What Is A Hysterectomy and How Does It Relate To Endometriosis?
What is a Hysterectomy?
A hysterectomy is a surgical procedure in which a woman's uterus is removed. There are two ways in which a hysterectomy can be performed, through the abdomen or through the vagina. After the uterus has been removed, the woman can obviously not bear children, so the procedure is not recommended for younger women except in extreme cases. In some cases, a woman may also need to remove her ovaries, an oophorectomy, or her ovaries and fallopian tubes, a salingo-oophorectomy. In these cases, a woman will also go into early menopause, with all that that entails, so these procedures are only performed in younger women when there are no other options.
What is Endometriosis?
The endometrium is the lining of the uterus. Each month, in response to hormonal fluctuation, the endometrial tissue thickens in preparation for the implantation of a fertilized ovum. When this does not occur, the tissue slough off and bleeds out through the vagina, and the circle starts anew. In endometriosis, pockets of endometrial tissue grow outside of the uterus, usually on the fallopian tubes or ovaries, but sometimes on the inside of the abdomen. In rare cases, these tissues can also be found outside the pelvic region. Like normal endometrial tissue, these abnormal tissues respond to the hormonal cycle and grow and slough off each month. Because they are not in the uterus, however, they don't have access to egress through the vagina. Consequently, the blood and dead tissue build up in places where there is no room for them and cause surrounding tissues to become irritated. This trapped blood can also cause cysts and scar tissue to form, and, depending on its location, can lead to infertility. Because of the irritation to surrounding tissues and growth of cysts, women experience pain, usually during the time of their period. For some, however, the pain can be continuous.
What Treatment Options Are Available to Women with Endometriosis?
If the symptoms are not acute, doctors may prescribe simple pain medications to help with symptoms during the time of menstruation. An oral contraceptive, taken regularly for a long time, may be all that's necessary to reverse all symptoms. The pills prevent the hormonal signals that cause endometrial tissue to grow, and without this, there is no buildup of foreign tissue. Another option is to take medications that temporarily block the production of ovarian stimulating hormones. These drugs can affect a remission in endometriosis, but they also cause an artificial menopause. Surgery may help women who are having trouble conceiving. It can also reduce pain. Most surgery involves going in and removing the extra-uterine tissue patches. In extreme cases, a hysterectomy may be required.
When is a Hysterectomy Required?
A hysterectomy is always a last resort when treating endometriosis. Women who still want to bear children cannot undergo this procedure. For some women, a hysterectomy alone can bring relief, but many also require a complete oophorectomy. The removal of the ovaries means that the body is no longer producing most of its estrogen or any progesterone, thus any endometrial patches will simply wither away. This complete loss of hormones also results in the woman going into early menopause, and hormone therapy may be necessary.
Sources: http://women.webmd.com/guide/hysterectomy http://www.mayoclinic.com/health/endometriosis