Can a Hysterectomy Cure your PCOS?

As an integrative gynecologist, I talk to and care for women seeking a second opinion on a variety of medical issues. One of the most common questions I’m asked is “Will a Hysterectomy Cure My PCOS?”

Even the organization which “governs” my specialty, the American College of OB/GYN, has acknowledged that about 70% of hysterectomies are not indicated, and it is documented that approximately 45% of hysterectomies performed on premenopausal women do not have pathology findings which match the preoperative diagnosis. As bad as that all sounds, I’d like to share additional concerns.

Some gynecologists are recommending to women with PCOS that they have a hysterectomy to treat their condition. In some cases, the recommendation includes removing both ovaries as well. And these recommendations are to remove organs which do not contain cancerous or precancerous cells.

First and foremost, many gynecologists have little to no foundational knowledge of PCOS. If your physician is one of them, I highly and emphatically urge women to become armed with the facts to protect themselves from medically induced harm.

PCOS is fundamentally a problem of intra-body hormonal communication, not of structural or anatomic issues. The development of multiple tiny cysts on the ovaries, giving the condition its name, is a consequence of the hormonal dysfunction, not the cause. The remedies can involve major lifestyle changes, detoxification, various nutraceuticals, pharmaceuticals, and possibly hormones. Unless the unfortunate development of cancer occurs or advanced endometriosis or problematic fibroids develop, surgery is not indicated.

Removing the uterus has potential consequences in premenopausal women. Such surgery has a small association with increased incontinence and some women feel it changes their sexual responses, but the biggest issue is that it can accelerate the onset of menopause by reducing the blood supply to the ovaries. And of course, pregnancy is no longer a possibility.

Removing the ovaries is horrific for women with PCOS, from a metabolic perspective. Estrogen is essential to the proper metabolic functioning of the female body and women with PCOS have dysfunctional estrogen receptors and need the estrogen produced by their ovaries. With lower levels of estrogen, disorders such as hypertension and diabetes escalate in frequency, and obesity can worsen! For some women, there is a benefit of reduced levels of testosterone and improved acne, but for others it does nothing for their skin as their acne stems primarily from the high levels of DHEA and the pervasive systemic (body-wide) inflammation.

Many women with PCOS have menstrual dysfunctions-heavy periods, cramps, and irregularity. In virtually all women, these symptoms can be greatly reduced through the utilization of the treatment modalities mentioned above. Therefore, it would be the rare woman who should resort to surgery as a treatment for PCOS.

If surgery is suggested to you as the treatment of choice, please get another opinion. And of course, as a practicing integrative gynecologist, this is an essential part of my job. I’m here for women; to listen to them, care for them, particularly when it comes to a misunderstood, often times misdiagnosed and poorly treated PCOS.

*This is a repost of a guest post Dr. Gersh orginally posted on PCOS Diva at: http://pcosdiva.com/2015/04/will-a-hysterectomy-cure-your-pcos/

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