In this conventional world, surgical procedures have progressed quite dramatically over a period of time. More than 5,00,000 hysterectomies take place each year in the United States and these operations have escalated in numerals from a mere 14.3% in 2004 to a humongous 59% in present. Even Indian women are getting such medical procedures done at a growing rate. According to a survey, conducted by the Ministry of Health and Family Welfare in 2015-16, nearly 3.2 percent of the female population lying between the age group of 15-49 years have had a hysterectomy. However, the prevalence of such operations to get uterus removed is a bit higher in the age group of 30-39 years and is about 3.6 percent. But what is this hysterectomy and why are more and more female population turning infertile through such surgeries?
Hysterectomy – An Overview
A hysterectomy is a surgical method or operation for removal of uterus or womb (and sometimes the cervix along with some supporting tissues) of a woman. This uterus is the place where the fetus grows when a female is pregnant, and as such this renders the one who underwent such medical procedure, infertile. It is the second most frequently performed non-obstetric (unrelated to childbirth) major surgery, after cesarean sections, on females worldwide.
If a woman hasn’t reached her menopause, this method would stop her periods or monthly bleeding. In addition, if a surgeon operationally removes the ovaries before a woman reaches her menopause, she would suddenly enter induced or surgical menopause due to the loss of female hormones. Having said that, now let us take a look at the reasons why a woman would have such an operation despite knowing the repercussions related to it.
Rationale Behind Hysterectomy
The most common reason behind a hysterectomy is the growth of the uterine fibroid. Uterine fibroid is benign or non-cancerous muscular tumors that expand in the walls of the uterus. Also called myomas, they usually form between 16 to 50 years of age group, normally the reproductive years in which estrogen levels are fairly high.
Although the exact cause of such fibroid is unknown, some research studies indicate genetic alterations, hormonal changes and some other growth factors like rising of insulin in the body affect the growth of the fibroid.
These fibroids can induce significant heavy menstrual bleeding and pain. Initially, a doctor recommends myomectomy involving removal of just uterine fibroid, thereby leaving the uterus intact. However, if some medications and myomectomy fail, hysterectomy is the best possible option available.
There is an umpteen number of various other motives behind conducting hysterectomy:
The second leading reason, like uterine fibroid, endometriosis is another benign but painful disorder affecting the uterus. It takes place when tissue, normally lining the inside of the uterus known as endometrium, grows outside the womb.
Ordinarily residing in the lower abdomen or pelvis and involving ovaries, tissues lining the pelvis and fallopian tubes, women facing this condition often have to bear lower abdominal pain, peculiar vaginal bleeding, excruciating menstrual periods, and at times, loss of fertility.
Some of the reasons which lead to development to such a condition include problems with menstrual flow, embryonic cells development into the endometrial tissues, genetic and hormonal reasons and issues with the immune system. Hysterectomy is carried out only when hormone therapy and other less invasive medical methods fail to produce effective results.
This most horrific and dreadful medical terminology accounts for about 10 percent of all the hysterectomies that are performed worldwide.
The need for hysterectomy arises when a woman is affected by endometrial cancer, cervical cancer, cancer in uterus, ovaries and fallopian tubes.
Albeit, other kinds of treatment like chemotherapy or hormonal therapy may be utilized, depending upon the nature and extent of cancer.
Sometimes, women are also instilled with the fear of having cancer, which persuades the, to have their uterus removed even at a young age. For instance, in Andhra Pradesh, approximately 22% of women aged 40-49 years have had this surgery. If a woman tests positive for the presence of the BRCA gene, in order to reduce the risk of future cancer development, this operation may be received.
- Uterine prolapse
Uterine prolapse is another benign condition, wherein the uterus descends or slides down into the vaginal canal. It is triggered due to weak or stretched pelvic floor muscles, ligaments and tissues which fail to support the uterus in its normal position. Hysterectomy is required as it can lead to pelvic pressures, urinary problems and problems in bowel movements. In extreme cases, the uterus might protrude out of the vaginal opening.
As a consequence of the excessive generation of estrogen without progesterone, the lining of the uterus may become thicker, this condition is referred to as hyperplasia. This status of uterus generally causes abnormal bleeding and due to the potential to create uterine cancer, hysterectomy is vital when hormonal therapies fail.
- Abnormal Bleeding
It is a critical state, wherein the lining of the inner uterus called endometrium breaks through the muscular walls of the uterus known as myometrium.
Like hyperplasia, it causes the uterine wall to become too thick, leading to heavy bleeding and great pain. While doctors are unsure about the primary reason behind adenomyosis, some theories suggest it to be inflammation, injury to uterine tissues and fetal development.
- Placenta accreta
Placenta is the organ that supplies nutrients and other support to the growing fetus inside the womb. Placenta accreta is a serious situation that occurs when the placenta develops too deeply into the walls of the uterus. During delivery, it might result in heavy bleeding, in attempts to remove it. Thus, a cesarean delivery is accompanied by a hysterectomy to mitigate blood loss.
Other reasons behind performing a hysterectomy can be chronic pelvic pain, an infection caused by pelvic inflammatory disease, certain complications in delivery and heavy bleeding.
Also Read: Tips to Cope with Endometriosis
The Bottom Line
A hysterectomy is a general technique that can help improve your troubling symptoms and, in a few extreme cases, might prove to be lifesaving. Although you would not be able to get pregnant and may enter early menopause, surely this procedure can comfort and relieve you from unbearable agony and abnormal bleeding
If you face any symptoms, immediately consult a physician to run a careful diagnosis, in order to know the kind of treatment to have based on the conditions. Be it invasive cancer, presence of BRCA gene, heavy menstrual bleeding or unmanageable infection, hysterectomy is bound to give relief to the affected person.
However, certain side effects associated with the surgery like infection, blood loss, blood clots, bowel blockage, etc. must be dealt with precision and in a meticulous way.
Also Read: Can Uterine Fibroids Affect Your Fertility?