We're here to talk about surgical menopause. There are lots of ways to get to this state, but most of us got there as a secondary effect of having a hysterectomy with removal of our ovaries This is also called a TAHBSO or total hyst or some variety thereof—the critical element being the BSO, which is medspeak for bilateral salpingo-oophorectomy.
Once you get through the surgery and the recovery, which is itself no mean feat, you're left living happily ever after in your redesigned body. Or at least that's what your doctor told you, didn't he? Ummm, not to be disrespectful, but it's just not that simple. There turns out to be quite a lot that your ovaries were doing for you and that you now have to manage on your own. In a perfect world (yeah, right) you and your doctor would reach well-researched, well-reasoned mutual decisions on how to further and protect your total wellbeing. If you're there, you have our congratulations and you might as well move right along: you don't need us and what we have to say here. But if you fall in with the rest of us, bumbling along hoping someone got the license plates of that semi that just ran over you, welcome.
This website grew out of our having to do the work of figuring out what happened to us when we lost our ovaries and what to do about it. We're not going to tell you what to do because we're not you and haven't got a clue what you need. We are, however, perfectly happy to share what we've discovered along the way, so that you have a better information base to work with and can make more informed decisions about where you want to go with your body and your health.
Before we get started with the heavy stuff (and believe us, it's gonna be pretty dense going before we're done), there are a few principles around which most of what we have to say is based. They're so important we're starting right out with them.
TANSTAAFL is the acronym used by the late writer Robert Heinlein for the exact same purpose we are helping ourselves to it: it is the best way we know of to remind ourselves that we have to keep a firm grip on perspective. There ain't no such thing as a free lunch. Huh? To put it another way that may seem more applicable, there is a cost that comes along with every benefit. Nothing comes without a price, and unless you know the price and are willing to pay it, maybe you need to think twice. A lot of what we're going to look at here is price tags. After all, we got into this fix as the cost of another benefit: getting rid of a diseased uterus. We all had a physical defect that we tried to remedy, with some degree or another of success, with a hysterectomy. No matter how wretched we feel about the results, they always have to be weighed against the fact that we were messed up when we started. We never got the perfect health option, and now all we get are choices between lesser evils. Call us giddy optimists if you will, but we still think that we have a lot to work with. For a price.
Listen to your body: simple advice and you've heard it before. But it's critical now. With your ovaries go a lot of important feedback mechanisms. Systems that used to tend themselves now require more or less constant conscious monitoring and fussing. There aren't cut and dried answers. What works for each of us is different, and the only way to figure out the right approach is to try things and listen to how your body responds. The more carefully you listen, the more you learn. Next to this, lab tests and medical protocols are crude tools: they provide the rough guidance, but only you can tell when you have reached a point that makes you happy.
The more you know, the better decisions you can make for yourself. This is complicated stuff. We didn't want to know it all and we don't think you're going to be thrilled about plowing through it either. But face it: a menopausal woman isn't high on anyone's list but her own. Your doctor, unless you are very lucky, isn't going to want to work at this nearly as hard as you may. His professional life is ruled by cost-effective use of time, the demands of insurance companies and lawyers, and which drug rep took him to lunch last. If his approach to surgical menopause seems formulaic and simplistic, try to remember that this is the cost-effective approach for him to take. That doesn't mean that you have to buy the same line. Read our research, do more of your own, think about what you need, and fight for it. You're going to live longer than your mother and grandmother did, so you might as well be as healthy as possible while you're at it.
Okay, ready? Start reading at the top of the Table of Contents, and plan on making a couple trips through. There are outlinks we've thrown in here and there to illustrate or to offer another explanation of things. Don't feel you have to chase them all the first time—they're not going away. Go for a grasp of the basics and then work on filling in. With luck, you won't need every last bit of this—but you won't know till you see it. You don't have to go in any particular order, but if you follow down through the basics first, it will make, well, as much sense as possible.
Remember, this is a fast-changing field and new research is showing up every day as they finally (about time) get around to testing some of this stuff on real people like us. Most of the research about menopause has historically been done on women in natural meno or with only one kind of hormone, so a lot of what we read has to be taken with a grain of salt. But our numbers are growing and so is the potential market we begin to offer, hence our growing appeal as research subjects. What we're guessing today will be known tomorrow. Don't take everything here as the last word (for interim updates and breaking news, come to our discussion group)—it's only as recent as the posting date and the time we have to keep track of the latest publications. But it's more than you had when you started, right? Okay then. Read on.