Written by: Mary-Anne Bennett, Executive Contributor
Executive Contributors at Brainz Magazine are handpicked and invited to contribute because of their knowledge and valuable insight within their area of expertise.
Every year in Australia, thousands of women have a hysterectomy, and approximately 5% also have a partial or total oophorectomy. Whilst rates have steadily declined in the last ten years, what remains is the lack of information and informed consent.
The definition of informed consent according to the Australian Commission on Safety and Quality in Health Care states “a person’s decision, given voluntarily, to agree to a healthcare treatment, procedure or other intervention that is made following the provision of accurate and relevant information about the healthcare intervention and alternative options available, and with adequate knowledge and understanding of the benefits and material risks of the proposed intervention relevant to the person who would be having the treatment, procedure or intervention”.
Women are not told of the long-term impact that these procedures will have on their health. In a male-dominated healthcare system, women are led to believe that once their childbearing years are over and menopause is on the way, their uterus and ovaries become redundant.
Sound familiar? Here’s what I experienced in 2015.
At the height of my chronic health journey, I knew very little about how my body actually worked. I had just started at university, and all I knew was the basics about periods and hormones, and that menopause was inevitable, but nobody I knew had had a hysterectomy.
So when the doctors discovered that I had a large uterine fibroid and a cyst on one of my ovaries, the specialist recommended a hysterectomy and a unilateral oophorectomy.
At the time I thought it was a great idea, no more periods and it would solve my iron deficiency problems too. Double winner!
Never did anyone mention the long-term impacts on my hormones, and that it would increase my already high risk of cardiovascular disease, not to mention my risk of osteoporosis and neurodegenerative diseases.
I have learned so much about my body since then. And it serves no purpose to stay angry about the doctor's failure to provide me with the information I needed so I could truly make an informed choice.
So if you are considering a hysterectomy and or a oophorectomy, here is the information you may like to know to make an informed choice.
Hysterectomy is a common surgical procedure where a woman’s uterus is removed. It can be performed for various reasons, such as uterine fibroids, endometriosis, cancer, and heavy menstrual bleeding.
And while having a hysterectomy might sound like a great way to stop the pain, and inconvenience that periods bring, women are not told of the long-term implications that this standard surgical procedure can have on their health.
Along with having a hysterectomy, doctors often recommend that a partial or even total oophorectomy is performed ( removal of one or both of the ovaries) at the same time. Ovaries are the primary source of estrogen and progesterone, the two most important female hormones. When the ovaries are removed, the production of these hormones decreases significantly, leading to a condition known as surgical menopause.
Surgical menopause is characterized by hot flashes, night sweats, vaginal dryness, and other symptoms similar to menopause. The sudden decrease in hormone levels will impact a woman's quality of life and increase her risk of various health problems, including osteoporosis and heart disease.
I found a large amount of research on the physical and psychological impact of hysterectomies, on women’s health.
These are some key findings from recent studies:
Physical effects that include menopause symptoms, changes in sexual function, and an increased risk of osteoporosis and cardiovascular disease. Here's an article I wrote in Brainz Magazine ‒ "Getting to the Heart of the Matter- 7 Ways to Keep your Heart Healthy".
Hormonal changes that include a sudden and significant decrease in estrogen levels, leading to symptoms such as hot flashes, vaginal dryness, and low libido.
Reduced sexual function including decreased sexual desire, pain during intercourse, and difficulties with arousal and orgasm.
The effects can also lead to hormonal imbalances in other areas of the body, such as the thyroid and adrenal glands.
The thyroid, adrenal glands, and ovaries are all endocrine glands that play a vital role in regulating the physiological functions of the body. But how do they work together to regulate your hormones?
Thyroid and Adrenal Glands
The thyroid gland produces hormones that regulate the body's metabolism, while the adrenal glands produce hormones that help regulate the body's response to stress. The adrenal glands secrete cortisol, a stress hormone that can affect the metabolism and energy levels of the body. When cortisol levels are high, they can inhibit the production of thyroid hormones and disrupt the delicate balance of the body's metabolic functions.
Adrenal Glands and Ovaries
The adrenal glands also secrete androgens, which are male-like hormones that can impact female reproductive health. These hormones can affect the production of hormones by the ovaries, leading to hormonal imbalances and conditions such as Polycystic Ovary Syndrome (PCOS).
