Frauen die oft unnötig wegen gutartiger Erkrankung ihrer ORgane verlieren bekommen KEINERLEI dieser geforderten Betreuung!

Psychoonkologische Betreuung
und psychosoziale Nachsorge

Zur eingehenden Vertiefung dieser Bereiche wird auf das Manual „Psychoonkologie“ des Tumorzentrums München [1] verwiesen.

Zu den psychischen Krankheits- und Therapiefolgen  gehören bei mindestens der Hälfte der Patientinnen die Angst vor dem Rezidiv, geringere Leistungsfähigkeit, Anspannung und Nervosität und körperliche Beschwerden. Schlafstörungen, Angst vor frühem Tod oder Hilflosigkeit stellen sich erst in zweiter Linie ein. Ein Drittel der Patientinnen klagt über Angst vor Schmerzen
sowie geringeres sexuelles Interesse.Vor allem nach Exenterationen findet sich ein deutlich gestörtes Körpererleben mit all seinen Auswirkungen auf Partnerschaft und Sexualität. Besonders junge Frauen leiden erheblich unter den Folgen der meist unumgänglichen Kastration, insbesondere bei unerfülltem Kinderwunsch.

Derartige Stigmata, aber auch ein Haarverlust unter Chemotherapie, bedingen oft soziale Rückzugstendenzen und verstärken die weiblichen Identitätskrise. Im Hinblick auf die unterstützende Bedeutung der Partnerschaft sollte diese in das psychosoziale Nachsorgekonzept eingebunden werden. Neben der ärztlichen Begleitung wird hier auf Angebote ambulanter und stationärer psychoonkologischer und sozialtherapeutischer Beratung sowie Gesprächs- und Selbsthilfegruppen hingewiesen.

http://tumorzentrum-muenchen.de/fileadmin/manuale/905_Manual_Maligne_Ovariattumoren.pdf

Der Uterus - das unterschätzte Organ
Margit* kann es noch immer schwer fassen: "Ich hätte nie gedacht, dass die Folgen einer Unterleibsoperation so gravierend sein können. Ich fühle mich regelrecht kastriert." Margit hat eine Totaloperation (radikale Hysterektomie) hinter sich. Davon sprechen Mediziner, wenn einer Frau der Gebärmutterkörper und der Gebärmutterhals entfernt werden. Bleibt der Gebärmutterhals stehen, bezeichnen Ärzte die Operation als subtotale Hysterektomie. Manchmal werden bei dem Eingriff auch die Eierstöcke und Eileiter herausoperiert.

Anzeige

Margit ist kein Einzelfall. "Viele Frauen merken erst nach der Gebärmutterentfernung, dass sie etwas Wichtiges verloren haben", sagt Dr. Barbara Ehret, Geschäftsführerin des Internationalen Zentrums für Frauengesundheit (IZFG) in Bad Salzuflen. "Die Gebärmutter ist ein Identifikationsorgan. Sie gehört zu einer Frau, ohne dass sie sich darüber groß Gedanken macht", urteilt die Gynäkologin. "Ihr Entfernen bedeutet für viele Frauen den Verlust ihrer Weiblichkeit." Entsprechend heftig können die Reaktionen ausfallen. "Ärger, Wut, Trauer bis hin zu großen Depressionen", beschreibt Ehret, die lange Zeit Chefärztin einer gynäkologischen Reha-Klinik war.

Nach einer Totaloperation kommen Frauen eher in die Menopause
Dazu kommen körperliche Folgen: Die Wundheilung kann bis zu einem dreiviertel Jahr dauern, 7-9 Prozent der Frauen entwickeln Ehret zufolge Darm- und Blasenprobleme, oft gerät das Hormonsystem durcheinander. So kämen Frauen, denen die Gebärmutter entfernt wurde, im Schnitt vier Jahre früher in die Menopause, berichtet die Frauenärztin. Denn die Eierstöcke werden nach dem Eingriff schlechter durchblutet und stellen daraufhin ihre Hormonproduktion ein.  Erfolgt bei einer Hysterektomie auch die Entfernung der Eierstöcke, kommt die Frau sogar sofort in die Menopause. Sie überspringt die Wechseljahre, in denen der Körper sich langsam an die neue Hormonsituation gewöhnt. Das sei "ziemlich grausam, sogar wenn eine Frau schon weit in den Wechseljahren ist", sagt Ehret. "Ich kenne 52-jährige Frauen, die noch Monatsblutungen hatten und nach dem Entfernen der Eierstöcke total abgestürzt sind. Sie litten unter Schlaflosigkeit, Hitzewallungen, depressiven Verstimmungen und einem sehr labilen Nervenkostüm, aber auch unter einer trockenen Scheide und sexueller Unlust."

