Diagnosed With Polycystic Ovary Syndrome And Depression. Ovaries Are Larger Than Normal. Would Hysterectomy Help In The Above Issues?

Posted on Sat, 7 Sep 2013

Question: I have been diagnosed with PCOS and have also been diagnosed with major depression. I have been getting cysts on my ovaries ever since my last son was born in 2004. The ovaries are larger than normal and at my last physical my doctor informed me that my uterus is "bulkie". About 4 years ago I had an IUD put in, do to bleeding 25 days every month. The bleeding has stopped completly (no period for 4 years) but the IUD is do to be removed next year. I am 38 years old. Just wondering if a hysterectomy would help me out in the above issues? Thank you for your help, XXXXXXX

Answered by Dr. Aarti Abraham (13 minutes later)

Brief Answer:
Hysterectomy should be the last recourse.

Detailed Answer:
Hello XXXXXXX
Thanks for your query.
PCOS is a condition that is due to basic hormonal derangement.
Once your IUD is out, you should wait and watch for a few months, to see if the hormonal effects have been regulated with time, pregnancy and IUD use.
PCOS generally improves with age, as the estrogen levels decline.
Hysterectomy is not a cure for PCOS at all.
Also, PCOS is not responsible for heavy bleeding that you described.
You could be having other reasons for it such as adenomyosis ( thickening of the wall of the uterus ), fibroids in the uterus, or endometrial hyperplasia ( thickening of the inner lining of the uterus ).
As you have had no period for 4 years, chances are that after removal of the IUD, you would have improvement in your problems.
If they recur, you can have another IUD insertion , or medical management with progesterone or other drugs, till you are peri menopausal, when most of these conditions automatically improve.
Hysterectomy should be a last resort, to be considered only when all medical management fails.
Hysterectomy at 38 has its own set of complications, which are best avoided, such as surgical risks, anesthetic risks, risks of premature menopause etc.
Take care, and please feel free to ask further questions.

Above answer was peer-reviewed by : Dr. Mohammed Kappan

Follow up: Dr. Aarti Abraham (4 hours later)

Thank you for your answer.
One more question for u. With PCOS I am at high risk r ovarian cancer and in my family we have a history of cancer. Im scared that I going to end up being diagnosed with cancer. Would it make sense to get rid of the ovaries to prevent this from happening?

Answered by Dr. Aarti Abraham (28 minutes later)

Brief Answer:
DEPENDS ON BRCA TESTING

Detailed Answer:
Hi,

Thanks for writing back.

You have not mentioned what specific cancers run in your family.
Prophylactic ooophrectomy ( removal of ovaries ) is an option that is strongly recommended for women who have an inherited mutation of the BRCA 1 or BRCA 2 gene - two genes conclusively linked with ovarian and breast cancers.

Even if you have a strong family history of breast and ovarian cancer but no known genetic aberration , or if you have a strong family history, but prefer not to get tested for certain reasons, then also prophylactic oophrectomy maybe recommended.

It is best to discuss your situation with your Gynecologist and then proceed ahead accordingly.

Regards,

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Above answer was peer-reviewed by : Dr. Raju A.T