PCOS surgery: Is it a Cure?
Living with PCOS and its symptoms can be a daily struggle. So I understand your desire to find a quick fix or cure like PCOS surgery.
But is surgery really a cure for PCOS?
In this post, we will look at whether undergoing surgery can cure your PCOS. Learning about the different PCOS surgeries available, and their potential benefits and risks. Because surgery can be a scary thing and I want you to feel like you have all the information.
There is no cure for PCOS, but surgery may help alleviate some of the symptoms. The PCOS surgeries available include a hysterectomy, laparoscopic ovarian drilling and ovarian wedge resection. These surgeries may help with ovarian cyst pain, improve menstrual regularity and boost pregnancy rates. However, they do not help with the symptoms like acne, insulin resistance or hair growth. Because they do not address the root cause of PCOS which is a hormonal imbalance.
Table of Contents
1.1 Will a Hysterectomy Cure PCOS?
1.2 The Risks of a PCOS Hysterectomy
2. Laparoscopic ovarian drilling
2.1 Can laparoscopic ovarian drilling cure PCOS?
2.2 The Risk of laparoscopic ovarian drilling
3. Ovarian Wedge Resection
3.1 Is Ovarian Wedge Resection Safe?
3.2 What is laparoscopic ovarian wedge resection?
3.3 Can an Ovarian Wedge Resection cure PCOS?
4. Will Surgery Cure My PCOS?
Before we get into the different PCOS surgeries, let’s first look at what PCOS is exactly. This will help you understand the reasoning and aim for each surgical procedure.
What is PCOS?
PCOS is a complex metabolic and hormonal condition that affects 10-20% of reproductive-age women. Women with PCOS produce too many male hormones. The high male hormones interrupt the production of female hormones (estrogen and progesterone) and the natural ovulation cycle.
Doctors use the Rotterdam Criteria to diagnose PCOS. Women must show two out of the three signs.
1) High androgens - your body produces high levels of male hormones. Physical symptoms of this include excess body or facial hair and male pattern balding.
2) An irregular menstrual cycle - The average menstrual cycle is between 21 to 35 days (on average 28 days). A cycle is irregular if it lasts longer than 35 days or less than 21 days. A missed period would also be an irregular cycle.
3) Polycystic Ovaries - despite the name these are not actually cysts the way you may think of them, but many small follicles. These follicles contain eggs. When you don't ovulate the follicle does not break to release the egg. As a result, follicles stay in the ovary and the ovaries appear to contain many ‘cysts’. For an ovary to be polycystic, it must contain at least 12 of these 'cysts'.
As you can see, you don’t necessarily need to have polycystic ovaries to be diagnosed with PCOS.
So, you now know what PCOS is. Let’s talk about the different surgeries doctors recommend for the treatment of PCOS and their potential benefits and risks. So you can make an educated and informed decision on whether surgery is right for you and your PCOS.
What are the PCOS Surgeries?
Surgeons developed various procedures to try and alleviate the three signs of PCOS. These surgeries include a hysterectomy, laparoscopic ovarian drilling and laparoscopic ovarian wedge resection.
One of the most popular PCOS surgeries spoken about in the community is a hysterectomy.
What is a hysterectomy?
A hysterectomy is a surgical procedure performed by a gynecologist which often involves the removal of the uterus. But it can be used to remove the ovaries, fallopian tubes and cervix.
Now, there are different types of hysterectomies. But the surgery that is often recommended for women with PCOS is an oophorectomy. This involves the removal of the ovaries.
So, you might be wondering why doctors recommend a hysterectomy for PCOS.
Why is a Hysterectomy a Possible Surgery for PCOS?
Well, here's the thing.
The idea behind a PCOS hysterectomy is that if the ovary is removed, the production of male hormones and ovarian cysts will stop. As a result, PCOS symptoms will disappear.
Will a Hysterectomy cure PCOS?
There are several PCOS hysterectomy success stories online. For example, the journalist, Bonnie Bolden who was diagnosed with both endometriosis and PCOS.
In her article, Bonnie said when her ovarian cysts would rupture she used to suffer from excruciating pain. But since her surgery, she is pain-free and feels better.
She explained “my right ovary was bigger than my uterus, and my doctor confirmed that I also had endometriosis. She removed everything but my left ovary.” Bonnie’s hysterectomy was successful in stopping her chronic pain and improving her quality of life.
However Bonnie also writes, “My surgery got rid of the cysts, but I still have the hormonal imbalance that caused them.” So whilst the surgery was beneficial in her particular case it did not ‘cure’ her PCOS.
A Hysterectomy Doesn’t Get To The Root Cause of PCOS
While the ovaries release male hormones and produce ‘cysts’, they are not the real problem.
By removing the ovaries, the root cause still hasn’t been addressed.
This is something Bonnie discusses in her article. She says that while her surgery got rid of the cysts, she still has the hormonal imbalance that caused them.