Das sexuelle Empfinden lässt nach
Nach einer Gebärmutterentfernung leidet oft auch die Sexualität. Viele Frauen empfinden keine Lust mehr. Bis zu neun Monate könne es dauern, bis operierte Frauen sexuelle Aktivitäten wieder genießen könnten, sagt Ehret. "Auch Frauen, die besonders viel Freude am Sex hatten, klagen oft darüber, dass sie keine so intensiven Lustgefühle mehr erleben." Das gilt besonders nach einer Totaloperation: Denn um den Gebärmutterhals herum befinden sich wichtige Nerven für das sexuelle Empfinden.
Manche Frauen stört es, dass sich der männliche Samen nun in die verschlossene Scheide ergießt - nicht mehr in die Gebärmutter wie früher. Außerdem fehlt bei sexueller Erregung der Schleim aus dem Gebärmutterhals. Und der Schleim aus den Drüsen der Scheide und des Scheidenvorhofs reicht oft nicht aus, um die Vagina beim Geschlechtsverkehr ausreichend zu befeuchten, sodass ein Paar zum Gleitgel greifen muss.

Gebärmutter wird oft vorschnell entfernt
"Die Gebärmutter wird zu oft unnötigerweise entfernt", urteilt Ehret. Laut der Bundesgeschäftsstelle Qualitätssicherung entnahmen Ärzte im Jahr 2007 bundesweit 152.282 Frauen die Gebärmutter, 132.283 von ihnen wegen gutartiger Veränderungen. Hauptmotive für eine Hysterektomie sind starke Blutungen, Störungen und Schmerzen bei der Menstruation, Endometriose (gutartige, meist schmerzhafte Wucherungen von Gewebe der Gebärmutterschleimhaut), Myome (gutartige Wucherungen der Gebärmuttermuskulatur) und eine Senkung des Uterus. Bei Frauen mit abgeschlossener Familienplanung kommt zudem oft das Argument hinzu: "Das Organ brauchen Sie doch nicht mehr."  Auch als Krebs-Prophylaxe wird eine Hysterektomie gepriesen. "Viele Frauen glauben außerdem, dass sie durch eine Gebärmutterentfernung um die Wechseljahre herumkommen. Das stimmt aber nicht!", hebt Ehret hervor. Tatsächlich muss die Gebärmutter nur selten entfernt werden, zum Beispiel bei einer Krebserkrankung des Uterus und der Eierstöcke oder bei Blutungen, die sich anders nicht stillen lassen.

Vor einer Hysterektomie immer zwei Ärzte befragen
Einer Gebärmutterentfernung wird nach Ansicht von Ehret oft zu rasch zugestimmt. Eine Frau sollte in jedem Fall die Meinung eines zweiten Arztes einholen und dazu besser nicht in eine Klinik gehen. "Hier ist die Operationsbereitschaft meistens hoch", so Ehret. Lässt sich eine Hysterektomie nicht vermeiden, ist es wichtig, sich über die verschiedenen Operationsmethoden zu informieren. "Die heute übliche Laparoskopie wird verharmlost", warnt Ehret.  Bei dieser sogenannten Bauchspiegelung macht der Chirurg zwar nur 3-4 kleine Schnitte, um das OP-Besteck in den Körper einführen zu können. Die Gebärmutter muss aber genauso gelockert und herausgeschält werden. "Die Laparoskopie ist ein genauso großer Eingriff wie eine Operation am offenen Bauch", so Ehret. "Sie dauert sogar länger - bis zu fünf Stunden. Und bei ungeübten Chirurgen hat die Laparoskopie eine hohe Komplikationsrate. Blutungen und Entzündungen sind häufig."

