Wednesday, 26 August 2015

The terrible experience of a women after surgical menopause

I could sense  my eyes welling up,  when the patient was describing the daily  miseries in her life after hysterectomy. If this was just one unusual case in my practice, I would be a happier person, but unfortunately these patients are a recurring  phenomenon, all robbed of their youth by undergoing hysterectomy at an untimely age.

I glanced into the chart and it showed that, she was just in her late thirties, but I was looking at someone who looked like the mother of a women in her thirties ! She was dressed shabbily, wearing a dull loose fitting wrinkled cotton Kurtha. Grey hair was scruffy and messy, her wrinkled face was devoid of any makeup, the black circles around her eyes clearly indicated  lack of sleep.

She described her daily life as painfully slow, worse than death. Every single joint was hurting.  If its back pain today, tomorrow is neck pain and leg pain the next day. It is as if the pain has become a constant companion and is traveling throughout the body.

On and off she suffers from hot flashes, all the body parts will burn as if on fire, after each episode she would sweat profusely, making her drench and putting her in an awkward position in front of her family and friends. 

Every day she makes plans, but she just do not have the energy to implement anything, so tasks keeps getting postponed, even the trivial ones. Just getting out of bed in the morning is a daily  struggle. She keeps forgetting things easily, sometimes even important matters. Frequent outbursts at children and her partner has made her  unpopular even in her own family.

Her skin always feels dry and the hair has lost its sheen and number. Sexual life is almost nonexistent or painful and dry. Her partner, who  is a fit 40 year old is always nagging her  and has found solace in alcohol, as it helps him sleep better. (he feels)

Her tummy has bulged and husband is happily making fun of the tyres around her body. She correctly described it, the fat cells decided to relocate, left  the breasts and the thighs and settled in the tummy.

she summed up her condition in few words which expressed her desperation   “Doctor, I  feel death is better than this”.

So why is she going thru all this trauma?
Few years back, she used to get occasional back pain, an orthopedician confirmed after check up that everything was normal. Subsequently, she consulted a gynecologist who did a  hasty hysterectomy stating uterine problems as the cause for back pain. Of course the ovaries were preserved, as she was  only 34 years old. But her ovaries stopped working within couple of months, which is the usual story after hysterectomy, leading to a premature menopause. She was later diagnosed with disc prolapse, which probably could have been the cause for the back pain.

Now she is in a state of misery, because of surgical menopause. Even though she  tried  out different types of medicines including ayurveda, she felt no relief. 

After counseling about the advantages and side effects, we have put her on HRT, and she is feeling like a human again. The symptoms completely disappear, the moment you give estrogen to these women. The millions of neurons in the brain have estrogen receptors from the time it was an early embryo, so every single function of the brain is affected due to early menopause, which in turn affects each and every bodily functions.

You  may ask, why every women who undergoes menopause does not have all these symptoms or side effects. But the case is different in  women aged 45 years or more. The hormonal changes happen gradually and  slowly over many years, around 5 to 10 years of slow change happens during natural menopause. The neurons get used to the changes slowly, and body is steadily adapting. If you put cold water in a hot vessel it cracks, but if you slowly cool the vessel, it will not  break into pieces. Similarly, it is  more easier for the body to adapt and tolerate during the natural process of menopause and there will be less side effects of menopause.

So, it is very crucial to analyse the symptoms and the disease appropriately and accurately, before a decision for hysterectomy is taken, because the side effects of hysterectomy and menopause can be devastating on many women.

Dr. Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre
Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani, who specialises in surrogacy. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI, donor egg / sperm  and surrogacy. Her proficiency is in genetic abnormalities and high risk pregnancies.

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