October 20, 2024 • 16 mins
The thought of getting a hysterectomy can be extremely daunting for anyone. With so many uncertainties, from the risks and benefits of the procedure to the methods and recover time.
That's why this week, Toni is chatting with gynaecologist and hysterectomy expert Dr Praveen De Silva to ask all of her burning questions.
See omnystudio.com/listener for privacy information.
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Episode Transcript
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Speaker 1 (00:00):
We need to talk conversations on wellness with coasfm's Tony Street.
Speaker 2 (00:06):
Hello there, welcome to we need to talk. It's great
to have you with us today. We're talking hysterectomies and
there's a good reason for this. So I have just
turned forty, and I have a lot of friends that
have had a hysterectomy before they've even reached forty. They're
in their thirties. And I don't know if this is
a surprise to you, but for me, I always held
(00:27):
a notion that women over forty, possibly even in their fifties,
were the ones getting hysterectomies. I didn't realize it was
something that you got young, and I didn't realize the
reasons why you get a hysterectomy. And maybe it is
something that you should be looking into, but you don't
know much about it. So I thought I would get
an expert. And his name is doctor Pravenda Silver. He's
(00:50):
a consultant gynecologist working at Auckland Gynecology Group in Remaware
or Auckland. He's an OTAGO graduate who has done extensive
training in complex surgeries for women at Sintjo Hospital, which
is a prestigious center in Sydney. He also has research
interests in pelvit pain and nerve conditions that affect women.
If you want to follow him, his Instagram handle is
(01:10):
at doctor Pravene Desilver. It is so lovely preving to
have you here today to talk about this. Is it
common for women under forty to be getting hysterectomies?
Speaker 3 (01:21):
Yeah, thanks for having me Tony. It's a pleasure to
be here. Look, we are seeing it more and more,
and we were just having a talk before recording about this.
I do think that interestingly, if you look at the
stats in New Zealand, hysterectomy numbers are slowly declining since
the nineteen eighties. But you could contrast it with the
(01:42):
fact that I think it's a lot more in the
public sphere now. There's a lot more societal acceptance of
the surgery. I've had patients recently who they're very comfortable
telling workmates or colleagues that they're taking sick leave to
have a hysterectomy, or close family and friends, and so
I think with that, naturally there does come the information
(02:04):
out there that people do want to explore a hysterectomy
a discussion about it, So naturally I have got people
a bit younger than forty coming to talk about it.
Speaker 2 (02:14):
Yeah, what would be the average age do you think?
Speaker 3 (02:17):
So the average age in New Zealand is still in
their forties. Just to talk about what a hysterectomy is, Tony,
A hysterectomy is where surgically, the uterus and the cervix,
which is the bottom part of the uterus, is removed.
This is the organ that is present in females and
(02:38):
people assigned female at birth. It's the organ that's obviously
used for carrying children. Also the organ responsible for your periods,
and so it is a big decision to have a hysterectomy.
And I do think that the older age is because
a lot of people want to complete a family if
that's important to them before talking or having that conversation
(03:01):
about a hysterectomy.
Speaker 2 (03:02):
It's interesting you bring that up because I've got a
friend of mine who has actually needed a hysterectomy for
a while now, but wasn't comfortable entertaining the thought until
she reached forty. It was just a mental block I
think for her that she wanted to be of an
age where it felt right to be losing your reproductive organs,
because that's quite a major, I guess, psychological thing for women.
(03:25):
Would you say that, is that what you encounter with
the women you treat?
Speaker 3 (03:29):
Absolutely, Look, it is a big decision for many reasons. Firstly,
like you said, it is part of your reproductive system.
I think it's important that we don't confuse it with
removing your ovaries or losing your hormones, which is probably
the most common question that I get asked by people
when they visit me. Of course, there are some rare
(03:52):
situations where women do need to lose their ovaries during
a hysterectomy, but most of the time, overwhelmingly a hysterectomy
is just the removal of the uterus and the ovaries
continue to function. Obviously, like you said, it's the reproductive
thoughts as well. People need to be sure that they've
(04:12):
completed that, and I get if I ever have someone
who's on the fence, I always say, look, this isn't
the right time to entertain this idea. I think why
forty you ask, it's because people need to get to
a stage where they also have time to take leave
to get this thing done. I think it's quite empowering
(04:33):
for a lot of people. They get to forty and
they think, right, this is me sorting out my health,
sorting out my well being, and it's important and I've
put this at the top of my listener. A lot
of women in their thirties have young families, and it's
even if they want to do it, it's not as
easy as just taking time off because, as we'll talk
about today, there is a recovery involved as well. So
for many reasons, it's not super straightforward to just get
(04:56):
a hysterectomy at an early age.
Speaker 2 (04:58):
Right, Let's go back to the reasons why someone might
need a hysterectomy, and they are varied.