Buchtipp: Mehr zu den Operationsmethoden bei einer Hysterektomie
Dr. Barbara Ehret, Dr. Mirjam Roepke-BuncsakFrauen, Körper, Gesundheit, Leben - Das große Brigitte-Buch der FrauenheilkundeDiana-Verlag 2008, Preis: 21,90 Euro* Name geändert

Quelle: Mit Informationen von Dr. Barbara Ehret, Gynäkologin und Geschäftsführerin des Internationalen Zentrums für Frauengesundheit in Bad Salzuflen und Dr. Barbara Ehret, Dr. Mirjam Roepke-Buncsak: Frauen, Körper, Gesundheit, Leben, Diana-Verlag 2008 und Anatomica, Tandem-Verlag 2004
Autor: Martina Janning
Stand: 26-01-2009

This type of surgery is a major operation. It leaves you weak both physically and mentally and it is this point that the menopausal symptoms may kick in with a vengeance.

http://www.daisynetwork.org.uk/causes.html#Surgery

Professor Janice Rymer from the Royal College of Obstetrics and Gynaecology comments "Following removal of the ovaries, levels of testosterone drop dramatically by around 50% causing a potentially distressing decrease in sexual desire for many women."  Some women who have undergone the trauma of surgical menopause experience low sexual desire.[ix] Among surgically menopausal women who experience a loss of sexual desire, approximately one third are distressed and are classified as having hypoactive sexual desire disorder (HSDD)10**  "It is very rarely mentioned that in young women testosterone levels are actually higher than oestrogen. Many of my surgical menopause patients tell me they feel sexually numb and are really concerned about their relationship", comments Mr Nick Panay, consultant gynaecologist and patron of The Daisy Network, a nationwide support group for women with premature menopause.

Und das sind die Risiken und LANGZEITFOLGEN:
Sie stehen auf keinen Aufklärungsblättern, sind aber für jedermann in Wikipedia in Englisch nachzulesen:

• Longevity Risk
• Cardiovascular Risk
• Bone Density Risk
• Sexuality Risk

In general, Hormone replacement therapy is somewhat controversial due to the known carcinogenic and coagulative properties of estrogen; however, many physicians and patients feel the benefits outweigh the risks in women who may face serious health and quality of life issues as a consequence of early surgical menopause. The ovarian hormones of estrogen, progesterone, and testosterone are involved in the regulation of hundreds of bodily functions; it is believed by some doctors that hormone therapy programs mitigate surgical menopause side effects such as increased risk of cardiovascular disease [1], and female sexual dysfunction [2]. There are many options for hormone replacement currently available and a considerable controversy exists in regards to synthetic versus natural or bio-identical regimens.

Removal of ovaries causes hormonal changes and symptoms similar to, but generally more severe than, menopause. Women who have had an oophorectomy are usually encouraged to take hormone replacement drugs to prevent other conditions often associated with menopause. Women younger than 45 who have had their ovaries removed face a mortality risk 1.7 times greater than women who have retained their ovaries. [3]. Retaining the ovaries when a hysterectomy is performed is associated with greater longevity.[4] However, hormone therapy is commonly believed by many doctors to mitigate the mortality risks of oophorectomy [5].

Women who have had bilateral oophorectomy surgeries lose most of their ability to produce the hormones estrogen and progesterone, and lose about half of their ability to produce testosterone, and subsequently enter what is known as "surgical menopause" (as opposed to normal menopause, which occurs naturally in women as part of the aging process). "Surgical menopause" differs from naturally occurring menopause in several respects: Surgical menopause is an iatrogenic procedure, while menopause is a natural event. A menopausal woman has intact functional female organs, a woman with surgical menopause does not. In natural menopause the ovaries generally continue to produce low levels of hormones, while in surgical menopause the ovaries and their hormones are absent, which can explain why surgical menopause is generally accompanied by a more sudden and severe onset of symptoms than natural menopause, symptoms which may continue until natural age of menopause arrives [6]. These symptoms are commonly addressed through hormone therapy, utilizing various forms of estrogen, testosterone, progesterone or a combination of them.

Cardiovascular Risk

When the ovaries are removed a woman is at a seven times great risk of cardiovascular disease, [7][8][9] [10] but the mechanisms are not precisely known. The hormones produced by the ovaries cannot be truly replaced. The ovaries produce hormones a woman needs throughout her entire life, in the quantity they are needed, at the time they are needed, and released directly into the blood stream in a continuous fashion, in response to and as part of the complex endocrine system.

Bone Density Risk

In women under the age of 50 who have undergone oophorectomy, hormone supplements (usually estrogen) are often prescribed as part of hormone replacement therapy (HRT) to offset the negative effects of sudden hormonal loss (most notably an increased risk for early-onset osteoporosis) as well as menopausal problems like hot flashes that are usually more severe than those experienced by women undergoing natural menopause.