Now, there are various root causes of PCOS. They include insulin resistance, high cortisol and inflammation. So, to treat PCOS, you have to understand what is causing the hormonal imbalance and fix that.
Insulin resistance is still a problem
Insulin resistance is the most common root cause of PCOS, with about 70% of women suffering from this. This is a condition where the cells in the body struggle to absorb sugar in the blood because they have become desensitized to the effects of insulin. As a result, there is a build-up of sugar in the bloodstream.
To reduce blood sugar levels the pancreas starts producing even more insulin. High levels of insulin in the body then has the unwanted side effect of telling the ovaries to produce more androgens. Which then causes the PCOS symptoms women experience.
Studies show hysterectomies do not improve insulin resistance but instead may worsen the condition.
The Adrenals Release Male Hormones
When we are stressed the fight or flight stress response is activated. This causes the adrenals (an organ found on top of the kidneys) to release cortisol and adrenaline. As well as three male hormones, DHEA, DHEA-S and androstenedione.
As you can see, the ovary is not the only organ that releases male hormones, so do the adrenals. Excess male hormones released by the adrenals is the root cause of about 20-30% of women’s PCOS.
So removing the ovaries will not fix the excess production of male hormones from the adrenals caused by chronic stress.
Hysterectomies don't Lower Inflammation
Researchers have found that PCOS women suffer from chronic inflammation.
Inflammation is a response the immune system takes in an attempt to defend itself from outside invaders, such as viruses and bacteria.
While insulin resistance is a root cause of PCOS, studies have found obesity-induced inflammation can lead to insulin resistance. The inflammation and insulin resistance can then lead to the development of PCOS and its symptoms.
Hysterectomies do not suppress the immune system or lower inflammation.
To find out what the root cause of your hormone imbalance and PCOS may be, check out my 'Types of PCOS: Ultimate Guide'.
The Risks of a PCOS Hysterectomy
There are various complications and side effects that can occur when undergoing a PCOS hysterectomy. They include
- Blood clots- A blood clot can develop in the vein, which can affect blood circulation and oxygen. This can happen due to lack of movement after surgery.
- Vaginal problems- This can occur if you remove the cervix through a vaginal hysterectomy.
- Infection- Undergoing surgery always increases the risk of infection. An infection can develop from a wound or it can be a urinary tract infection.
- Ovary failure- 50% of women who have had a hysterectomy develop problems with their ovaries. Removing one of your ovaries puts your other one at risk. Within 5 years of removing one ovary, the other can fail. This is because when the womb is removed, the ovaries receive less blood.
- Early menopause-. When the ovaries are removed menopause occurs instantly. You see the ovaries receive signals from the brain to make hormones. When you remove the ovaries, hormones stop being produced. Early menopause increases the risk of osteoporosis and heart disease.
- Bladder or bowel damage- internal organs like the bladder or bowel can be damaged. This can result in infection and frequent urination.
Given the risks, you need to think long and hard about whether having a hysterectomy is the right decision. And if it can really help your PCOS.
Here's the deal.
Undergoing a hysterectomy to remove the ovaries may seem like a simple solution to PCOS. But it is not. Yes, removing the ovaries can stop ovarian cyst pain. However, a hysterectomy does not get to the root cause of PCOS by fixing the woman's hormonal imbalance. Meaning it does not address the insulin resistance, the chronic stress that is possibly causing an excess release of male hormones from the adrenals or the chronic inflammation. It also increases the risk of early menopause, blood clots and ovary failure.
So, a hysterectomy will not cure your PCOS. To treat it, you must get to the root cause of your hormonal imbalance. Having said that, in some cases a hysterectomy may be necessary. For example, when a woman has endometriosis, ovarian or uterine cancer, chronic pain caused by recurrent pelvic infection. So, I suggest speaking with your doctor to discuss your own personal case.
Laparoscopic ovarian drilling
Laparoscopic ovarian drilling is another surgery that is often spoken about in the PCOS community.
You might be wondering.
What is laparoscopic ovarian drilling?
Laparoscopic ovarian drilling was introduced in 1984 as a way to treat PCOS. It involves drilling 4-6 holes in each ovary using either a laser or electrical current to destroy parts of the ovaries.
Why is Laparoscopic Ovarian Drilling a Possible Surgery for PCOS?
Doctors believe destroying the male hormone-producing tissue in the ovary will help lower testosterone levels, stimulate the release of an egg each month and regulate the menstrual cycle. With the outcome of boosting pregnancy rates.
So, you might be wondering. Does this PCOS surgery help?
Can laparoscopic ovarian drilling cure PCOS?
Several studies have found huge benefits to laparoscopic ovarian drilling for women with PCOS.
A follow-up study found it improved menstrual regularity and reproductive performance among PCOS women. Now, this is encouraging for women with PCOS who suffer from menstrual irregularities and are trying to improve their fertility.
But here’s the truth.
While laparoscopic ovarian drilling may improve menstrual regularity, it is not a cure for PCOS.