Speaker 3 (05:04):
Yes, you're right, So there are many reasons why people
get hysterectomy. They can range from very serious things, so
about ten percent of hysterectomies will be for women facing
a female cancer and that's something that's thrust upon them
that they might not even be ready for. And then
(05:24):
following that, there are benign or non cancerous reasons why
people get hysterectomy. So the most common that I see
for this mainly bleeding issues, so difficulty with really heavy periods,
periods that are resistant to medication, that can't be managed easily.
(05:45):
They can go on for many weeks sometimes I've seen.
And also quite irregular bleeding can be really really hard
to manage and really can really cause despair for people.
And secondly, there can be can and diseases that cause
pain as well. So the most common is an inflammatory
condition we call adenomyosis. I call it the evil cousin
(06:09):
of endometriosis, where basically the uterus muscle can get very inflamed. Equally,
there's a there's a term called fibroids, which are where
women can get really solid growths inside the muscle of
the uterus and they can cause immense pressure, pain, heaviness,
bladder dysfunction. So, as you can see, there's a multitude
(06:31):
of reasons why people would consider a hysterectomy.
Speaker 2 (06:34):
Yeah, and so you mentioned that typically it's women in
their forties. What would be for you and your experience
as a surgeon, what would be the youngest women that
you have? Yeah, what do that operation on?
Speaker 1 (06:47):
Look?
Speaker 3 (06:48):
I do in my practice encounter people in their thirties,
and in some very rare situations even younger than thirty.
I think it is important to also have the discussion
that there are people having gender affirming surgery, and that
is something that we It's a multidisciplinary team and there
is a lot of thought and counseling that goes into that.
(07:10):
But but I respect that if people want that procedure done,
we can offer that. There are equally people who do
not want to have a family, and they're very clear
about that, and and I think we are seeing that
that insurgent certain situations as well, and I respect that
for adults who are sure that that they want the
(07:30):
hysterectomy for that reason. On some very sad situations, I
see people who have had multiple fertility attempts and they
realize that their health and well being is going to
take priority over repeated attempts. And it is a difficult
discussion to have, but still something that I really respect
people you know that that are in that position and
(07:52):
it must be very very tough for them.
Speaker 1 (07:55):
This is we need to talk with Tony Street.
Speaker 2 (07:58):
So the process of of having a hysterectomy, how long
is the surgery, what is involved, and what's the recovery like.
Speaker 3 (08:06):
As beneficial as a hysterectomy can be for people and
there's no denying that. I think a lot the attraction
for a lot of people is that it's a definitive operation.
So for people who are having really difficult periods and
horrible pain where they're almost on daily pain relief, the
idea that they can do something to really change that
(08:27):
and transform that is very enticing. But like you said,
it is a major surgery, and so it is done
more and more commonly these days by what we call
minimally invasive approaches, and that's something that I'm very passionate about.
So what minimally invasive means is that rather than in
the olden days where you could get a cesarean scar
(08:47):
or a rather large cut on your abdomen, these days
you can get small cuts through something called known as
keyhole surgery. In Sydney and even now in Auckland we're
doing robotics as well, which is very similar to keyhole.
What that surgery involves, Tony, is small cuts are made
on your tummy, which can be smaller than one centimeter.
(09:09):
Women usually get about three or four of them for
the surgery to be performed, and that does lead to
a much quicker recovery. And so I think that's quite
exciting for a lot of people. The surgery itself takes
about two hours, and most people would stay in hospital
for two nights before they can return home.
Speaker 2 (09:27):
It's not too bad, is it, when you consider that
you're getting your reproductive organs removed, Like I'm sure it
was a lot longer, you know, ten to fifteen years ago.
Speaker 3 (09:36):
Yes, certainly, And there are some situations where people still
need to get a large cut, and also a potential
complication from the surgery is needing to convert and do
a large cut during the surgery, so there are always
risks involved. I think you're right, two nights doesn't sound
too bad. It's still, in all honesty, can take a
few weeks to really start to feel normal again. I
(09:57):
do find for a lot of a lot of my
patients they've got a young family at home, and I
always tell them to stay the extra night because you know,
if you go home and you know, if your kid
just wants mum, especially jumping on their lap and things
like that, you know, I do really want people to
be a bit careful about that.
Speaker 2 (10:15):
Yeah, what would the time off work be?
Speaker 3 (10:17):
If you yeah, time off work? I always say a
blanket two weeks is appropriate. I at the same time
get a lot of people who are doing extremely busy
jobs and two weeks is not quite quite you know,
it's too much for them. And I've got a lot
of people working from home at the end of one week,
so it's only my job to advise. We also say
(10:38):
no driving for one week after this kind of surgery,
and so that that is mainly the recovery. Other important
things that people ask me, for example, Tony is exercise
and gym work, so I always say cancel the gym
membership for a month, no no heavy lifting, and also
nothing inside the vagina for one month. So returning to
(10:59):
have sex, swimming, things like that, you do need to
block it off. And it's interestingly because we've had a
lot of people wanting a hysterectomy over the summer but
then realized afterwards that that means no beach for the
month as well, which has been a bit.
