Hysterectomies have been in the news lately. We recently saw that for women with gynae cancers, open hysterectomies may give better outcomes than laparoscopic – this makes sense for a number of reasons – with a scope, you only see what the scope sees so if you miss an angle…you miss seeing what’s there, which, when it comes to getting clean margins in cancer surgery, is obviously super important.
Open hysterectomies however present their own challenges – in the short, medium and long term. Women have the increased risk of excessive bleeding and infection in the short term, as well as dealing with potentially restricted tissue mobility, pain, inhibited diaphragm and pelvic floor muscle function.
Like everything else, knowledge is power – I recently had a chat with Dr Brianne Grogan, of FemFusion Fitness, about how women can best prepare for having a hysterectomy, you can have a listen here:
Another report which caught my attention during the week, was the PopScience article titled: ‘The medical community is finally realizing the uterus is more than a ‘baby house’
The report goes on to look at how the uterus and ovaries have many important roles and functions beyond carrying a baby to term. If you’ve been to one of my courses or presentations, you’ll have heard me discuss the unfortunately high rate of hysterectomies – in the US, it’s the second most common surgery carried out on women (after C sections). While hysterectomies are often incredibly beneficial, they are often done for inappropriate reasons too – for endometriosis, pelvic pain or other unknown aetiologies of dysfunction. In fact, Corona, in her 2014 paper stated that up to 20% of hysterectomies may be unnecessary. What worries me even more, however, is that many women often have their ovaries removed unnecessarily at time of hysterectomy – being told ‘this way, you’ll never get ovarian cancer’.
While it is true that many ovarian cancers are not detected until they are advanced, because of seemingly innocuous symptoms like abdominal bloating or pelvic pain, what women may not be aware of is that your risk of osteoporosis, dementia, cardiovascular/ coronary artery disease, lung cancer, Parkinson’s disease and ALL CAUSE MORTALITY goes up if your ovaries are removed, according to Stewart’s 2012 research. So yes, if you carry the BrCa1 or BrCa2 genetic mutation, your risk of breast and ovarian cancer is significantly elevated to between 35-70%, so that is a discussion women should have with their medical practitioners (but I just want to point out – it is not 100%). What we do know is that these genes are responsible for about 10 to 15 percent of all ovarian cancers. Which means 85% of ovarian cancers aren’t genetically driven.
All of this to say, that if you are working with women who have had a hysterectomy, for whatever reason, as healthcare practitioners, we need to be aware of the short, medium and long term implications of this surgery, from scar tissue to waking up in instant menopause if you’ve had your ovaries removed, from breathing, bladder and bowel function to bone, brain and heart health.
Jenny Burrell and I have collaborated on many projects over the years, but our Optimal Health After Hysterectomy course was a real passion project for us. We really worked hard to bring a complete overview of the anatomy and physiology of hysterectomy, the short, medium, and long term issues women face and strategies for returning, as the title says, to Optimal Health After Hysterectomy.
As part of our December birthday and Christmas celebrations, we’re offering discounts and bonuses on all of our courses, but this one is particularly close to our hearts.
Until next time!
Onwards and Upwards,