Bottom Line/HEALTH: In the West, we have a nasty habit of cutting out parts of our bodies that we think are broken. But those parts are in your body for specific reasons, so what do we want to cut them out for? In particular, hysterectomies. Ladies, do you really want to give up your uterus and ovaries? Why should you think twice about that?

I’m Sarah Hiner, President of Bottom Line Publications, and this is our Conversation With the Experts, where we get the answers to your tough questions from our leading experts.

Today I’m talking to Dr. Holly Lucille, a leading naturopathic physician and an expert in integrative medicine. Dr. Lucille was listed in Time Magazine’s ALT list as one of the top 100 most influential people and is the author of Creating and Maintaining Balance: A Woman’s Guide to Safe Natural Hormone Health. You can learn more about her at www.drhollylucille.com.

Welcome, Dr. Holly.

Holly Lucille, ND, RN: Thank you.

Bottom Line: Let’s just right out of the gate, why are hysterectomies dangerous?

Dr. Lucille: Mostly because it’s a major surgery, and there are complications from major surgery – I mean, the list goes on and on and on. You need to think about the potentials. There could certainly be pain afterwards, infection at the incision site or a systemic infection. Fatigue is a big one.

Also after a major surgery like that, a woman could be at a risk for a blood clot. There’s something called deep vein thrombosis that could happen. We want to make sure post-surgery that if you start getting a pain in your calf and you’ve never really done anything to actually cause that pain, then you would need to rule out any of these dangers.

Bottom Line: Besides that – I mean, that applies to all surgeries, but how about for hysterectomies in general, where they’re cutting a part out of your body that went in there for a reason, it had a role. And now they’re thinking it’s done, just throw that part away.

Dr. Lucille: Especially with a hysterectomy, there can be some blood that pools around the bladder, which then causes bladder spasm. And then there are also vaginal issues more specific to this major surgery. But to your point, listen, we need to make sure we use the least invasive methods to treat first.

There are many different reasons why perhaps a surgeon would recommend a hysterectomy. Something called dysfunctional uterine bleeding, so bleeding that is not normal. Maybe we could identify and treat the cause of that instead of going in, and if in doubt, just cut it out.

Also, are you having a partial hysterectomy or a total hysterectomy? Those ovaries, they are what create our hormones. So when you have a total hysterectomy, you basically go into something called surgical menopause. So boom, smash, right away. It’s a jolt to your system. Those are the production of your sex steroid hormones, your gonads. So there is an abrupt disruption in hormone balance, and that is certainly a consequence of hysterectomies for sure.

Bottom Line: When you take the full hysterectomy, so you take the uterus and then you take the ovaries out, and you’re thrown into that – then are the doctors generally giving somebody supplemental hormones, which we know are risky? Or are you now just living with a depletion of hormones, which puts you at risk for osteoporosis and heart disease? There are a number of issues if you get thrown into that too early.

Dr. Lucille: Yeah, it’s tricky because we need to understand the reason why these little lovely organs were taken in the first place. Was it because it was a hormone-sensitive cancer that was growing? Ovarian cancer, uterine cancer. Was there a mass? If you’ve got a hormone-positive cancer, the last thing you want to do is actually give hormones. So the treatment post-surgery would be different for everyone.

However, it’s important if you go into menopause surgically way before your average menopause that if you can be on some – first of all, one, adrenal support. Your adrenal glands, believe it or not, they’re your built-in backup system for pre- and postmenopausal hormone production. Those are the glands that step up to the plate when your ovaries take a well-deserved break. But if your ovaries are yanked in a landfill somewhere, then you’re going to want to definitely support your adrenals, because they are going to primarily try to kick in and cover some of that hormone production.

So if you can safely have bioidentical hormone therapy on – and this would be actually I’d say replacement therapy, because this is something to replace. Natural menopause, we shouldn’t use the word replacement; nothing to replace. We want to restore function first. But here, absolutely.

Bottom Line: Let’s separate it out, because you made an important point. If you’ve got cancer, you do what you have to do to be able to get through cancer, and if that requires surgery. But almost 50% of the hysterectomies actually, as you said, are for bleeding or fibroids or something like that. And often the doctors will go in and they’ll say, “Let’s take the uterus out. As long as we’re in there, we can take other parts out too.”

If you just take the uterus out, aside from the risks of surgery in general, how dangerous is just a uterus removal to the rest of the functioning of your body?

Dr. Lucille: The rationale for some of these surgeries completely baffles me. One of the things I’ve heard most is, “You’re not going to have children anymore; you really don’t need it.” That is just not true. I think that it’s risky. That uterine tissue is connected, and there is disruption when an organ is taken out.

I think we could say the same thing with gall bladder, I think we could say the same thing with our appendix. They’re like, “Well, you don’t need your appendix.” I don’t think that that is true. I don’t think that we were made by mistake. It’s part of our immune system that has no function whatsoever. So we really need to think this through.

And also, just because your doctor says this is what you need to do, please, everybody, get a second opinion. Go to a more comprehensive, maybe naturopathic physician that’s going to say, “Listen, you’ve got fibroids, but we could maybe be realistic about shrinking them, treating them, and then saving your organs.” So, get that second opinion. Make sure you’re informed fully first instead of “Well, my doctor said it has to come out.” That’s not good healthcare.

Bottom Line: Aside from cancer surgery, when you really truly have pieces that are very, very broken and very dangerous, is there ever a reason for somebody to have a hysterectomy?

Dr. Lucille: Sure. In the case where uterine fibroids are causing extensive bleeding and we can’t keep up on the anemia that’s being caused subsequent to that, that might be an issue. If we have to be very realistic in shrinking multiple fibroids, perhaps ovarian cysts that are causing pain – there’s a cervical plexus down there of nerves, so it can be very, very painful – sometimes a procedure is definitely noted.

But, once again, we want to start with the least invasive methods first of not only diagnosing, but treating as well.

Bottom Line: All right, great. Thank you, Dr. Holly Lucille. The bottom line on hysterectomies? It’s real surgery. Any time you’re in the hospital, any time you go in for invasive surgery, you are at risk of infection, side effects, problems, all sorts of things that can go wrong in that surgery – besides the fact that these pieces were put into your body for a reason. You do not want to get slammed into early menopause without having those hormones in there, just for the sake of your convenience.

If you do have fibroids, if you do have any other problems that are leading you to surgery, then try to have a second opinion first. Do whatever you can that is not surgical and not invasive to try and resolve the problem. There are many options for treatments for many conditions. This is Sarah Hiner with Bottom Line.

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