| July 9, 1999 | |||
| Ask WHPU | |||
Endometriosis despite Hysterectomy and Oophorectomy |
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I had a complete hysterectomy and my ovaries removed 14 months due to endometriosis. My GYN assured me that after the surgery I would be able to take HRT because it would be a lower dose of estrogen than what my ovaries produced, thereby causing the remaining endo would whither away and die. The endo pain continued so he pulled me off the HRT, saying that after six months of no estrogen the endo would die for sure. That didn't happen... -- Name withheld |
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Your situation is not surprising since hysterectomy and ovariectomy
are not always curative of the symptoms of endometriosis, and because that
surgery does not remove all of the endometriosis implants in the pelvis.
Perhaps more was done than you are aware of in an attempt to remove the
implants, or perhaps they have grown back from the microscopic disease that
couldn't be seen by your surgeon. Or perhaps other pain syndromes, such as
interstitial cystitis, or hyperactive bowel syndrome are the cause of the
pain. Another variable is body weight, because a heavy person makes more
estrogen than does a thin person, and perhaps this factor, if present, is
adding to the estrogen-induced symptoms.
The other hormone of importance is progesterone which obliterates endometriosis. An alternative to stopping the estrogen would have been to continue it along with norethindrone, a synthetic progestin, in a patch product called Combipatch by Rhone-Ponolac-Rhorer. Or this could have been done orally with Searle's Lo-estrin 1/20, taken every day. Another approach would be to administer Depo-Provera by IM injection monthly, or Provera orally at 30mg daily, with or without estrogen. Even Danazol, 400mg daily would probably have reduced the symptoms. All of these medical treatments take 8-12 weeks before the benefit can be evaluated-it's a slow process, killing the endometriosis. So be courageous, and keep asking your physician for help, or for a referral to an endometriosis specialist.
I hope that this information is useful to you, and Good Health!
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