Some studies have found that increased bone loss or fracture risk is associated with oophorectomy. [11] [12] [13] [14] [15] Reduced levels of testosterone in women is predictive of height loss, which may occur as a result of reduced bone density,[16]

Sexuality Risk

Oophorectomy generally greatly impacts sexuality in women, reducing or eliminating the ability to have an orgasm, and lowering sexual desire. This reduction is greater than that seen in women undergoing natural menopause [17]. Some of these problems can be addressed by taking hormone replacement. Increased testosterone levels in women are associated with a greater sense of sexual desire, and oophorectomy greatly reduces testosterone levels. [18] Reduction in sexual wellbeing was reported in women who had been given a hysterectomy with both ovaries removed.[19]

http://en.wikipedia.org/wiki/Oophorectomy

http://www.ligue-cancer.net/article.php3?id_article=92

Quelles sont les conséquences des traitements ?
Les conséquences chirurgicales sont directement le reflet de l'arrêt des fonctions des ovaires, dans la fécondité d'une part, dans la fabrication d'hormones d'autre part :

• L'ablation des ovaires, des trompes et de l'utérus, entraîne une stérilité définitive.
• L'ablation des ovaires se traduit également par un arrêt de la sécrétion d'estrogènes et de progestérone.
• Au plan hormonal, les suites dépendent de la situation de la femme au moment de la découverte de son cancer. Deux cas de figure principaux peuvent se présenter :
• La patiente n'est pas ménopausée : en cas d'exérèse des deux ovaires, cela revient à créer une ménopause artificielle (l'ablation des deux ovaires est une castration chirurgicale) ; les deux ovaires ne sont donc plus là pour assurer la sécrétion hormonale ovarienne, d'estrogènes et de progestérone.
• La patiente était déjà ménopausée : la castration chirurgicale va accentuer la carence hormonale qui caractérise la ménopause. En effet, la ménopause n'est pas un tarissement complet de la sécrétion d'hormones par les ovaires.

Was sind die Konsequenzen der Behandlungen?
Die chirurgischen Konsequenzen sind der unmittelbare Stopp der Ovarfunktion, einerseits der Fruchtbarkeit und andererseits der Hormonproduktion:

• Die Entfernung der Eierstöcke, der Tuben und des Uterus bringt die definitive Sterilität mit sich
• Den Hormonhausalt betreffend, hängen die Folgen von der Situation der Frau zum Zeitpunkt des Entdeckens ihres Krebses ab. Zwei grundlegende Erscheinungsbilder können sich präsentieren:
• Die Patientin, die nicht in der Menopause ist: im Falle der Entfernung der beiden Eierstöcke kommt es zu einer künstlichen Menopause (die Entfernung der beiden Ovarien ist die chirurgische Kastration); die beiden Ovarien sind also nicht mehr vorhanden um die ovarielle Hormonsekretion von Östrogenen und Progesteron sicherzustellen.
• Die Patientin, die schon in der Menopause war: die chirurgische Kastration wird das hormonelle Defizit, das die Menopause charakterisiert, verstärken. Denn in der Tat, die Menopause bedeutet ja nicht das komplette Versiegen der Hormone durch die Ovarien.

Au sujet de la vie sexuelle
Bien sûr, tout au long des traitements, il vous sera difficile d'avoir des rapports normaux. Mais ensuite, plus ou moins rapidement, les relations peuvent et doivent reprendre, en pleine harmonie.
Dans tous les cas, parlez-en avec votre partenaire et aussi à votre médecin.
Il est du reste souhaitable que vous en entreteniez en couple, avec votre médecin.

Zum Thema Sexualleben
Natürlich wird es schwierig sein im Zuge der Bahndlungen normale sexuellen Verkehr zu haben. Aber dann, mehr oder weniger rasch können oder sollen die Beziehungen wieder aufgenommen werden, in voller Harmonie.
In allen Fällen sprechen Sie darüber mit Ihrem Partner und auch mit Ihrem Arzt.
Es ist übrigens wünschenswert, dass Sie sich als Paar mit Ihrem Arzt beraten.

http://www.ligue-cancer.net/article.php3?id_article=92

WHAT IS A HYSTERECTOMY?

A hysterectomy is a surgical removal of the entire womb or uterus, which induces a "surgical menopause". Frequently, in addition to the uterus, one or both of the ovaries are removed during the same operative procedure.

IS THERE A DIFFERENCE IF THE OVARIES ARE REMOVED?

Although, we usually refer to premenopausal women who have had a hysterectomy as having experienced a "surgical menopause" they are not menopausal in a "hormonal" sense unless their ovaries have been removed.