Thyroid and Ovaries:
Thyroid hormones have a direct impact on the regulation of the menstrual cycle and ovulation, and in turn imbalances in thyroid function can lead to menstrual irregularities and fertility issues.
The thyroid gland is responsible for regulating metabolism and energy levels, and the levels of estrogen and progesterone in the body heavily influence its function.
When these hormone levels change as a result of a hysterectomy, it can have an impact on the function of the thyroid gland, leading to hypothyroidism or other thyroid-related problems.
There is a substantial amount of scientific evidence supporting the impact of a hysterectomy on a woman's hormones. Here are some of what they found:
Women who undergo a hysterectomy are more likely to experience symptoms of surgical menopause and hormonal imbalances.
Women who underwent hysterectomy with bilateral oophorectomy were more likely to experience hot flashes, night sweats, and other symptoms of surgical menopause compared to women who underwent hysterectomy without oophorectomy.
Women who had a hysterectomy with bilateral oophorectomy had an increased risk of hypothyroidism. Women who underwent this procedure were more likely to develop hypothyroidism within the first five years after surgery, and this risk increased with age.
Women who underwent hysterectomy with bilateral oophorectomy had significantly lower levels of testosterone compared to women who underwent hysterectomy without oophorectomy.
Testosterone plays an important role in a woman's sexual health and well-being, and low testosterone levels can lead to sexual dysfunction and decreased libido.
So what does this all mean for you?
Let me summarize the basic facts for you-
Hysterectomy can have a significant impact on a woman's hormones. The removal of the uterus and/or ovaries can lead to surgical menopause and hormonal imbalances.
Hormonal imbalances (especially estrogen and progesterone) increase your risk of cardiovascular disease, osteoporosis, and neurodegenerative diseases. Here is one of my earlier articles that I wrote for Brainz Magazine ‒ 3 Reasons Why Your Hormones Matter.
Testosterone is an important hormone for women and deficiency can impact sex drive, sexual pleasure, and libido. Your ovaries, thyroid, and adrenal glands work in unison to balance hormones, regulate your metabolism, and help you manage stress. If you tried to ride a tricycle without one of the wheels, how well would it work?
What can you do?
Listen to your body, and learn how it works. Only with knowledge and a true understanding of your own body can you truly be in control of your health.
If you would like to know more about how I can help you with your hormone health, you can book a Free 30-minute Health Consult to discuss your health today.
Mary-Anne Bennett, Executive Contributor Brainz Magazine
Mary- Anne Bennett is a leading thinker on women's health, harnessing the power of food to overcome chronic illness. After suffering from a range of chronic health issues which doctors could not explain, Mary-Anne went to university to study nutrition at the age of 50 to learn how to heal. This decision ignited her passion to help others get to the root cause of their chronic health issues and find the path to healing. As Director and Clinical Nutritionist at Adelaide Nutrition and Wellbeing, Mary-Anne's success comes from her strong belief that chronic illness is not a normal part of aging. Using the principles of nutritional medicine, everyone can heal.
References:
Johnson N, Keady J, Simpson JL. The epidemiology of hysterectomy in Australia. Aust N Z J Obstet Gynaecol. 2005 Aug;45(4):284-9.
Teede HJ, Dalais FS, McNeil JJ. Trends in hysterectomy and oophorectomy in Australia between 2001 and 2015. BJOG. 2019 Aug;126(9):1156-1163.
Carter J, Kedda MA, Tilson LK. Hysterectomy and removal of ovaries in Australia. Med J Aust. 2008 Mar 3;188(5):275-9.
Homburg, R., Adrenal and gonadal steroidogenesis in polycystic ovary syndrome. Hum Reprod Update, 2000. 6(5): p. 497-504.
Negro, R., et al., Thyroid autoimmune disease and infertility. J Endocrinol Invest, 2011. 34(4 Suppl): p. 13-16.
Berberi, A. and K. Tiwari, Cortisol-thyroid axis: A review. Indian J Endocrinol Metab, 2016. 20(6): p. 735-741.
Australian Charter of Healthcare Rights | Australian Commission on Safety and Quality in Health Care https://www.safetyandquality.gov.au/consumers/working-your healthcare-provider/australian-charter-healthcare-rights