Laparoscopic Ovarian Drilling Doesn't Get To the Root Cause of PCOS
First off, a study revealed the predictors of success include the level of luteinizing hormone (a hormone released by a region in the brain that helps your reproductive system) and the duration of infertility. As well as the level of male hormones and insulin resistance.
They found women who do not have high male hormones and are less insulin resistant may benefit more from this type of surgery.
Secondly, there is no clear evidence laparoscopic ovarian drilling can improve the symptoms or risk factors of PCOS. Including insulin sensitivity, cholesterol levels, hair growth or acne.
Because of this, experts agree it should not be a first-line treatment or a treatment of choice for PCOS women.
The Risk of laparoscopic ovarian drilling
Unfortunately, there are potential risks to laparoscopic ovarian drilling. These risks include the development of scar tissue. After surgery, the body tries to repair itself but it doesn’t know the difference between one organ and another. As a result, organs can stick together and cause further complications.
A further possible risk is premature ovarian failure (POF). This can occur if the ovarian blood supply is damaged or if a large number of punctures are made. Too many punctures can destroy the number of ovarian follicles and the production of anti-ovarian antibodies.
Ovarian Wedge Resection
Ovarian wedge resection is not commonly used to treat PCOS. But it is a possible PCOS surgery.
What is Ovarian Wedge Resection?
Ovarian wedge resection became a recognized invasive treatment approach for women with anovulation and PCOS in 1935 by Stein and Leventhal. This surgery involves creating an incision in the abdomen to get access to the ovaries. Doctors use a clamp to stabilize the ovary in place and then a scalpel to remove part of the ovary.
Why is Ovarian Wedge Resection a Possible Surgery for PCOS?
Here’s the thing.
Women with PCOS do not ovulate, so experts believed it could help restore ovulation. Two reasons why they thought it helped was because the cysts were removed and the size of the ovary reduced.
Is Ovarian Wedge Resection Safe?
Doctors eventually stopped using ovarian wedge resection because of how invasive it was and its severe risks. Which included scar tissue, a greater risk of infection, bleeding and damage to the abdominal cavity where the surgery took place. As well as a decrease in the ability to conceive because part of the ovary has been removed.
But get this.
What is laparoscopic ovarian wedge resection?
Laparoscopic ovarian wedge resection does what the traditional surgery did but in a less invasive way. Doctors now create a small incision to insert a laparoscope, a long thin viewing device, into the abdomen. A laser is then used to make an incision into the ovary. The tissue is removed and the ovary is then stitched up.
This approach results in less scar tissue and quicker recovery time.
Can an Ovarian Wedge Resection cure PCOS?
Well, here’s the deal.
Stein explains that from his research and testing, the ovarian wedge resection procedure restored menstruation in over ninety-five percent of his patients. Many of them also went on to conceive as a result.
In addition, further research shows laparoscopic ovarian wedge resection resulted in excellent pregnancy rates, a reduction in male hormones and Luteinizing hormone (LH). These findings sure sound encouraging for women with PCOS who are looking to improve fertility and lower male hormones.
But get this.
It decreases insulin sensitivity, worsening insulin resistance. Which is something PCOS women need to improve to help reverse their PCOS.
Will Surgery Cure My PCOS?
There are various surgeries available for the treatment of PCOS including a hysterectomy, laparoscopic ovarian drilling and laparoscopic ovarian wedge resection. Evidence shows these surgeries can alleviate some of the PCOS symptoms.
A PCOS hysterectomy that removes the ovaries has been shown to stop the unbearable pain caused by burst cysts. But there are considerable risks and it does not get to the root cause of PCOS.
Laparoscopic ovarian drilling surgery can improve menstrual regularity and reproductive performance in non-PCOS women. But has not shown benefits for PCOS women who have high androgens and are insulin resistant.
A laparoscopic ovarian wedge resection may boost pregnancy rates, reduce male hormones and luteinizing hormone. Though it can worsen insulin resistance.
Surgery does not get to the Root Cause of PCOS
Unfortunately, none of these surgeries will cure your PCOS because they do not address the root cause. That is the hormone imbalance.
They do not address the insulin resistance, chronic stress/adrenals, or inflammation that may be causing the excess production of male hormones and PCOS symptoms. So, this is why women who undergo surgery for PCOS do not see an improvement in their excess hair growth, acne or insulin resistance.
Unfortunately, there is no quick fix to PCOS. It is best to seek medical help and guidance about your PCOS before you make such an important and life-changing decision.
Disclaimer: The information and content provided in this blog, as well as any other linked materials, are not intended and should not be used as a substitute for professional medical advice. always consult your health care provider or seek professional medical treatment if you need medical assistance. You should never delay or disregard professional medical advice because of something you have read on this blog. Call your doctor or emergency services immediately if you think you may be having a medical emergency.
Hey there! I am Despina Pavlou, founder of PCOS Oracle and online coach. I want to share with you the diet and lifestyle changes I made to naturally reverse my PCOS and achieve hormonal balance. I believe using my holistic approach you too can take back control from PCOS.