In the United States, hysterectomy is the second most performed surgery on women with over 600,000 done each year. The biggest travesty in these statistics is that only about 10% of these hysterectomies are medically necessary.
It was once believed that a woman’s uterus only existed to reproduce and nourish a growing baby before birth and was otherwise expendable. This is no longer believed to be true and the uterus has been tied to many other vital functions in a woman’s body. The most notable and concerning is how the uterus has been associated with a woman’s heart health.
What Is Removed During A Hysterectomy?
During a hysterectomy, a woman’s uterus is surgically removed. Sometimes other reproductive organs are removed at the same time which may also include:
- The ovaries (one or both);
- The cervix;
- The fallopian tubes.
There are 3 types of hysterectomies which are:
- Partial Hysterectomy – Only the uterus is removed.
- Total Hysterectomy – Removal of the uterus and cervix, also may include other reproductive organs.
- Radical Hysterectomy – Only performed in dire cases (when cancer is an issue) and includes the surgical removal of the uterus, cervix, upper portion of the vagina, surrounding ligaments, and some lymph nodes.
- Oophorectomy – One or both ovaries are removed. About 78% of hysterectomies performed on women between 45 and 65 also include oophorectomy.
What Are The Long-Term Consequences Of Hysterectomy?
In addition to the known risks of short-term complications like bleeding, infection, bladder injury or incontinence, bowel injury, and ovarian failure, there are numerous long-term side effects related to the loss of the uterus. Several studies including one study conducted by the Mayo Clinic have brought to light more information about the complex function of a woman’s uterus. Hysterectomy may lead to:
- Mental health issues – depression and anxiety;
- Hormone imbalances;
- Spatial memory problems;
- Decrease in sexual satisfaction;
- Ovary failure (after removal of the uterus);
- Loss of structural integrity can lead to pelvic prolapse, urinary incontinence, bowel issues, and fistulas;
- Premature aging;
- Increased risk for Parkinson’s disease;
- Increased risk for stroke;
- Significantly higher risk of coronary disease;
- Osteoporosis and/or bone fractures.
Coronary Disease Linked to Hysterectomy
Heart disease is the leading cause of death for women in the United States. This is an interesting fact when you compare the statistics regarding the number of unnecessary hysterectomies that are performed each year. Studies have shown that the risk of heart disease is greatly increased for pre-menopausal women who undergo a hysterectomy.
According to The Women’s Health Initiative Observational Study published in the AHA journal, ongoing data for 89,914 women was studied over five years. 36,864 of these women had undergone a hysterectomy and of those 18,432 had also had their ovaries removed.
The analysis of the data revealed that obesity and diabetes were prevalent among the women who had undergone a hysterectomy and in almost every case, they showed a significantly higher baseline risk for heart disease. Furthermore, the risk factors for women who also had their ovaries removed were elevated especially in regards to hypertension and diabetes which were of increased significance for this clinical study.
Non-fatal heart-related issues such as angina, peripheral arterial disease, and congestive heart failure were 25% higher in women who had their uterus removed through a hysterectomy. Patients who had undergone a hysterectomy had a higher fatality rate and the group that had also had their ovaries removed had even higher fatality rates.
A study was conducted by the Mayo Clinic that included 2,100 women who had undergone a hysterectomy but had retained their ovaries. The study revealed that compared to women in the control group who had not had a hysterectomy, these women had a 14% higher risk of abnormal levels of blood fat, an increased risk of 13% for high blood pressure, an increased risk of obesity by at least 18% and over 33% higher risk of experiencing heart disease.
The long-term health issues for women who undergo a hysterectomy before they are 35 years old are almost 5 times more likely to experience congestive heart failure and almost 3 times more at risk for coronary artery disease and heart attack.
Your Ovaries And Your Heart
You may be asking yourself “What do ovaries have to do with heart health?” This is a good question and one that is still being researched to determine a solid answer.
The ovaries are a woman’s main source of estrogen and when functioning properly will supply them with the necessary amount of estrogen they need before reaching menopause. Estrogen serves many purposes in a woman’s body.
The Role of Estrogen in Women’s Health
- Weight regulation;
- Sexual function;
- Bone health;
- Temperature regulation – hot flashes;
- Mental health/depression;
- Sleeping issues;
- Helps regulate blood vessel walls to prevent plaque build-up and blood clots;
- Helps control blood fat content (lipids);
- Assists in the regulation of fibrinogen (related to blood clotting) which can increase the risk of stroke and heart disease.
When the ovaries are removed or fail due to hysterectomy, it causes a sudden decrease or loss of estrogen and causes the onset of menopause. Young women who are suddenly thrown into menopause can experience many the unpleasant side effects of menopause.
Menopause Side Effects
- Hot flashes;
- Night sweats;
- Mood swings/anxiety;
- Weight gain;
- Low sex drive and vaginal dryness;
- Concentration and memory Issues;
- Related menopause heart palpitations due to hormone fluctuations.
When menopause begins naturally, it allows the slow progression of these symptoms however when induced suddenly due to hysterectomy, the symptoms can hit with a vengeance. Many women are treated with hormone replacement therapy (HRT) to help alleviate these symptoms but sometimes HRT brings a host of other women’s health issues with it.
Hormone Replacement Therapy Risks
For years, hormone replacement therapy (HRT) was thought to be the estrogen answer for women who have undergone a hysterectomy. Women were given medication that would emulate the estrogen that was no longer being produced by their ovaries in an effort to keep everything functioning as it should. HRT did help women with some of the issues related to low estrogen levels but in the long run health risks of HRT may have outweighed the benefits.
The health risks of HRT include:
- Elevated risk of breast cancer;
- Elevated risk of heart disease;
- Higher levels of c-reactive protein and inflammatory markers;
- Higher risk of stroke and blood clots in the heart and lungs during the first 12 months of use among certain women;
- Increases the growth of uterine fibroids;
- Estrogen dominance heart palpitations.
Hysterectomy for Uterine Fibroids
One of the most common reasons doctors treat women with hysterectomy is due to the presence of uterine fibroids. Uterine fibroids are non-cancerous tumors that grow in and around the uterus. These tumors are known to grow and become large or numerous in estrogen-rich environments causing many unpleasant symptoms. One of the most well-known symptoms is very heavy and prolonged menstrual cycles which cause anemia and can affect a woman’s quality of life.
Many women who are dealing with the symptoms of uterine fibroids are not informed of other treatments as an alternative to hysterectomy and agree to the surgical removal of their uterus.
Uterine Fibroid Embolization – a Safer Alternative to Hysterectomy
There is a treatment for fibroids called uterine fibroid embolization (UFE) that does NOT require surgery and is performed as a 45-minute outpatient procedure. UFE cuts off the vital blood supply to the fibroids and they shrink and die. The recovery time from UFE is normally only a week and patients leave the procedure with only a bandaid.
Most fibroid symptoms are relieved within 3 months and some women’s symptoms disappear as quickly as their first menstrual cycle. UFE is a safe, quick, and non-surgical procedure that effectively treats uterine fibroids without a hysterectomy and the removal of the uterus. Many women who have had UFE have successfully become pregnant and delivered full-term healthy babies.
If you are suffering from symptoms of fibroids and hysterectomy has been the treatment recommended for you, please contact Atlanta Fibroid Center and set up a consultation. There are alternatives for fibroid treatment besides hysterectomy and all the long-term complications it brings with it. We would welcome the opportunity to talk with you about uterine fibroid embolization and how it may help you!