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For Women With Endometriosis, Answers Are Few

In early February, Melanie Greeke was preparing for her hysterectomy with a mixture of joy and dread. The 27-year-old mother of three had been experiencing unbearable pain, headaches and nausea for the better part of a year. Finally, after seeing several doctors and being turned away time and again, she was diagnosed with endometriosis.

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What’s the Latest on Hormone Replacement for Prevention?

Hormone replacement therapy (HRT) is the use of estrogen alone (for women who have had a hysterectomy) or combined with progestin (for women with an intact uterus). It is primarily used in menopausal women for relief of symptoms, particularly hot flashes. For many years, providers recommended that women continue to take HRT after menopause to prevent chronic conditions such as heart disease.

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The Possibility of Infertility Looms for Cancer Patient

Staff writer Andrea Torres chronicles her breast cancer experiences in Tropical Life.

A woman in her early 30s should not have to think about infertility. But breast cancer changes everything.

Doctors have highly recommended that I have a hysterectomy, surgery to remove the uterus, and a prophylactic oophorectomy, removal of my ovaries. Both would be a preemptive move against uterine and ovarian cancer, which can develop after breast cancer.

Thinking about it has been difficult, especially faced with a gynecological appointment this week. On Saturday, I had a crying episode that lasted hours. I haven’t had one in months. Three of my best friends, all males, tried to comfort me.

I called Lawrence Pena, 34, who has a 2-year-old girl named Ella. After he heard my trembling voice, he asked, “What happened?”

“I sat in the shower holding my stomach crying this morning,” I said. “I haven’t been able to stop the tears.”

He listened and said, “It’s going to be OK.” I was calm again. He talked for a bit. And then his phone died.

Although the surgery is common, I am scared. Every 10 minutes, 12 hysterectomies are performed in the United States, or about 600,000 in a year. And about one-tenth of 1 percent of those, about 660 women, die from complications.

Also, when the procedures are done before age 45, there is an increased mortality risk associated with cardiovascular disease, osteoporosis, a decline in psychological well-being, and neurologic and mental disorders, such as cognitive impairment, dementia and Parkinsonism, which is similar to Parkinson’s disease. Of course, there are others who don’t experience these issues.

Estrogen treatment may prevent some of these, but for some breast cancer patients, estrogen feeds tumors. To block estrogen, I am taking a chemoprevention drug called Tamoxifen for the next five years. The drug protects me from osteoporosis, but increases the risk of cancer in the uterus.

Even more concerning is that I inherited a genetic mutation known as BRCA2. This increases my risk for breast and ovarian cancer. Hence, my doctors’ recommendation to undergo a hysterectomy and remove my ovaries. Compounding this are uterine fibroids and some “abnormal cells” found in the uterus.

Some women, who are not as high risk, may have the option of undergoing regular pelvic exams, combined with ultrasounds and blood tests to monitor any possible irregularities in their uterus and ovaries.

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Drs. OZ and Roizen: Relieve menopausal symptoms

Like the wildfires sweeping New Mexico, menopause can leave women feeling scorched and doused. Hot flashes, heart palpitations and brain fog can make daily life challenging.

Unfortunately, alarms about hormone therapy have scared many women away from a treatment that banishes symptoms. An update by the U.S. Preventive Services Task Force suggests estrogen, alone or taken with progesterone, increases the risk for stroke, blood clots, and gallbladder and urinary problems. While they DO admit the recommendations don’t apply to women thinking about HT for menopausal symptoms, or those who have had a hysterectomy before age 50, they make women hesitant to take advantage of the benefits…

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