Psycho-social problems of women who had undergone hysterectomy

More documents

Recommendations

Info

hormone replacement therapy was prescribed were still taking the medication after12 months. Overall, only 10% of menopausal women in the U.S. are takinghormone replacement therapy. Given these facts, there is a compelling argumentfor avoiding unnecessary hysterectomy whenever possible. It is clear that optimalhealth is maintained by uterine and ovarian preservation, except when cancer isalready present or there is a family predilection for cancer (Michael E. Toaff, MD,MSc)Recent studies show that the symptoms of surgical menopause (sudden onset ofmenopause after removal of the ovaries) are more severe and prolonged comparedto symptoms during natural menopause (when ovarian function graduallydiminishes). The aging ovaries continue to produce certain amounts of estrogenand androgens for at least ten years after the start of menopause. Androgendeficiency affects bone loss, libido, muscular and fat distribution, the sense of wellbeing, energy, and appetite. Preservation of the ovarian production of estrogen andandrogen, albeit reduced compared to the reproductive years, may contributesignificantly to a woman's health. This is another rationale for preserving thegenital organs even after menses have ceased.Other long-term adverse effects of hysterectomy have been reported. Somestudies, although not all, report that new urinary symptoms such as frequency,urgency, and incontinence occur in 30% of woman after hysterectomy. This maybe the inevitable result of bladder denervation (surgically cutting off the nervesupply to the bladder) during hysterectomy. Also, slow propulsion constipationdevelops in about a third of women after hysterectomy, even without the presenceof rectocele. Frequently, hysterectomy leads to sagging of some internal genitalorgans such as the anterior vaginal wall (dropped bladder or cystocele) andposterior vaginal wall (rectocele). These conditions may cause symptoms such asdifficulties in urination, stress urinary incontinence or constipation, difficulty in
penetration during intercourse, and vaginal infection. These conditions may besevere enough to require surgical correction.Emotional health may also be affected by hysterectomy. The uterus has greatpsychological significance for some women, more so in certain cultures. Althoughmany women have no emotional difficulties after surgery, hysterectomy may befollowed by problems such as depression, anxiety, and sexual dysfunction. Theissue of sexual function after hysterectomy is complex. Some women feel that bylosing their uterus they have lost their womanhood. They may feel that theirpartner no longer desires them leading to loss of libido. One physical consequence,which may result from hysterectomy, and may directly affect sexual function, isshortening of the vagina resulting in pain during deep penetration. The mostimportant effect of hysterectomy on sexual function may be on orgasm. For somewomen, "deep" orgasm involves rhythmic uterine contractions. Followinghysterectomy this important component is lacking and such women complain of adramatic decline in the quality of their orgasm. For women whose orgasmicpleasure does not depend on uterine contractions, hysterectomy may not lead to adecline in the quality of their sexual response. In fact, many women report thathysterectomy led to an improved sexual life, especially when hysterectomyeliminated major medical problems such as bleeding, pain, and/or prolapse of theuterus. In other women, fear of an unwanted pregnancy always had a negativeeffect on sexual function and elimination of this fear by hysterectomy hasenhanced pleasure.Finally, many women are strongly opposed, in principle, to the removal of anyorgan, genital or otherwise, unless absolutely necessary.In this discussion the drawbacks of hysterectomy have been summarized. Aswomen have informed themselves regarding these issues many have resistedhysterectomy until they are convinced that it is absolutely necessary for their wellbeing.After 30+ years in the practice of obstetrics and gynaecology it remains my
Page 1 and 2: ABSTRACTTitle - Psychosocial Proble
Page 3 and 4: PSYCHOSOCIAL PROBLEMS OF WOMEN WHO
Page 5 and 6: Dysfunctional uterus bleeding (DUB)
Page 7 and 8: Vaginal hysterectomy is prefered wh
Page 9 and 10: Vaginal bleeding—this should dimi
Page 11 and 12: hospital reported 1547 hysterectomi
Page 13 and 14: ) The study also gathered first han
Page 15 and 16: and found no evidence of hormone di
Page 17 and 18: Any kind of surgical intervention o
Page 19: esulting absence of ovarian estroge
Page 23 and 24: heavy, prolonged and irregular blee
Page 25 and 26: hysterectomy. She complained of wei
Page 27 and 28: Case no: 2Nirmala is 42 years old a
Page 29 and 30: She did not perceive it as a “los
Page 31 and 32: esult of her hysterectomy. She was
Page 33 and 34: miscarriage following tubular pregn
Page 35 and 36: A change was found in the intensity
Page 37 and 38: Depression in the patient before su

Psycho-social problems of women who had undergone hysterectomy

Create successful ePaper yourself

Delete template?

Save as template?