Depression After Hysterectomy: One of the Many Silent Side Effects

With the advancements in medical technology and available non-surgical procedures, there are alternatives to hysterectomy for treating benign uterine fibroids. As more research is done, scientists uncover more evidence that the uterus does not just lie dormant when there is no pregnancy to nurture, but it serves other important functions. Women should do their due diligence, ask questions, get second options, and seek other possible solutions before they undergo a hysterectomy unless it is for uterine cancer. Before we get into all the reasons why fibroid fighters should opt-out of hysterectomy, let’s look at some alarming statistics.

Most Hysterectomies Are Unnecessary

Every year, over 600,000 hysterectomies are performed in the U.S. The truth is that the vast majority (some say as high as 90%) of the hysterectomies performed are not medically necessary. For many women that suffer from fibroids particularly if they are not interested in future fertility, hysterectomy is the first and only treatment option offered by their doctor. Many women also do not know there are other much less invasive options.

Interestingly, the word hysterectomy contains the root hyster which is the Greek word for “womb” or “uterus”. It is also the root associated with the word hysteria which was once a medical condition only women “suffered with.”

19th Century women were completely dependent on the men in their lives. With so little power, control, and independence, stress, anxiety, and depression were common among Victorian women. These women struggled to cope with a static existence under the thumb of strict gender ideals and unyielding patriarchy. Women that tried to confront or oppose this were often the women that were “diagnosed” with hysteria. They exhibited a wide array of “symptoms”: loud talking, irrational, brash, overbearing, promiscuous, and a tendency to cause “trouble”.

Hysteria was often attributed (by the male physicians of that time) to sexual frustration and “treated” by private clitoral stimulation at home (or if she was not able to do this at home, with a physician in their office). If this “treatment” failed, women were committed to asylum. Once hysterectomy became available, the asylum was replaced with hysterectomy.

While hysteria is no longer considered a valid medical diagnosis, hysterectomy remains pervasive in our society and is the 2nd most common surgery performed in the United States. This is particularly surprising since only 50% of the population has a uterus. The most common reason why hysterectomy is performed is for benign uterine fibroids.

Top Reason Why a Hysterectomy Is Performed

According to Johns Hopkins, the top reason a hysterectomy is performed is to treat benign fibroid tumors. Alleviating uterine fibroid symptoms is the main reason OB/GYNs perform hysterectomies.

The general line of thinking was that if the woman was done having children, she no longer needed her uterus because that was the only purpose it served. Today, through ongoing research, we have learned that this is not the case and both the uterus and ovaries are connected to hormonal, physical, and mental health.

Types of Hysterectomy

  • Total hysterectomy – this is the most performed type of hysterectomy and consists of elimination of the uterus and the cervix entirely but the ovaries are not removed.
  • Hysterectomy with oophorectomy – the entire uterus and one or both ovaries are removed. If one ovary is removed it is called oophorectomy and if both ovaries are involved it is called a bilateral oophorectomy.
  • Radical hysterectomy – often necessary in cases of cancer, the uterus, cervix, and often part of the vagina, is removed. The lymph nodes in the pelvic area may also be removed.
  • Partial hysterectomy – the uterus is removed but the cervix remains.

Is It Better To Remove or Retain the Ovaries During a Hysterectomy?

Historically, the medical community thought that leaving the ovaries when performing a hysterectomy would ensure that necessary hormones were still produced and distributed but this is not always the case. In fact, as many as 1/3 of patients that have a hysterectomy but keep their ovaries will still go into immediate menopause after the surgery.

Removing the ovaries during a hysterectomy is normally done as a precaution for some women to prevent ovarian cancer. Continued research must be done to determine if leaving the ovaries causes more problems than removing them.

We do know that removing the ovaries of a younger woman brings on the sudden onset of menopause, increases the risks of heart disease, and may cause mental health issues.

Studies Reveal that Hysterectomy Can Lead to Decline in a Woman’s Mental Health

There is a connection between removing a woman’s uterus and her mental health. A recent study concluded that women who have undergone a hysterectomy removing only the uterus and leaving the ovaries, have an increased risk for long-term anxiety and depression. The study excluded any participants who may previously have had issues with depression or anxiety to obtain unbiased results.

A peer-reviewed publication written by mental health experts stated that when the rats studied were put into a medically induced menopause (which is the result of a hysterectomy where the ovaries are also removed) there were also several changes in their brains that raised anxiety-driven behavior and despair.

It is understandable that young women who have undergone a hysterectomy that wanted to have children may afterward suffer from depression and sadness. But the aforementioned study revealed that it went even beyond this particular age group.

Risk of Heart Disease Increases after Hysterectomy

Women who undergo a hysterectomy have significantly higher risks of experiencing heart disease. The younger the woman at the time of her hysterectomy, the higher the risk elevated. Heart disease is the number one killer of women each year.

Structural Integrity Compromised Due to Hysterectomy

The uterus serves many purposes and providing structural integrity to other vital organs is one of them. The bladder and bowels both rely on the uterus for support as well as to keep them in their places.

Undesirable structurally related side effects that can occur as a result of a hysterectomy include:

  • urinary incontinence;
  • pelvic prolapse;
  • bowel problems;
  • pelvic fistulas.