HYSTERECTOMY WITH OVARIAN PRESERVATION
Women, in whom the ovaries are retained, although they no longer have monthly periods, will not experience menopausal symptoms or the effects of hormonal deprivation. That is, as long as the ovaries continue to function normally, or until the age an expected natural menopause would have occurred, or sooner if the ovaries have been compromised by the surgery.

Unfortunately, even if the ovaries are preserved, they become dysfunctional up to 50% of the time within 3 years following the surgery. Nevertheless, in women under the age of 45 preservation of the ovaries is an important consideration when reasonable.

HYSTERECTOMY WITH OVARIAN REMOVAL
If both of the ovaries are removed the source of estrogen and testosterone production is lost. The fall in hormone levels is sudden and severe. It is a very different circumstance, than a natural menopause where the decline in estrogen levels may be gradual in onset and ovarian testosterone production may continue for several years.

Women in this category, who are without the benefit of HRT, often have the most severe menopausal symptoms and long-term consequences of sex hormone deficiency. Health, quality of life and longevity are affected. There is a statistically shorter life expectancy, associated with a higher rate of death, mostly from heart attacks, strokes, and osteoporosis. Libido and sexual function deteriorate.
A hallmark study published 1983 in the Journal of the American Medical Association revealed a significantly increased death rate among women 40-50 years of age who had had a hysterectomy and who were without the benefit of estrogen replacement, as compared to those who were estrogen users. For those who had their uterus removed, the rate was 3 times higher. For those who also had both ovaries removed, the rate was 8 times higher. It is apparent that careful consideration should be given to HRT after a surgical menopause.

DOES HRT HELP?

Most of the routinely prescribed programs of HRT are usually effective in preventing the long-term consequences of hormone deficiency and maintaining quality of life.

DOES HRT WORK FOR ALL WOMEN WHO HAVE THEIR OVARIES REMOVED?

Unfortunately, following the surgery, there is a group of women who experience life-altering symptoms, which are unresponsive to the routinely prescribed regimens of HRT. This often presents a dilemma. We have a woman who has undergone a major surgical procedure. She has been told that if she takes HRT, her quality of life, including her libido and sexual function, will be the same, if not better.
If she is fatigued, having symptoms and has no libido in the immediate post-operative period, it may not seem unreasonable to her. After all, she just had a major surgery., didn’t she? A few months go by and she is still fatigued, having flushes, insomnia, problems with her memory and she has no sex drive.
She does the reasonable thing. She returns to her physician, who changes her HRT regimen several times. Months go by, and she feels no better. She returns to the doctor again and restates her concerns. The physician looks at her, shakes his or her head, almost, but not imperceptibly, and speaks.
"You weren’t psychologically ready for this surgery," or " Are you having trouble at home." And then, "This has nothing to do with the surgery … you need to see a therapist."
She looks at the physician in disbelief, just having suffered the indignity of having her legitimate concerns invalidated. She feels betrayed, and wonders what she has to do, after leaving this "jerk's" office to regain her life. So, she goes to several new physicians, and is placed on several additional HRT regimens, without success. Next, she purchases several vitamin and/or herbal preparations and rubs on progesterone cream with no improvement. She reads everything she can that seems to address her problem. Ultimately, if nothing helps, she begins to doubt that she will ever feel like herself again. And, sometimes she even begins to wonder if some of the problem is actually in her mind.
Well, it’s not in her mind. If she felt fine prior to her surgery, and now does not, it is probably related to the surgery. On the other hand, it could be an amazing coincidence, but I keep reading that great detectives don’t believe in coincidences, so why should we.

Does this sound like an unlikely scenario? Well, it’s not. There are many women who feel exactly this way and are desperately trying to regain their quality of life.

SO HOW CAN THEY FEEL BETTER?
They need to find a physician who is knowledgeable in the treatment of menopausal women and who has expertise in the wide range of HRT therapeutic options. Ultimately, if nothing else seems to work, "subcutaneous hormone implants" are almost always effective. The sections of the web site, MENOPAUSAL SYMPTOMS, ABOUT HRT, METHODS OF HRT and REGIMENS, will provide more information about this.

WHAT IF THEY CAN’T FIND A PHYSICIAN LIKE THAT?
It would be helpful to contact a compounding pharmacy, such as College Pharmacy for information about some of the HRT options that are available. They will provide information about their products to patients and their physicians regarding availability and appropriate use. There is a link to their web site on the links page. If necessary they can also provide the names of physicians to whom they provide specialized HRT products.

