting their patients complain bitterly of a severe menopausal syndrome when ovaries have been removed years after cessation of menses, has established the fact of ovarian estrogenic function long after menopause.”
Every day, the ovaries produce approximately 60 micrograms of testosterone, and this is even more important after menopause when the rest of the body declines in its testosterone production. The body uses testosterone not only for sexual drive and response, but for maintenance and repair – and it is also converted into estrogen. And after menopause, ovaries typically account for 40% of the body’s testosterone production – up from 25% before menopause.*
Misconception #2: The only function of the ovaries is childbearing
The ovaries are not just reproductive organs – they are the foundation of life! Not only does new life spring from them, they are essential for the healthy continuation of every woman’s life.
Take away a woman’s ovaries, and she can no longer build strong bones and muscles or create healthy skin. Her cardiovascular systems become stressed, fat clogs her arteries, and her metabolism is altered in unhealthy ways. Normal blood pressure becomes difficult to maintain. Her emotional stability, energy levels, sense of well-being, and appetite are affected, due to the alteration of the chemicals in the brain. In addition to all of this, her ability to respond sexually can be diminished.
These conditions may start to appear after the loss of ovarian function primarily because the vital chemicals they manufacture govern many aspects of our body and hormones. Scientifically, the relationship between estrogen, testosterone and progesterone has been known for years, but still there is a lot that remains unknown when it comes to the depth and breadth of influence our ovaries have on a woman’s bodily functions.
Now mind you, the list above are reported conditional changes. However, I can attest to some of these conditions sure from my own experience. Hence, I was happy to research this topic so that I could properly adjust my post surgery lifestyle to support my body in a more educated, empowered manner. So I take heart health and bone health pretty seriously at this point, as I desire to live a full vibrant life even without my magnificent ovaries.
Misconception #3: Preventative removal of ovaries is justified as it decreases the risk of cancer
The fear of cancer, combined with belief in the first two misconceptions, has allowed another myth to take hold: “removal of the ovaries is not only necessary, but beneficial as well.”
I can tell you firsthand that removing my ovaries has had significant negative impacts on my body and well-being. I would never wish my experience on any woman, which is why I’m writing this to encourage women to do their own in-depth research before making such a decision. Even knowing I had cancer, I still give this advice. If I could go back, I may have waited a bit longer before surgery to try some more alternative approaches.
Hollenbeck studies reveal doubts about any such benefits of ovary removal. “In weighing all of these facts it seems that the best we could accomplish would be the prevention of subsequent ovarian cancer in 3 women out of every 10,000 hysterectomies”.* (Hollenbeck)
Tragically, the incredible irony surrounding the practice is shown by many studies which reach the same conclusion: ovaries that are left in place during a hysterectomy undergo cancerous changes less often than in the population as a whole.
The following conclusion from a 1984 article continues to uncover why prophylactic ovary removal is difficult to justify. “Routine oophorectomy would deprive enormous numbers of women the essential benefits afforded by these steroid-secreting (sex hormone producing) organs.”*(Cutler)
The truth is, ovaries perform a multitude of functions. “Undergoing this removal throws women’s bodies into what is called ‘surgical menopause’, because menopause starts immediately after surgery.” * (Plourde). And research proves: “surgical menopause accelerates all the processes of natural menopause”. * (Rudy). The effects on the body are tremendous. Bodies can be thrust into rapid adjustments, compared to the natural slow transition over years for natural menopause. This abrupt overnight change, and the complete loss of chemicals, which would normally continue to be manufactured by menopausal ovaries, leads to more severe symptoms than women experience when they are allowed to go through menopause naturally. This includes greater cardiovascular damage and bone loss. * (Hollenbeck)
In fact, all the evidence today points to the fact that it is imperative to heed the studies done in the mid-80’s “Because oophorectomy has such profound influences at every age, particularly is devastating relation to osteoporosis, we suggest that oophorectomy only be performed when the ovaries are diseased.” * (Garcia)
Misconception #4: Ovaries left intact during a hysterectomy will continue optimal functioning
Women who elect to save their ovaries, feeling confident they will be left with all the production these organs provide, need to be aware that, sadly, saving the ovaries does not guarantee that they will function as before. * (Plourde)
The human body is miraculous as a unit, and it was designed in so many ways to function as a whole, so it’s no wonder that removal of the uterus alone can lead to ovarian failure. Chemicals secreted by the uterus are part of a feedback loop that stimulates the ovaries, so this disruption could be part of the hormonal disruption and can also impact ovarian blood supply.
