{"id":13319,"date":"2021-10-28T19:27:51","date_gmt":"2021-10-29T00:27:51","guid":{"rendered":"https:\/\/naturalwomanhood.org\/?p=13319"},"modified":"2025-01-24T09:36:31","modified_gmt":"2025-01-24T15:36:31","slug":"si-vous-envisagez-une-hysterectomie-pour-endometriose-lisez-dabord-ceci","status":"publish","type":"post","link":"https:\/\/naturalwomanhood.org\/fr\/if-youre-considering-a-hysterectomy-for-endometriosis-read-this-first\/","title":{"rendered":"Si vous envisagez une hyst\u00e9rectomie pour endom\u00e9triose, lisez d'abord ceci"},"content":{"rendered":"\n

Many people believe that a hysterectomy (removal of the uterus, sometimes accompanied by a bilateral oophorectomy\u2014removal of the ovaries) is a definitive cure for endometriosis; in fact, a few years ago actress Lena Dunham<\/a>, and even more recently, comedian Amy Schumer<\/a>, have made headlines with their decisions to have hysterectomies to treat their endometriosis. Unfortunately, as the Endometriosis Association points out<\/a>, the belief that a hysterectomy can \u201ccure\u201d endometriosis is a myth. In fact, there is no known cure for endometriosis, which is thought to be an autoimmune disease (although the exact cause of endometriosis isn’t known, either). However, when combined with excision surgery, a hysterectomy \u201cmay reduce or eliminate symptoms,\u201d but (the Endometriosis Association warns) it is \u201cnot a sure cure.\u201d Plus, it is a treatment that comes with a high cost: permanent infertility. <\/p>\n\n\n\n

Endometriosis pain can be so bad that women are willing to consider a total hysterectomy\u2014which means permanent infertility <\/span><\/h2>\n\n\n\n

Endometriosis<\/a> is a condition in which tissue similar to the lining of the uterus (the endometrium) grows outside of the uterus. These endometrial lesions can be found growing pretty much anywhere within the pelvic cavity: On other pelvic organs, such as the fallopian tubes and the ovaries, to (less frequently) on other organs<\/a>, such as the bladder and the intestines. These lesions can even from adhesions that bind structures within the pelvic cavity together. <\/p>\n\n\n\n

Like the endometrium, these lesions are stimulated throughout the menstrual cycle, and then “break down” and bleed during menstruation. But, since this bleeding tissue is not within the uterus (like the endometrium is), it can\u2019t leave the body. As a result, it is trapped and forms scar tissue and adhesions that can cause symptoms ranging from pain, to heavy bleeding, to gastrointestinal problems<\/a>, to painful intercourse, and infertility. Most commonly, however, women with endometriosis experience pain\u2014which can be so severe that they may find themselves desperate for any form of relief, even if it isn’t necessarily curative (as, again, there is no known cure), and even if it means permanent infertility. <\/p>\n\n\n\n

When considering your options for endometriosis treatment<\/a>, it\u2019s important to find a provider you trust<\/a>, and to understand all the possible benefits and drawbacks of the proposed treatment(s). In this article, we\u2019ll discuss a few of the most important considerations to keep in mind when considering your options for endometriosis treatment.<\/p>\n\n\n\n

Chances of disease or symptom recurrence <\/span><\/h2>\n\n\n\n

According to one study<\/a>, \u201cthere is an approximate 15% probability of persistent pain after standard hysterectomy [i.e., a hysterectomy without removal of the fallopian tubes and ovaries as well] with a 3-5% risk of worsening pain or new symptom development.\u201d The researchers note that this persistence in symptoms is likely due to insufficient removal of endometrial tissue, not the development of new tissue. It is also more common among women who do not have their ovaries removed with their uterus. As Dr. Elizabeth D. Cox, a Natural Procreative Technology (“NaPro”) OB\/GYN writes<\/a>, \u201cThere is no cure for endometriosis, and removing the uterus without removing the endometriotic lesions will rarely improve symptoms.\u201d <\/p>\n\n\n\n

An article<\/a> by Dr. Philippa Bridge-Cook, executive director of The Endometriosis Network Canada, states that even with removal of the ovaries and the Fallopian tubes, symptom recurrence rates range from 8% to 10%. And one study<\/a> of 61 women comparing patients who had excision surgery with patients who had excision surgery combined with a hysterectomy found that removing a woman\u2019s uterus, ovaries, and Fallopian tubes \u201cwas not associated with improved outcomes when compared with uterine-sparing surgery.\u201d While 61 is a small sample size, it\u2019s still data to keep in mind when making this decision. <\/p>\n\n\n\n

Considering the impact on fertility <\/span><\/h2>\n\n\n\n

Excision surgery can effectively remove endometriosis (although recurrence is possible with this surgery, too), often while restoring or improving a woman\u2019s ability to have a child. According to the Pope Paul VI Institute<\/a> (home of NaProTechnology), NaPro surgical treatment of endometriosis is 56.7% to 76.4% effective in treating infertility. A hysterectomy, by definition, eliminates a woman\u2019s ability to have children. If you want to have children, and your doctor believes it may be possible with the right kind of treatment, a hysterectomy is not the treatment for you. <\/p>\n\n\n\n

