Endometriosis after Hysterectomy
The endometrium or uterine lining thickens each month in preparation of a potential pregancy. The hormone estrogen prompts the endometrium to do this. Another female sex hormone, progesterone, prompts the plump lining of the uterus to shed when pregnancy does not occur.
When endometrial cells have spread beyond the uterus and to other parts of the body, these cells respond to estrogen and progesterone in preparation of a pregnancy but when the pregnancy does not occur the blood that is produced is unable to leave the body because there is no exit.
This tissue thickens, breaks down and bleeds just as it is supposed to do when it is in the uterus but the blood is trapped and stays in the body, irritating the surrounding tissue.
When blood is trapped, adhesions, scar tissue and cysts develop and organs become bound together, which causes pain. Pelvic pain is a very common symptom of endometriosis. Many women with this condition find it difficult, if not impossible, to get pregnant.
A woman suffering from endometriosis may experience pain during ovulation, sexual intercourse and while on her menstrual period; lower back and thigh pain; bladder and bowel problems and problems when having a bowel movement. The pain and symptoms may increase at the time of the menstrual period but some women experience constant pain.
Endometriosis is considered a chronic condition, which, if unresponsive to other forms of treatment, can lead to a hysterectomy, which is the removal of the uterus and the ovaries as well.
Endometriosis accounts for a considerable percentage of the hysterectomies that are performed. However, this procedure doesn't necessarily remedy endometriosis.
Endometriosis generally does not reappear after a woman has undergone a hysterectomy, although it is possible, particularly if the woman is taking estrogen therapy, and if the disease has spread well beyond the uterus.
In order to survive and thrive, the endometrial tissue requires estrogen to feed it. Estrogen is produced, primarily, by the ovaries. When a woman has a hysterectomy and removal of both of her ovaries, which is called an oophorectomy, the estrogen level in her body declines immediately and significantly, which throws her into menopause.
Endometriosis Post Hysterectomy and Oophorectomy
Usually, endometriosis and the accompanying pain go away as soon as the hysterectomy with oophorectomy is performed because the primary estrogen source, the ovaries, has been removed. However, if a woman chooses to take hormone replacement therapy (HRT) following her hysterectomy, endometriosis can persevere or recur because estrogen is reintroduced into the body via HRT.
If the Disease (Endometriosis) isn't Fully Removed During the Hysterectomy...
After a hysterectomy is performed and endometriosis recurs this indicates that the abnormal tissue has spread far beyond the lining of the uterus and has attached itself elsewhere. When endometriosis has developed outside the uterus, removal of the ovaries may not correct the problem. Endometriosis may not be completely detected during the hysterectomy and therefore not entirely removed. When this happens, pain may very well persist post-hysterectomy.
If you have been advised to have a hysterectomy to treat your severe endometriosis realize that this may not be the answer to your problem, although hysterectomy is generally the course of action that is taken. There is no guarantee that this procedure will completely remove the endometriosis if it has spread. There is also no guarantee that endometriosis will not return.
It may be in your best interest to try different approaches, such as improving your health in general, eating better, exercising and attempting to find your body's balance before resorting to a hysterectomy.