Gynecologists and medical ethicists have recently debated whether hysterectomy is used excessively and unnecessarily and whether this demonstrates a disdain for women's health in comparison to men's.
Hysterectomy is the surgical removal of the uterus. It may also involve removal of the cervix, ovaries, Fallopian tubes, and other surrounding structures. Usually performed by a gynecologist, a hysterectomy may be total or partial.
Men are more likely to have prostate and testicular cancer than women are to develop uterine and ovarian cancer, yet men are much less likely to have their reproductive organs removed than women. While hysterectomy procedures have declined in affluent nations, they continue to be performed in the global South as a result of historical racial, sexist, and prejudiced practises.
The procedure has frequently been carried out throughout history and in various regions of the world without taking into account the social, physical, or financial circumstances of the patient, or even with her consent. In the US, black women are more likely than other women to have hysterectomies. Compared to other Western Australian women, Australian Aboriginal women have experienced a higher rate of hysterectomy. Romani women who underwent hysterectomies as a form of coerced sterilisation 1 were still fighting for compensation as recently as 2012.
Media stories about non-consensual hysterectomies were out on women in US immigration detention facilities have surfaced even in the last three years. Global South nations are particularly affected by the detrimental impacts of needless hysterectomies. Although India’s hysterectomy rate is much lower than in many Western countries2 – such as the United States where 600,000 women undergo the procedure every year – reports of unnecessary surgeries in its handful of states such as Rajasthan, Bihar, Chhattisgarh and Andhra Pradesh, does worry its medicals practitioners. Over the past 30 years, hysterectomy rates have decreased in most developed economies. However, they have grown in South America, Africa3, and Pakistan.
Theoretically, only specialised gynaecologists are qualified to perform gynaecological procedures after having open discussions with patients about when a hysterectomy may be medically essential or when it is merely one of many therapeutic options. However, a gynaecologist may more frequently suggest hysterectomy to older women and those who do not plan to have children since they believe that the uterus is a worthless organ that only increases the risk of developing cancer in the future.
Hysterectomy is not always essential, even in the United States, where it is one of the most popular surgical operations for women, and informed consent needs to be improved. Of course, hysterectomy is crucial in the treatment of severe tumours, but it may also be necessary for a number of non-cancerous illnesses that have not improved with more conservative measures. The question of whether hysterectomy was the appropriate course of action for non-cancerous diseases has historically caused disagreement among clinicians and practitioners. Gynecologists and medical ethicists have recently debated whether hysterectomy is used excessively and unnecessarily and whether this demonstrates a disdain for women’s health in comparison to men’s.
A gynaecologist may more frequently suggest a hysterectomy to older women and those who do not plan to have children since they believe that the uterus is a worthless organ that only increases the risk of developing cancer in the future. Optional hysterectomy, ovary removal, and breast removal can all lower cancer risk in women at elevated risk for such tumours due to Lynch syndrome, a history of the disease in the family, or known breast cancer genes. Prophylactic body-part removals, however, may be hazardous for women without such a family history. Clinicians that recommend hysterectomies to all of their patients without weighing the risks of cancer vs surgery are not putting the patient first.
As long as they are adequately informed of the risks, benefits, and drawbacks of various treatment choices, receive high-quality, specialised surgical care, and have access to the proper aftercare and recovery support, there is nothing wrong with patients voluntarily choosing hysterectomy. When there is no aftercare and a high level of poverty, women are likely to experience far worse surgical results. The most marginalised women have been disproportionately affected by hysterectomies, which are also typically concentrated in groups that are already marginalised due to racial, ethnic, age, criminality, disability, gender inequality, lower class, or poverty. Black American women have, perhaps understandably, been less likely to follow doctors’ advice for hysterectomy. Hysterectomy may be used to cover up sterilisation practises that would otherwise draw attention as violations of human rights, such as in the gynaecological treatment of women and girls with intellectual disabilities. Hysterectomy is still frequently prescribed as a therapeutic surgery for a variety of benign conditions.
Concerns concerning hysterectomy go beyond surgical safety and post-operative rehabilitation. According to data, elderly women whose uterus was removed before menopause had a higher risk of developing various ailments, such as Alzheimer’s disease, other types of dementia, hypertension, stroke, other cardiovascular diseases, thyroid cancer, new mental health issues, and “multi-morbidity.”
The topic of whether unneeded hysterectomy should be the default, advised as the first line of therapy for uterine fibroids and other non-cancerous problems, is raised by emerging correlations between hysterectomy and diseases of ageing. This new evidence has to be considered in clinician training.
For many people, the danger of these prospective negative effects could be just as significant as the equally speculative risk of developing reproductive cancer. To ensure that practitioners are aware of how the procedure has disproportionately impacted women from the most impoverished backgrounds, gynaecology instruction in universities may also take greater notice of the varied experiences of hysterectomy in different cultural and historical contexts.
There isn’t much proof that such material is being taught in university curriculum.