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/
I know this article is older. But I need director. On what to discus s with my dr and possible treatments. I have had PCOS since my teens. Although I didn’t know it until my mid 20’s. I had all the typical symptoms of too much estrogen. Had rapid large amounts of unexplained weight gain, developed high blood pressure when it had always been on the low side. Along with infertility. This is how I discovered I had pcos. The pill had masked some of my symptoms, then when I tried to get pregnant I had a hard time. Well then after having issues I had twins (with medical help), not too many years later I had several issues with Ovarian cysts. Even on the pill. I had some rupture, some had to be surgically removed and finally one ovary had to be removed. It was severely misshapen. Not too long after I decided to go off the pill. I felt like this was bad for my body, and decided the bad out weighed the good. Surprisingly I got pregnant with a singleton all on my own. Then a few years after that I was having issues with my other ovary. (By the way, I had my tube tied when I delivered my youngest, just in case) I started having pain and knew I had another cyst. Well this one was causing me a bit of pain every day. I had finally gone into the Dr and was told I could have a full hysterectomy and it would help my issues, rather then doing another cyst removal. I had my surgery scheduled and about a week before I was due to go in, the cyst ruptured. Previously, when this had happened, I would have sudden extreme pain. This time the pain did not dissipate. So I went to my Dr who told me to go to the ER since my pain was continuing. I went to the ER and they confirmed the cyst had ruptured. So then decided I needed surgery on more of an emergency basis. Because my cyst ruptured, my abdomen had all that gunk floating around, that had been in the cyst. So I was told they would only remove my ovary. They did not want to risk complications or infection by also removing my uterus and repairing my bladder. I also had a large fibroid they said would shrink. Well, I tried to take hrt to combat the menopause symptoms and a year and half after the ovary removal, I developed TNBC. My question is I’m not sure now what to do to help my numerous issues from hormone imbalance. I am now morbidly obese, have high blood pressure, migraines, chronic inflammation and fibromyalgia, chronic pain etc. is there anything natural I can do? Or certain things I should talk to my dr about, so that I can possibly get my body working properly and hopefully lose weight along with some of the other issues that go along with PCOS?
Hi thank you for the information in your post. I would really like your professional help and opinion on what I’ve been experiencing and living with. Ever since I first started my period at the age of 11 or 12 it would always come on time and lasted for about 3 to 4 days with the 4th day just minimal blood. I would get no pain prior to or during my cycle and this went on for years until my early twenties. Then I started getting pain on my left side from my leg to my toes when my period would be due but my period was still regular every month as clock work on time and no pain during and lasted 3/4 days. However, in my mid twenties when I started thinking of getting pregnant it would not happen. I then experience missing my period for 3 to 4 months and when it the came it was the heaviest I ever experienced in life, It was gushing and I was in pain and it lasted for about 14 days. After that it went back to my normal. during this time I always had my regular pap smears done with normal results, I also had an ultra sound and at that time was told that my ovaries were clear. In between that I finally got pregnant and was so happy about it but it turned out to be an empty ovum and was naturally aborted. Not long after that I experience missing my period again and thought I was pregnant however the same gyne told me I had PCOS then did another pelvic ultra sound this time it was different when she pressed on the left to get a clearer picture it hurt it really hurt, I was in pain. I was not pregnant and this time she said she’s seeing cysts in my ovaries and give me a prescription for some tablets to be taken with increasing dosage over a period of time I can’t remember the name at the moment. The very next day I started to bleed very heavy and it continued every day for 18 months straight, with me passing some huge clots. I never took the tablets I was afraid to. Now I’m 46yrs and my period has totally stop but I get the symptoms of a period, I’ve developed back pain on my left side that has different levels of severity and heightens just before a period is due. I thought that I was going through pre menopause but recently I started passing a clear gel like when ovulating, I have dry skin which at times itches and leaves welts when I itch. I have acne under my chin which I never before even in my teens had an acne problem, I have high blood pressure for which I take meds never had that issue before, I’m not diabetic but yes I’m very much over weight and that has increased through out the years. Although I’ve dieted and exercised and tried many weight loss programs they never had much significant progress, the most I lost was 65lbs and gained it all back with extra. I really hope you can give me some insights and steer me in the right direction. Thank you for your time and kind consideration.
What do you do if you already had a hysterectomy but aren’t tolerating any of the Hrt. I feel so stuck
Wonderful article. Thank you for being an educated and thorough doctor.
Hello Dr Gersh,
I have pcos and I am having horrible premenstrual syndrome (suicidality, very deep depression before and during periods) By tracking my symptoms I noticed recently that it was hormone-related and related to my menstrual cycles. SSRI and other antidepressants have not worked and made me more suicidal so I had to stop them. I have tried dozens of antidepressants in the last 10 years with no success. I tried talk therapy also. What about removing ovaries of women with pcos because of severe mental health issues related to hormones ? The rest of the month I am ok. Could a permanent contraceptive implant stop my periods entirely / help me? Help. My quality of life is near zero because of this.