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    We Need To Talk About Hysterectomies And How They Really Affect Women

    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?

    The Stats

    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.”

    The Research

    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. More

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    Everything You Need To Know About Endometriosis

    Endometriosis: what a bloody mess. It’s a condition as common as asthma and diabetes, but not as often discussed. It’s estimated that one in ten women suffer from endometriosis. The condition can be so debilitating that women often need to stay home, missing work or other important activities. 

    What are the symptoms of endometriosis?

    While ramped-up period pain is often associated with endometriosis, it doesn’t end there. The most common signs are:

    Cramps — Common PMS cramps generally show up right before your period. Pelvic pain caused by endometriosis can show up days (even weeks) earlier than the expected PMS discomfort.

    Gastrointestinal or bladder issues — Sometimes the uterine lining can travel and attach itself to the bladder or bowels and can cause painful issues like constipation, diarrhoea, or the feeling that you’ve got a UTI.

    Painful sex — If you’re feeling pain during deep penetration (as opposed to say, the insertion of the penis) your gynae may suspect endometriosis.

    Backache — endometrial glands can travel along the back or frontal wall of the pelvic cavity, which can cause back pain or stomach aches.

    Fertility issues — When endometriosis is severe, it can damage or block the fallopian tubes or distort the pelvic cavity, lowering your odds of reproductive success. Around 70% of patients with endometriosis will have no fertility issues. According to the American Society of Reproductive Medicine, up to 30% of women with endometriosis struggle to get pregnant, doctors are unsure whether it’s to do with endometrium distorting the pelvic anatomy, altering the chemicals that affect egg quality or the implantation environment of the embryo, or whether another factor affects how sperm move up the fallopian tube.

    If you suspect something’s not right, go see your doctor, stat.

    READ MORE: 10 Tips To Keep Your Vagina Happy And Healthy

    Who’s affected?

    Women and girls of reproductive age, mostly between 15 and 49. There is a hereditary element, but scientists don’t know if one gene or a family of genes predispose women to endometriosis. There isn’t a known equivalent of the BRCA gene (which indicates if someone has a higher risk of developing breast cancer), but scientists are trying to determine if one exists, to then help identify people needing laparoscopic surgery for endometriosis diagnosis.

    How it grows

    Endometriosis is thought to be linked to oestrogen levels, with research indicating that sufferers show resistance to progesterone, the other female sex hormone. This is one possible explanation for associated infertility, as progesterone is necessary to thicken the uterus lining each month. Without it, the uterus may be an unfavourable habitat for an embryo to embed and form a pregnancy.

    READ MORE: 6 Reasons That Explain Why You’re Constantly Tired


    Because scientists believe the growth of endometriosis lesions is driven by oestrogen, patients are prescribed drugs to stop ovaries producing the hormone, which subsequently reduces pain, stops the problem progressing and reduces adhesion size. Typical medication includes the combined pill, progestogens, a progestogen IUD (like the Mirena coil); or a GnRH (gonadotropin-releasing hormone) agonist, which causes temporary menopause.


    The aim is to alleviate pain by removing the endometriosis, dividing adhesions or removing cysts. Conservative surgery is usually done via laparoscopy (keyhole surgery). The surgeon will either cut out the adhesions (known as excision) or destroy them using heat or laser (ablation). Complex surgery is required when the endometriosis adhesions are spread across multiple organs, like the bowel or bladder.

    READ MORE: 12 Reasons Why You’re Suddenly Experiencing Painful Sex

    Severe pain

    Chronic pain affects many women with endometriosis. This can lead to central sensitisation, whereby the more exposure a person has to pain, the lower their threshold becomes. Brain imaging studies have shown that chronic pain patients have a reduced volume of grey matter in the area associated with muscle control and sensory perceptions, such as memory and self-control.


    Hysterectomy is a radical surgery for endometriosis and, if guidelines are followed, should only be considered if a patient hasn’t responded to other treatments. Most experts agree that it should only be used in adenomyosis (where adhesions grow into the uterus wall). More

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    6 Of The Most Common Myths About Endometriosis

    It’s estimated that a whopping 200 million women around the world are impacted by endometriosis — this is a staggering statistic! While so many women live with this disease, there’s still a lot of misinformation and a lack of awareness of exactly how it impacts a woman’s body. First off, what exactly is endometriosis? Endometriosis […] More