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Need second opinion regarding removal of ovary during hysterectomy

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Practicing since : 2001
Answered : 1663 Questions
My wife is scheduled for a hysterectomy this coming Tuesday, December 17th, After our preop appointment with her OBGYN my wife has decided to keep one ovary. The dr. said that my wife had one ovary with a small cyst and other was fine. The reason my wife wants to remove the one ovary is because her body over produces estrogen and feels if she gets one removed her estrogen levels might balance out so she won't have anymore breast tenderness, etc. I told her I think if the dr, can remove the cyst she should keep both ovaries for hormonal balance, etc. Her dr would not give us an answer either way of which would be best.. Please help.
Posted Wed, 1 Jan 2014 in Thyroid Problem and Hormonal Problems
Answered by Dr. Shehzad Topiwala 11 hours later
Brief Answer: Hormonal imbalance Detailed Answer: I see Endometriosis in your medical history. Is the OBGYN performing surgery in connection with that? Is the doctor planning to remove the uterus because there is 'endometrium-like tissue' growing around the uterus? Are you implying that the doctor also plans to remove both ovaries? Is it that the doctor recommends removing both ovaries but your wife wishes to keep one? Or is it the other way around i.e. your doctor does not wish to remove either ovary but your wife wants to get the one with the cyst out? In general, let me advise you some important and pertinent facts about ovaries and estrogen: Ovaries in normal health, produce balanced amounts of estrogen. There are only a couple instances where they over produce hormones. One broad category is PCOS (Poly-cystic Ovarian Syndrome) and the other is hormone-producing tumors of the ovary.The former is typically associated with excessive male hormones and the latter with female hormone excess The only other hormonal imbalance related to the ovary is that of menopause in which the ovaries stop making estrogen. This can happen naturally at an average age of 52 in women, or it can be a result of various conditions like surgical removal of the ovaries, radiation, chemotherapy etc OBGYN are generally well qualified in making these determinations. And so if your OBGYN doctor opines that you have a condition that requires removal of the ovary or both ovaries to cure a problem, then it is obviously necessary
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Follow-up: Need second opinion regarding removal of ovary during hysterectomy 7 hours later
The reason for my wifes surgery is severe endometriosis, possible andomyosis. The doctor left it up to her to decide is she wants to keep both ovaries or one. There was a tiny cyst on the one ovary and other and the other is fine. My wifes reason for taking one is to possibly help her balance her hormones so she does not experience severe PMS symptoms 28 out of 30 days. She has not had a normal menstrual cycle in years. She is very frustrated and over it. I am trying to get as many opinions as I can to try to help her make an educated decision. If she decides to keep just one ovary will that be enough for her bodies hormones to function and regulate properly? Please respond.
Answered by Dr. Shehzad Topiwala 18 minutes later
Brief Answer: Ovaries Detailed Answer: Well, now that you mention she has not had regular periods in a while, one needs to ascertain if her ovaries are functioning normally at the present time. If they are functioning normally, then she should not be having such irregularity in her menstrual cycle. Blood tests for hCG, FSH, TSH and Prolactin will give some idea as to whether she has other endocrine conditions causing this menstrual disturbance or if she is approaching early menopausal transition. If the latter is the case, then her ovaries are already not producing enough estrogen. Removing one or both in this instance will matter little because menopause will likely occur soon anyway. However, if the hormone tests suggest that menopausal changes have not yet begun, and other endocrine problems are ruled out then you need to have a detailed discussion with your OBGYN as to what are the chances of one ovary being sufficient to sustain estrogen production to prevent menopausal transition from occurring earlier than normal ( ie at around 48). This discussion will entail joint decision making in close liaison with your doctor. I suggest you work closely with your OBGYN and weigh pros and cons before surgery
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