Research shows that as many as 20-44% of hysterectomized women may experience decreased ovarian function, or ovarian failure. * (Siddle) So, even when both ovaries are preserved, many studies demonstrate that women experience abnormal hormonal and menopausal symptoms.
The below statistics were reported by Dr. Seely, Dr Watson and Dr Vuorento.
23% show increased Follicle-stimulating hormone levels, which indicates a decrease in ovarian function
Bone density is lower than normal
39% demonstrate deficient progesterone levels one month after surgery and 6 months later showed no signs of improvement.
When only one ovary is left, there is an even greater possibility that it will shut down. This result is so common, one article concluded with “The fact that ⅓ of the patients undergoing USO (one ovary removal) will develop ovarian dysfunction raises the question whether there is a place for this procedure.” * (Bukovsky)
In short, removing the uterus is a gamble; women have no way of knowing if they will be thrown into surgical menopause even if they opt to leave their ovaries intact. But that being said, having lost my ovaries, I’ll still opt to try to keep them.
As long ago as 1932, a study looking at the question of uterus removal (keeping ovaries) found that the frequency of menopausal symptoms in hysterectomized women under 40 was eight times greater than in those who did not undergo surgery; systems occurred within two years of surgery in 92% of the women. And 44% of hysterectomized women enter into menopause by age 45, compared to only 13% of women who have never had the surgery. * (Siddle)
Though numerous articles prove a direct relationship exists between hysterectomy and early menopause, very few women are informed of this potential. As a result, women start to experience these symptoms, don’t understand what is happening, and then consequently may not get the support and help they need to prevent the early onset of the menopausal conditions and long term vibrancy of body and mind!
Total ovary function is still unknown
The medical community is very much in the dark as to the total ovary function, both premenopausal and post menopausal. Consequently, researchers are just now identifying some of the chemicals that are lost due to the removal of our childbearing organs. And it’s simply not possible for doctors to artificially replace something when they have no idea what it is, what it does, how much it is needed, or when it is needed.
In reality, after almost a century of removing these organs by the millions, medical science is only beginning to piece together some of the complex interrelationships these essential hormone and chemical-making organs have with the rest of the body. There are still so many areas that need to be explored and clarified as to how the ovaries function throughout a woman's life.
Until more is understood, “standard medical practice” should not mean removing healthy organs whose entire functions remain unknown, and therefore can not be easily replaced. Ovaries play a vital role in a woman’s long-term health and well-being, and every woman deserves to be fully informed and supported in her decision to hold onto these powerful organs whenever possible.
Sources:
-Garcia C, Cutler WB. Preservation of the ovary: A reevaluation. Fert Steril. 1984 Oct. 42 (4):510-4
-Bukovsky I, Halperian R. Ovarian function following abdominal hysterectomy with and without unilateral oophorectomy. Eur Jour Obstet repo Biol. 1995 Jan 58(1):29-32
-Siddle N, Sarrel P, Whitehead M. The effect of hysterectomy on the age at ovarian failure: Identification of a subgroup of women with premature loss of ovarian function and literature review. Feral Steril. 1987 Jan. 47 (1): 94-100
-Hollenbeck SJR. Ovarian cancer-prophylactic oophorectormy Amer Surg. 1955. 21:442-6
-Lepine LA, Hills SD, Marchbanks PA et al. Hysterectomy Surveillance - United States 1980-1993. MMWR, U.S. Centers for Disease Control. 1997 Aug. 46 (SS-4):1-15
-Sightler SE, oike GM, Estape RE, Averette HE. Ovarian Cancer in Women with prior hysteretomy: a 14-year experience at the University of Miami. 1991 Oct 78(4):681-684
-Rudy DR, Bush IM. Hysterectomy and sexual dysfunction: you can help. Patient Care. 1992 Sept 30. 26(15):67-82
-Plourde, E. Your Guide to Hysterectomy, Ovary Removal & Hormone Replacement.
-Cutler, WB. Hysterectomy Before & After
-Streicher, L. The Essential Guide to Hysterectomy
