Hysterectomies affect millions of women of all ages. Yet, receives almost no attention. A newly released book and podcast by Melanie Verwoerd under the title: “Never Waste a Good Hysterectomy” aims to break this cycle of silence.
How common are hysterectomies?
Estimations are that 1 out of 5 women will have a hysterectomy by age 55. In America, the procedure is performed on 600 000 women annually. There are approximately 20 million American women at any stage who have had hysterectomies. In the EU, about 1.5 million hysterectomies are performed per annum, compared to 55 000 in the UK, 700 000 in India and 41 000 in Canada.
There are no statistics available in South Africa.
“We know that hysterectomies affect women of all ages,” says Melanie. “However, if we look at the patterns globally we know that the majority of hysterectomies are performed on women over 40 and it increases over 50.”
That’s not to say that young women don’t get hysterectomies. There are medical reasons to undergo the procedure, with Lena Dunham opening up about her procedure and the fallout. For some, hysterectomies might be necessary when dealing with endometriosis or fibroids.
Dealing with hysterectomies
Having a hysterectomy is a radical, invasive operation. It involves removing the uterus, meaning a woman can no longer give birth. It also has an impact on a woman’s hormones, since the uterus is the housing station for hormones like oestrogen and progesterone.
For Melanie, her hysterectomy happened when doctors discovered a growth in her uterus. “When an ovarian growth is detected (usually through an ultrasound), they will usually (if you can afford it) do a CT or MRI scan. If they can see that it is a hard mass of a certain size – and not a fluid-filled cyst, they get more worried,” she explains.
“The sad and infuriating thing is that the only way they can then determine whether it is malignant or benign is to do surgery to remove the growth and for pathologists to look at it.
“However, because they don’t want to do another surgery if the growth is indeed malignant, they will almost always do a pre-emptive radical hysterectomy. (Where they remove, the ovaries, uterus, some ligaments, and the cervix.) They usually also remove part of the omentum, which is a fatty curtain that protects your organs – but where cancer cells like to hide. They will usually do an abdominal cut (as opposed to laparoscopic or vaginal procedure) because they don’t want parts of the tumour to chip off and “seed” in your abdomen if it is cancer. This of course means that it is a much bigger operation that involves a much longer recovery period.”
What’s infuriating for Melanie is that so little money and time is spent on research in the women’s health space that detecting and treating conditions such as hers ends up being invasive, costly and mentally and physically draining.
“For example, more than double the amount of research funding globally is spent on prostate cancer. Thus, today, prostate cancers can be detected through simple non-invasive blood tests,” Melanie says. “Unsurprisingly, the 5-year survival rate for ovarian cancer is around 29% compared to over 95% in prostate cancer.”
Hysterectomies take looong to recover from
One of the things not spoken about enough is the long recovery time, as well as the emotional toll it takes on women. “Women are often told that it takes a maximum of 6 weeks to be back to your old self again,” says Melanie.
“I have not met a single woman who felt that way. Although vaginal and laparoscopic hysterectomies have much shorter recovery times than abdominal cuts, it can take months for women to feel 100% fine again in all aspects. “
The Psychological Ramifications
“It is not only physical but there are a lot of psychological ramifications as well,” explains Melanie. After having undergone such a procedure, it’s common for women to feel depressed. Then there’s how the hysterectomy affects young women who have yet to enter menopause.
“If ovaries are removed in pre-menopausal women it will of course put them into immediate menopause and so they have to deal with the intense hormonal crash,” says Melanie. “Many women also find that they gain weight, which is most probably more linked to hormonal changes than the actual operation and some find it very difficult to get their sexual groove back.”
Then there are all the other physical changes that happen post-op. There can be complications post-op, like prolapse (when organs start to exit the vagina), incontinence (urine leakage), bleeding and general pelvic floor problems. All of these take a long time to resolve, from months to a year, if there’s adequate and rigorous treatment. And it can affect a woman’s sex life in a big way.
Melanie’s hope with the book and accompanying podcast is to shed light on the matter and press for further research into the issue, so that women aren’t faced with such dire odds in the doctor’s office.
Never Waste a Good Hysterectomy: The Podcast (available on all major platforms) features interviews with health and medical experts. Common questions such as: “Where did my pelvic floor go? How to get my sexual groove back? What happens on the day of the operation? How much bleeding is normal? Why are my hormones playing havoc? How to recover emotionally and get your partner to wash the dishes and cut the lawn during your recovery” are answered.
The podcast is available on Apple Podcasts, Spotify and all other major podcast platforms.