Hysterectomies, the surgical removal of the uterus, are a common procedure as a treatment or preventative measure against endometrial, cervical, ovarian, and uterine cancers. A hysterectomy involves removing only the uterus, while the ovaries and fallopian tubes remain intact. Even in a total hysterectomy, where both the uterus and cervix are removed, this procedure does not remove the ovaries, which are separate organs.
However, 78% of hysterectomies also involve the removal of the ovaries, known as oophorectomy. While these surgeries are often intended to prevent or treat cancer and other gynecological conditions, there is increasing concern that they may be overused, posing significant risks that may outweigh the benefits. This is particularly concerning given that a woman’s lifetime risk of developing uterine or ovarian cancer is only about 2.8% and 1.3%, respectively.
According to the CDC, about 600,000 hysterectomies are performed annually, making it the second most common surgery for women, following cesarean deliveries.
Approximately only 10% of hysterectomies are performed to treat cancer. This means that the remaining 90% are used for non-cancerous, non-life threatening health conditions. In the United States, around
- 30% of hysterectomies are performed to treat endometriosis
- 30% are performed to treat menorrhagia (heavy menstrual or vaginal bleeding)
- 27% are performed to treat fibroids
The remaining procedures are used to treat chronic pelvic pain, uterine prolapse, adenomyosis, etc.
The need for hysterectomies is increasingly questioned. While the procedure is beneficial for certain high-risk groups, its widespread use for other indications is less clear. For example, uterine fibroids can often be managed with less invasive treatments such as hormonal therapy or myomectomy, both of which preserve the uterus and ovaries. In many cases, these alternative treatments are effective and avoid the risks associated with hysterectomy.
According to Dr. William Parker, the former chair of the obstetrics and gynecology department at Saint John’s Hospital and Health Center in Santa Monica, Calif., “there’s nothing in gynecology that has one treatment.” He adds, “If you’re only getting one option, it’s likely that your doctor doesn’t know how to do the others” (Masters, 2007).
Hysterectomies are frequently recommended for women at high risk of developing uterine or ovarian cancers. Ovarian cancer is especially concerning, as it is the fifth leading cause of cancer deaths among women, however the lifetime risk of developing ovarian cancer is extremely low (as previously mentioned, less than 2%).
Associated Cancer Risks:
Hysterectomies that include the removal of the ovaries completely eliminate the risk of uterine and ovarian cancer because these tissues are no longer present in the body.
However, even after a hysterectomy, the risk of cancer is not entirely gone. Women who undergo hysterectomies may still develop primary peritoneal cancer—a rare but serious cancer that originates in the tissue lining the abdomen and behaves similarly to ovarian cancer. Unfortunately, hysterectomies are not a foolproof preventive measure and that cancer risk, albeit reduced, remains a concern.
Researchers are continuously finding that hysterectomies can increase the risk of other cancers:
- A 2013 meta-analysis found that women who have had a hysterectomy have a 30% higher risk of kidney cancer. (PMID: 23818138)
- A 2016 study found that compared to non hysterectomized women, significant risks were observed for thyroid cancer. (PMID: 26800386)
- Researchers have found an increased risk of brain cancer for hysterectomized women especially if they had the procedure for benign reasons under the age of 45. (PMID: 26800386)
- A 2023 study found that women who have had a hysterectomy have an increased risk of colorectal cancer, especially rectal cancer. (PMID: 37775754)
Other Risks:
Hysterectomies pose considerable risks beyond cancer. In her article “The ‘madness’ of unnecessary hysterectomy has to stop,” Judith Garber notes:
“The prevalence of these surgeries leads women to believe they are benign. But they can be incredibly damaging. Many women report reduced libido and sexual sensation likely due to severing of nerves and blood vessels and possibly other mechanisms. Personality changes are also a common complaint.
There are additional risks of having the uterus removed. Hysterectomy can lead to bladder and bowel dysfunction, prolapse, and incontinence as well as a 4-fold increased risk of pelvic organ fistula surgery. Other risks include certain cancers – rectal, thyroid, renal cell, and brain – as well as heart disease (#1 killer of women). Heart disease risk is 3-fold according to this study. This one went further and looked at risk by age at hysterectomy. It found that ‘Women who underwent hysterectomy at age ≤35 years had a 4.6-fold increased risk of congestive heart failure and a 2.5-fold increased risk of coronary artery disease.’” (Garber, 2019).
The actual procedure of a hysterectomy carries several risks, as with any major surgery. These include the possibility of excessive bleeding, infection, and complications from anesthesia. There is also the risk of injury to surrounding organs, such as the bladder, ureters, or intestines, which can lead to further issues and require additional surgeries.
Additionally, the removal of the ovaries during a hysterectomy has significant implications for a woman’s hormonal balance and quality of life. The ovaries are responsible for producing essential hormones such as progesterone and testosterone. Removing the ovaries induces surgical menopause, leading to a sudden and drastic decrease in these hormones. This can accelerate aging, increase the risk of chronic conditions like heart disease and autoimmunity, impair cognitive function, and result in symptoms such as hot flashes, night sweats, psychological problems, depression, anxiety, loss of sexual function, and mood swings.
A Different Approach:
Hysterectomies can be viewed as a primitive approach to medicine, reflecting a historical tendency to remove vital organs rather than addressing underlying health issues.
Unfortunately, women have been led to believe that their sexual organs are only important during their reproductive years. The uterus, ovaries, cervix, and fallopian tubes play crucial roles in maintaining overall physiological function and hormonal balance. Women deserve more nuanced and considerate care that recognizes the integral functions of these organs.
We know that the uterus, cervix, ovaries, and Fallopian tubes are hormone-sensitive tissues. In almost all gynecological conditions from endometriosis to cancer, elevated estrogen plays a significant role. This is because estrogen helps cells multiply and rapidly grow, and explains why we see the uninhibited growth of tissues like fibroids, the uterine lining, and tumors. One of the most important components of treatment and prevention is ensuring adequate progesterone levels, which counters the effects of estrogen.
- Ensure adequate estrogen / progesterone ratio
- Ensure adequate vitamin D levels (vitamin D has been demonstrated help prevent & reverse the cancerization of hormone-sensitive tissues)
- Reduce oxidative stress (this includes limiting intake of polyunsaturated fats, which are highly estrogenic and have been demonstrated to disrupt ovarian function (PMID: 34498184))
- Address heavy metal toxicity
- Remove exposure to endocrine disrupting chemicals in personal care products
- Address emotional health and traumas
While surgery is an available option and sometimes necessary, it does not address the underlying reasons why endometriosis, fibroids, pelvic pain, or cancer developed. We have to consider the terrain that has contributed to its growth: hormone imbalances, toxicity, nutrient deficiencies, stress. When we don’t address all these factors, we risk the chance that disease could manifest in other areas of the body.
Removing organs comes with significant risks, should be approached with great caution, and used only when absolutely necessary.