Tubal ligation

Dear Dr. Fink,

It is my understanding that ovaries do not stop functioning at the time of (natural) menopause, but just function to a lesser degree. The ovary(s) stop producing eggs, menstruation ceases, but the ovaries most often continue to produce estrogen, just in lesser amounts, and may do so into the woman's 70's or 80's.

You fail to mention in your post that many women after a hysterectomy, when their ovaries are not removed often suffer from ovarian isolation. Blood supply to the ovaries most often are affected which can cause one or both ovaries to fail. This is a common occurrence not only after hysterectomy with the conservation of the ovaries, but also after tubal ligation. Unlike a natural menopause, losing all function of both ovaries puts the woman in a castrated state.

Women who undergo hysterectomies (without the removal of their ovaries) because they still physically have their ovaries are often told when returning to their doctors with hot flashes, loss of sex drive, and other meno symptoms that they cannot be menopausal because they still have their ovaries. They are misinformed, not educated about the risk of ovarian isolation, and are denied hormone testing, proper diagnosis, and treatment. If they have indeed suffered from ovarian isolation and are in fact in a castrated state then massive bone loss - caused by the removal of the uterus - is one side effect...

Women are not informed of this risk in order to sell them the surgery. Women are rarely informed before hysterectomy to the possibility of ovarian isolation occurring. More often women are falsely told that because their ovaries would be left in place that they will continue to function and that they will have a natural menopause - period. The truth is it is not known if her ovaries will continue or not.

What is needed is

LESS hysterectomies for benign conditions.
Proper informed consent before hysterectomy which would include information such as alternatives to hysterectomy (including FRS) - (this is law in CA, NY, and TX - Due to the advocate women's rights work Dr. Hufnagel did in putting these laws in place). - These laws have never been enforced.
Educating women of the possibility of ovarian isolation occurring. (law)
Better care for women after hysterectomies such as regular hormone testing to ensure that her ovaries did not fail, and diagnosis and treatment if they do. - so she doesn't suffer massive bone loss, HD, etc…