Decrease or Elimination of Sexual Satisfaction After a Hysterectomy

There is also a large network of nerves and blood vessels that flow within the uterus and to the ovaries, vagina, labia, and external genitalia that are associated with sexual satisfaction. Studies have shown that some women have decreased sexual function after undergoing a hysterectomy. According to the study done by Maryland Women’s Health, the risk of sexual dysfunction is not unfounded and since each individual is unique it is hard to estimate who it will affect.

Removing A Woman’s Uterus Can Lead to Memory Problems

An additional study completed by the University of Arizona using lab rats showed that removing the uterus significantly affected spatial memory. Spatial memory is the type of memory that helps a person remember where they set their car keys down just a little while ago or the route they usually take when going to the grocery store. It is also responsible for our ability to navigate through a darkroom in our house without bumping into things by helping us remember where our furniture is when walking to the bathroom in the middle of the night.

While most research in regards to spatial memory has been done using rats, there have also been human trials and the results were very similar. Experts have determined that the spatial memory in rats is akin to that of humans so results yielded when testing rats will be very similar to what could be expected in humans.

From the previous discussion on the numerous potential negative side effects of hysterectomy, one should keep in mind that the average age of hysterectomy is 39 years; with some hysterectomies being done on women less than 30 years of age. Therefore, these numerous, significant, life-alternating changes are occurring in young women for benign disease, i.e. fibroids.

Expert Recommends Avoiding Hysterectomy

Dr. Laughlin-Tommaso, MD an OB-GYN and researcher for the Mayo Clinic stated, “Our study shows that removing the uterus may have more effect on physical and mental health than previously thought”.

“Because women often get a hysterectomy at a young age, knowing the risks associated with the procedure even years later is important.” She also stated that alternatives should be tried to treat benign gynecological conditions before considering a hysterectomy.

Removing the Uterus Can Affect the Ovaries

All the evidence points to the fact that having a hysterectomy can cause the demise
of the ovaries (if left intact) bringing on early menopause. This would indicate that when this is mentioned as a treatment for a non-benign gynecological issue it should be a reason for pause.

In addition, we know that women who also have their ovaries removed may experience many issues including premature aging, osteoporosis, dementia, Parkinson’s, coronary disease, stroke, depression, anxiety, and more.

Increased Awareness of Alternatives to Hysterectomy Is Necessary

Healthcare professionals and those who are there to facilitate women’s reproductive health need to be made more aware of the connections between women’s reproductive organs and their wide range of influence over a woman’s overall health.

In turn, women need to understand these correlations and take control of their reproductive health. It is always a good idea to research and understand all treatment options available and the associated pros and cons of each. Numerous studies have shown that most Gynecologists fail to mention nonsurgical treatment options like Uterine Fibroid Embolization (UFE) to their patients that have symptomatic uterine fibroids.

Alternatives to a Hysterectomy

Some treatments that may alleviate health-related issues pertaining to a woman’s reproductive system while retaining the uterus include:

  • Hormone therapy, e.g. birth control pills, progestin-containing IUD;
  • Antifibrinolytics, e.g. tranexamic acid;
  • Uterine fibroid embolization (UFE);
  • Laparoscopic surgical radiofrequency ablation;
  • MRI-guided focused ultrasound;
  • Open or laparoscopic surgical myomectomy.

Uterine Fibroid Embolization as a Treatment for Uterine Fibroids and Adenomyosis

The most common reason a woman is referred for hysterectomy is due to uterine fibroids. Why is this? Fibroids are benign, non-cancerous growths that cause heavy bleeding, pain, and pressure, infertility, among other unpleasant symptoms. Uterine fibroid embolization (UFE) is an excellent, cutting-edge, non-surgical procedure that can eliminate fibroids and has been proven effective in 90% of treated patients.

UFE is a non-surgical, outpatient procedure and can eliminate fibroids of any size, even if they are deeply embedded into the uterine wall, unlike a myomectomy. There is no hospital stay and recovery is a short 5-7 days instead of 6-8 weeks after surgery.

Uterine Fibroid Embolization Preserves the Uterus

One of the best parts of a UFE procedure is that it preserves the uterus and the rest of the reproductive organs. The majority of women who undergo UFE experience total remission from their fibroid-related systems and gain back their quality of life. Many women who experienced fertility issues were able to get pregnant and deliver healthy full-term babies. The births following a UFE are typically full-term and vaginal, whereas births following surgical myomectomy are delivered by c-section.

Women suffering from fibroids are continually told that they will have to undergo a hysterectomy and this is just not true. A hysterectomy is an option, but with the overwhelming success of UFE, hysterectomy should be relegated to the last resort option. To see for yourself, click on the following link. These are real women who were told they needed a hysterectomy to treat fibroids. The women didn’t want surgery but were not given any other option. Fortunately, they heard about UFE and Dr. Lipman of The Atlanta Fibroid Center®!

If you or a loved one are facing the decision to undergo a hysterectomy for uterine fibroids, take time to research other options. No matter what your doctor may or may not have told you about UFE, get a second opinion from the doctors at the Atlanta Fibroid Center®. They have performed more UFE procedures than anyone in the country.

 

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