IF THERE ARE POTENTIAL PROBLEMS, WHY WOULD ANYONE HAVE A HYSTERECTOMY, OR THEIR OVARIES REMOVED?
No one should have a hysterectomy or any surgery if it’s not necessary. In the past far too many hysterectomies were performed. Even today patients need to remain vigilant and consider the benefits and potential consequences before making a decision.
But there are instances when surgery is reasonable. One indication for surgery is the presence a malignant or premalignant involvement of the uterus, cervix or ovaries. Another, is uncontrolled uterine bleeding, which is unresponsive to more conservative therapy. Vaginal bleeding can cause life-threatening anemia and often surgery is the only option. Endometriosis, and a condition called adenomyosis, can be painful and life altering and surgery is still the best option in many cases. Surgery is often the most reasonable option for women who have a ‘uterine prolapse,’ a condition where the uterus protrudes into the lower vagina. The surgery also performed for benign growths of the uterus, called "uterine fibroids," when they are thought to be the cause of bleeding unresponsive to non-surgical therapy, pain or impingement of other organs.
Sometimes, women who have surgery for these indications find that their quality of life is significantly improved. This is particularly true when the problem is endometriosis, vaginal hemorrhage and uterine prolapse.

WHAT CAUSES IT?

The decline in sexual desire is likely a direct result of diminished sex hormone levels on the brain itself. Although estrogen plays a part, the hormone that has been shown to be most closely associated with sex-drive is testosterone.

The ovary, although incapable of producing estrogen after a "natural" menopause, may continue to produce significant amounts of testosterone for several years. This is the reason why many women maintain a good sex-drive for a considerable length of time. These testosterone levels provide additional benefits to the naturally menopausal woman. Tissues of the body are able to convert some of this circulating testosterone to estrogen. This is the mechanism by which naturally menopausal women have fewer and less severe symptoms and health problems usually attributed to sex hormone deficiency. If a postmenopausal woman were to undergo removal of her ovaries, this benefit would be lost.

WHAT ABOUT PREMENOPAUSAL WOMEN WHO HAVE HAD A HYSTERECTOMY?

If the surgery is performed prior to menopause and the ovaries are preserved and their hormone secretion is unaffected, there may be no change in libido following the post-operative healing period. In fact, some women experience a post-surgical increase in sexual desire if prior to the surgery they had been distracted by heavy bleeding or significant pelvic pain. There is evidence, however that in this group of patients, ovarian failure occurs up to 50% of the time within 3 years following the surgery. If this happens, a diminished libido and other menopausal symptoms would reflect the decline in hormone levels. Unfortunately, some physicians are not aware of the frequency of ovarian failure following hysterectomy. I have seen many patients who were in this category, who found it necessary to come to my office because their physicians did not believe their symptoms were possible or related to the surgery.

If the surgery is performed prior to menopause and the ovaries are removed, the fall in estrogen and testosterone levels is abrupt and severe. As would be expected this type of surgically induced menopause almost always, results in a dramatic fall in sexual desire.

Dr Nosanchuk is currently in practice in Southeastern Michigan and is accepting new patients. His office is located in Bingham Farms, a suburb of the Detroit Metropolitan Area. Dr N specializes in the care and treatment of menopausal women and has a special interest providing treatment to women whose lives have been altered by their menopause, hysterectomy, or both. This includes strategies to restore quality of life, by resolving problems, such as persistent symptoms, loss of libido and disturbances of sexual function.

http://menopausehysterectomy.com/Menopause.htm

So ist die Aufklärung bezüglich Hysterektomien im englischen Netz

Topic Overview

What is a hysterectomy?

A hysterectomy is surgery to take out a woman’s uterus, the organ in a woman's belly where a baby grows during pregnancy. After a hysterectomy, you will not be able to get pregnant.

Other organs might also be removed if you have severe problems such as endometriosis or cancer. These organs include the cervix (the lower part of the uterus that opens into the vagina), the ovaries (glands on both sides of the uterus that release eggs for pregnancy), and the fallopian tubes (the passageway between the uterus and the ovaries).

Whether or not the ovaries are removed will depend on your age and risk for certain types of cancer. For example, removing the ovaries lowers the risk of ovarian cancer and some types of breast cancer. But, if you have your ovaries removed before the age of menopause, you will go into early menopause, and you may be more likely to get heart disease or osteoporosis. Be sure to discuss all the benefits and risks of removing your ovaries with your doctor.

See an illustration of the female reproductive system.