Premature Ovarian Failure: A Not Uncommon Result
Of Early Hysterectomy
A 42-year-old patient came into my office one year after a hysterectomy for uterine fibroids. The ovaries were not removed, yet she began having hot flashes within six months of the surgery. Her doctor said this was “impossible” because she still had her ovaries. Between hot flashes she was cold. Because she also complained of fatigue, depression, loss of libido, worsening allergies, and insomnia he started her on an antidepressant. The medication helped a little, but because the patient did not feel comfortable with the diagnosis or the treatment, she saw me for a second opinion.
The history was rather characteristic of premature post surgical ovarian failure. Despite the fact that the ovaries were left in, it is extremely common for the ovaries to shut down early after surgery because of disruption of their blood supply. Gynecologists do not acknowledge this phenomenon. Such an attitude can only be maintained by not listening to their patients. This is a common story.
I did saliva testing of sex hormone levels and indeed found that the patient’s estradiol, progesterone, testosterone, and cortisol were all low. Weakening adrenal function with low cortisol can cause the underactive thyroid symptoms she had, like cold temp and fatigue.
This case illustrates the interplay between the hormones, the unwanted and unrecognized effects of surgical intervention, and the dangers associated with uninformed traditional medical doctors who don’t know all they should know about what they are doing and don’t pay enough attention to womens’ complaints. In this patient’s case, ovarian production of hormones dropped precipitously despite the patient being nowhere near menopausal age. The patient’s doctor inexcusably did not recognize the hormonal implications of her symptoms, or their connection with the surgery that he performed. He compounded his error by prescribing medication that was not indicated, and did not address the true cause of this patient’s problems. His failure to diagnose the underlying cause was also about to put his middle aged patient at risk for the continuing discomfort of untreated menopausal symptoms including irritability, hot flashes, and insomnia, premature aging of skin and body, osteoporosis, sexual dysfunction, chronic fatigue, underactive thyroid function, and the side effects of anti-depressant medications. Her relatively young age at the onset of the post surgical ovarian failure put her at much greater risk of these serious problems in both the short and long term. If and when the patient’s doctor finally comes to hisssenses and realized he was dealing with a hormone imbalance, he would no doubt have prescribed pharmaceutical company horse estrogens unopposed by progesterone (“because you no longer have a uterus”) rather than identical-to-human hormones in the proper balance, and in doing so would have increased her risk of breast cancer in the process.
The moral of this story is the same as many others that I have shared. “Modern medicine” can be dangerous. There is a place for traditional medical and surgical care, but before ever having surgery, and certainly any time you start not feeling well after surgery, seek out the services of a well trained and experienced natural medicine physician for another perspective on the problem.
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