Thursday, December 9, 2004
Elizabeth Plourde checked into the hospital for a hysterectomy and woke up from surgery with not only her uterus gone, but both her ovaries as well.
It was the mid-1980s and her doctor, as well as another one who gave her a second opinion, had assured her that a hysterectomy would end her heavy menstrual bleeding. As for the frequent painful cramping she was having, her doctor said he would explore during the surgery to see if he could find what was causing it.
When Plourde came out of the anesthesia to find all her reproductive organs gone, she was shocked.
“But my doctor said, ‘You’ll feel so much better’,” Plourde recalled. He told her that, since she was over 40 and didn’t need her ovaries for their eggs anymore, he had removed them along with her uterus to save her from ovarian cancer.
“He said it was standard medical practice,” she said.
Plourde went home, trusting her doctor that she’d feel better. Instead, she plunged into ill health and depression. Her heavy bleeding was gone, but she still had painful cramping. Her blood pressure skyrocketed. She became so depressed she often could not leave the house, and even started having suicidal thoughts.
She began a three-year odyssey of fruitless doctor visits and psychological counseling before finally meeting a doctor who recognized what was wrong: Plourde had a detrimental hormonal imbalance as a result of having her reproductive organs removed.
Over the course of months, the doctor experimented with different levels of hormone replacement — and different methods of delivering them into her body — before finally coming up with the appropriate balance and method. She now has pellets implanted just beneath the skin on her buttocks, which deliver small amounts of natural hormones into her system. Combined with a progesterone cream, the natural hormone replacement therapy returned Plourde to her pre-surgery self.
During what Plourde calls her three years of “hormone hell,” she began researching reproductive organ removal.
A clinical laboratory scientist by profession, Plourde realized as she delved into the complex medical studies and other data on the topic that while she could understand them, the average “lay” woman would not be able to.
She also discovered some alarming statistics. Every year 645,000 hysterectomies are performed, while a half million women have their ovaries removed.
Only 5 percent of women have their ovaries removed because of cancer or pre-cancerous conditions; 95 percent have them removed out of “fear of cancer,” Plourde said.
After discovering statistics showing that women often suffer symptoms similar to hers after having their reproductive organs removed, Plourde vowed to write a comprehensive book on the topic that women could understand. The result is “Your Guide to Hysterectomy, Ovary Removal and Hormone Replacement: What All Women Need to Know.” Plourde was in town last
month to host a women’s health lecture based on her book.
“We all deserve to know how our ovaries work, how our uterus works,” Plourde said. “We don’t learn what they do for us in high school.” As a result of her research — and personal experience — Plourde believes that while reproductive organ removal is sometimes medically necessary and prudent, it is overprescribed. Furthermore, women aren’t educated prior to having surgery about the potential for physical and mental problems.
“When we lose our hormones, we don’t feel like ‘us,’” Plourde said. The ovaries produce important hormones — even after the childbearing years — that play such disparate roles as increasing serotonin, which elevates mood, to preventing bone loss to protecting the heart and arteries. In addition, doctors and researchers admit they are only starting to understand some of the functions of the hormones produced by the ovaries.
“Medical science is only beginning to piece together some of the complex interrelationships these essential hormone and chemical manufacturing organs have with the rest of the body,” Plourde said. “Until more is understood, ‘standard medical practice’ should not mean removing healthy organs whose entire functions remain unknown, and therefore cannot easily be replaced.”
Plourde recommends hormone replacement therapy (HRT) for women who have had reproductive organs removed, as well as for those going through natural menopause.
“Women’s bodies were not designed to function without ovarian hormones,” she said. “Their loss impacts every system in the body.” Plourde said HRT has gotten a bad rap recently with the Women’s Health Initiative, a long-term study that was cut short when it was found that women on HRT — specifically those taking Premarin, the widely-prescribed synthetic estrogen made from pregnant mare’s urine — were at increased risk of stroke and heart disease.
Plourde says the evidence against synthetic hormone replacement “has always been there,” but that the billions of dollars drug companies make from HRT-related drugs has kept the them at the forefront of hormone replacement therapy.
“Now, hormone replacement gets a bad rap — but they were using the wrong hormone,” Plourde said. Plourde recommends HRT with natural hormones, also called human-identical hormones or compounded hormones. She also says it’s important to find the appropriate delivery system for the compounded hormones, whether it’s pellets, skin patches, cream or pills.
“Every woman is different,” she said. “What works for some might not work for others.” Compounded hormones are available at several nation-wide pharmacies, including College Pharmacy and Bellevue Pharmacy Solutions.
Plourde implores women to become educated about their bodies and what surgical removal of reproductive organs — as well as hormone replacement — means for them.
“There’s so much misinformation out there,” she said. “Learn about your body, learn what the symptoms are, then learn what’s right for you.”