Surgical menopause
The ovaries produce estrogen, progesterone and androgens to regulate the menstrual cycle. When a hysterectomy occurs, these hormones get suddenly interrupted and their levels fall resulting in symptoms of menopause. This is termed surgical menopause. Although removal of ovaries becomes unavoidable in most hysterectomy surgeries, every effort is made by the surgeon to leave the ovaries intact in order to avoid the sudden absence of hormones. Most often, surgical menopause is caused quite dramatically when there is surgical interference like hysterectomy, bilateral oophorectomy, where both the ovaries are removed. A woman undergoing surgical menopause experiences certain symptoms more profoundly than women going through menopause normally. Since there is abrupt disruption of hormones after hysterectomy, the menopausal symptoms are more severe, more frequent and last longer when compared to natural menopause. The symptoms are triggered by the body's sudden inability to make certain hormones due to the removal of ovaries.
Estrogen is immediately given after surgery to try to prevent the intense changes especially the hot flashes that can occur in woman undergoing hysterectomy. However the use of estrogen is itself controversial and it is not usually recommended for women with existing or high risk of cardiovascular disease. A lowest dose of estrogen for the shortest possible time is recommended.
Surgical menopause risks
- Women with surgical menopause are seven times more prone to cardiovascular disease risks.
- They run the risk of osteoporosis as estrogen plays a vital role in bone formation.
- Gum tissues are affected and regular dental check ups are advised to tide over this problem.
- Women younger than 45 years and who have had their ovaries removed face a mortality risk 170% higher than women who have retained their ovaries after oophorectomy. Hormone replacement therapy is commonly advised as it is believed by many doctors to mitigate the mortality risks.
- There is a definite lowering of sexual desire in women who have undergone surgical menopause. This reduction is greater than that seen in women undergoing natural menopause.
Contraceptive pill
Birth control pills are oral contraceptives that inhibit the body's fertility level through chemical means. The oral contraceptive contains synthetic hormones that alter the woman's hormonal system so that ovulation is prevented. The birth control pill has been around since the 1960s and is popularly used even today. The modern combination pills are popular on account of the fewer side effects and high success rate. But the birth control pill does not offer any protection against sexually transmitted diseases (STDs) or HIV and AIDS.
Estrogen and progesterone are the key hormones that keep a woman's menstrual cycle going. The contraceptive pill contains both these hormones, which go into making a hostile environment for an embryo to develop. Modern pills contain less estrogen than their earlier versions. The birth control pill works as a contraceptive by blocking the release of an egg. While a woman is on birth control pill, the brain no longer signals the ovaries to produce an egg each month. In this way, the contraceptive pill seeks to block ovulation so as to prevent a pregnancy. The cervical mucous becomes thick and unreceptive to sperm thereby making its progress through the fallopian tubes difficult. The endometrium also becomes unreceptive to receive the fertilized egg.
The combined birth control pills contain both the hormones estrogen and progesterone. Combination pills prevent the ovaries from releasing eggs. The progesterone-only contraception pills thicken the cervical mucus making it difficult for the sperm to travel. Combination pills are more effective than progesterone only pills. The success rate of birth control pills is about 97 - 99%, if taken correctly. The pill is an easily reversible method of contraception. If the woman is also taking antibiotics such as rifampin or anti-seizure medications, the birth control pill may not be as effective. Some anti-HIV protease inhibitors and anti-fungal oral medication may also affect the efficacy of oral contraceptives.
Hashimoto's Thyroiditis
Hashimoto's Thyroiditis is an autoimmune disease brought about by immune system attack on the thyroid gland. Consequently the body does not produce enough thyroid hormones to set the rate for metabolism. The thyroid cells are unable to convert iodine into thyroid hormone. This disease progresses slowly and often it is not detected. Hashimoto's Thyroiditis is often noticed in women of childbearing age. The symptoms may be similar to that of hypothyroidism. This disease is named after the Japanese physician Hakaru Hashimoto who first studied and described this condition.
Symptoms of Hashimoto's Thyroiditis include sensitivity and intolerance to cold and dry hair and skin. The woman suffering from Hashimoto's Thyroiditis is likely to suffer muscle cramps and increased menstrual flow. There is fatigue and difficulty in concentration. Goiter or swelling of thyroid may be seen. There is hair loss and possible weight gain. As the disease progresses, there may be symptoms such as joint stiffness and facial swelling.
Blood tests of patients suffering from Hashimoto's thyroiditis will reveal elevated levels of antibodies. Treatment for Hashimoto's Thyroiditis includes replacement of thyroid hormones. The dosage will be prescribed by the doctor to maintain the right balance.
Bibliography / Reference
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