A hysterectomy and oophorectomy will throw you into menopause <\/span><\/h2>\n\n\n\n

A hysterectomy that includes the removal of the ovaries immediately puts a woman into menopause, because she is no longer producing estrogen (which is ordinarily produced by the ovaries in younger, still-fertile women–although some small amounts of a weaker estrogen, estrone, are still produced by the adrenal gland). Worse, this sudden \u201covernight\u201d drop in estrogen, according to the University of Michigan Health System<\/a>, causes more severe menopausal symptoms than one would experience during the natural season leading up to menopause, known as perimenopause<\/a>\u2014which under normal circumstances is a slow process taking place over the course of several years. Low estrogen also causes the bones to begin to thin, which increases a woman\u2019s risk of developing osteoporosis later. Furthermore, Bridge-Cook writes, \u201cthe beneficial effects of the small amounts of hormones that continue to be produced post-menopause from the ovaries are gone.\u201d <\/p>\n\n\n\n

Unfortunately, even a hysterectomy without <\/em>a bilateral oophorectomy can cause menopause to begin an average of 3.7 years earlier than it would have otherwise, Bridge-Cook writes (possibly due to scarring and reduced blood flow to the ovaries from the hysterectomy surgery). <\/p>\n\n\n\n

Complications and risks <\/span><\/h2>\n\n\n\n

All major surgeries carry a certain degree of risk, which needs to be considered by the patient and their physician and weighed against the desired outcome. Bridge-Cook reports that a hysterectomy plus bilateral oophorectomy can cause pelvic floor and bladder dysfunction, and usually (10 to 20 years after the surgery) can also increase a woman\u2019s risk of urinary incontinence and vaginal prolapse. <\/p>\n\n\n\n

Of course, endometriosis excision surgery is not without risks, either (again, as with any major surgery). Excision surgery carries with it the usual risks of any surgery, which a hysterectomy carries as well. However, the University of Michigan Health System notes<\/a> that the risks associated with excision surgery in particular are rare, and may include pelvic infection; uncontrolled bleeding requiring a larger incision; the formation of scar tissue after the surgery; and damage to the bowel, bladder, or ureters. <\/p>\n\n\n\n

Deciding which endometriosis treatment is right for you <\/span><\/h2>\n\n\n\n

As with many things when it comes to endometriosis, there is no clear consensus, because there is still a lot of research that needs to be done. As one article<\/a> puts it, \u201cDebate continues over the role of hysterectomy and of concurrent oophorectomy, with little reliable evidence to inform practice.\u201d Dr. Ken Sinervo, medical director of the Center for Endometriosis Care, believes that<\/a> there are two times a hysterectomy might be required for endometriosis: when the disease is so extensive that it is impossible to excise all of it (which is quite often the cases with Stages 3 and 4<\/a> of the disease), and when a woman also has one of several other conditions, such as adenomyosis, \u201ca condition in which endometrial glands and stroma have penetrated and started to grow within the muscular lining of the uterus (the myometrium).\u201d <\/p>\n\n\n\n

So, if you are suffering from endometriosis and wondering, \u201cShould I have a hysterectomy?\u201d the right answer for you will depend on many factors. By understanding the benefits and risks, and speaking to a trusted doctor who is experienced in managing the condition, you can make the decision that\u2019s right for your health and well-being. <\/p>\n\n\n\n

Additional Reading:<\/p>\n\n\n\n

The Difficulties of Diagnosing and Categorizing the Stages of Endometriosis<\/a><\/p>\n\n\n\n

Considering endometriosis surgery? Here\u2019s how to find a good endo surgeon<\/a><\/p>\n\n\n\n

5 Lesser Known Symptoms of Endometriosis You Might Not Know About<\/a><\/p>\n\n\n\n

Managing Endometriosis Pain with Fertility Awareness<\/a><\/p>\n\n\n\n

Endometriosis and Autoimmune Disease: What\u2019s the Connection?<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"De nombreuses personnes pensent qu'une hyst\u00e9rectomie (ablation de l'ut\u00e9rus, parfois accompagn\u00e9e d'une ovariectomie bilat\u00e9rale...","protected":false},"author":78,"featured_media":13320,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","csco_singular_sidebar":"","csco_page_header_type":"","csco_page_load_nextpost":"","csco_post_video_location":[],"csco_post_video_url":"","csco_post_video_bg_start_time":0,"csco_post_video_bg_end_time":0,"footnotes":""},"categories":[5364,5181],"tags":[5807,6369,5790],"class_list":["post-13319","post","type-post","status-publish","format-standard","has-post-thumbnail","category-endometriosis","category-reproductive-and-menstrual-disorders","tag-endometriosis-pain","tag-hysterectomy","tag-will-endometriosis-come-back","cs-entry","cs-video-wrap"],"acf":[],"yoast_head":"\nConsidering a hysterectomy for endometriosis? - Natural Womanhood<\/title>\n<meta name=\"description\" content=\"Having a hysterectomy for endometriosis isn't right for everyone, and will cause permanent infertility. 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