Speaker 2 (11:14):
Yeah, that's hard, isn't it.
Speaker 3 (11:16):
It is?
Speaker 2 (11:17):
So what are the benefits then? Does that then mean
I'm going to want it in black and white here
you don't get a period anymore.
Speaker 3 (11:25):
Yeah, I think we always have to be very careful
with the counseling about pain, and I think, like you
said in your introduction, I do have a really strong
interest in pelvic pain and a historyct toomy can help
a lot with pain, but it's very hard to guarantee
that that can fix pain because there are so many
things that can cause pain in the pervic area. But
with the bleeding, I can give one hundred percent money
(11:47):
back guarantee that you won't have a period ever again,
which for some people is an extremely empowering thing.
Speaker 2 (11:54):
What is the feedback from some of your patients been.
Speaker 3 (11:58):
It's been life changing for so many people. I just
I recount some women recently who had told me they
weren't comfortable going to their office because of the amount
of bleeding that they were getting since COVID. They just
stayed working from home. And you know, one or two
women recently told me that they can just go back
to the office now and it's not an issue for
them anymore. So that was an incredibly rewarding thing to hear.
(12:23):
I think people can be intimate to gain after hysterectomy
if that's something that you want to talk about, and
sometimes the bleeding and pain has got in the way
of that. As well, So that's a big positive and
just using it as a springboard to starting to work
on your health again, I think for a lot of people,
because people who are bleeding really heavily, it can make
(12:43):
you feel really run down and really awful. It's a
term known as anemia, which basically means that you're losing
your blood volume every month, and so that changes when
you don't have bleeding.
Speaker 2 (12:53):
Okay, so you recover from the operation, you're back to
potentially the gym, back to work. What is the ongoing
care look like as the medication you have to take
for the rest of your life.
Speaker 3 (13:04):
How does that look for each person? Things can be variable.
I know that your podcast has talked a lot about
menopause and about hit hormone replacement therapy, and again to Feeld,
a common question that I get asked, is am I
going to have to be on hormone replacement therapy or
on estrogen for the rest of my life? If I
have a hysterectomy and as long as the uterus and
(13:27):
cervix are the only things being removed, there is no
reason to be on long term medication such as that. Unfortunately, naturally,
every person is going to go through menopause at some
stage in their lives, and so having a hysterectomy does
not change that. And so generally speaking, people shouldn't need
to be taking long term medication after a hysterectomy.
Speaker 2 (13:46):
Yeah, what would your advice be to people like perhaps
my friend who has waited longer than perhaps she needed
to to get this hysterectomy. What would your advice be
in terms of any fear that women might have about
having this operation.
Speaker 3 (14:04):
Yeah, it's a really good question. I think it's healthy
and it's natural to have some some fear. A lot
of people that I meet Tony, they've been so well
throughout their whole lives and this is the first time
that they're having to think about a general anesthetic or
an operation, and so it can be intimidating. And my
(14:24):
advice is, do your research, make sure that you have
read about the surgery. There are really good avenues to
get accurate information. Definitely meeting with a gynecologist that you
feel comfortable with to ask all the important questions. And
I always say to people, write down the things that
are important to you and take them with you to
(14:45):
the appointment, so that you can know for sure that
this is the operation that you want, because while as
a surgeon, I do think it's a very helpful operation,
it isn't for everyone. And I have equally some people
who come and meet me talk through the whole thing
and then being very confident that that's not what they
want and that they're happier with other medical options, which
(15:06):
there are plenty of.
Speaker 2 (15:07):
This might sound like a bizarre question, but I think
there might be some hesitancy in the fact that you
are losing your reproductive organs, and for many women that
is what makes them a female. So are they any
feelings post surgery that you know you are there's something missing?
I mean, it could just be a mental thing.
Speaker 3 (15:27):
But it's a really good question, Tony. I think just
because you've completed your family doesn't equate to being happy
to lose your uterus. I don't think I've met anyone
who's happy to lose the uterus. I do have a
few personal anecdotes where women named their uterus because there
was annoying them so much, and you know, things like that.
(15:50):
But generally speaking on a serious note, there can be
psychological thoughts about no one wants to lose a part
of their body and it is an organ and it
goes back to the idea that I think people are
suffering so badly that they're willing to entertain that, and
there's no denying that it's a helpful operation for people
(16:10):
who are really suffering.
Speaker 2 (16:11):
Yeah, oh, doctor Previn, thank you so much for today.
Thank you for giving us all of that information. And
hopefully if you're listening to this and you fall into
the category where it could be something that might help
improve your life, or like you say, you're wanting to
get your health back on track, then a gynecologist is
absolutely the place to start and at least get the
(16:32):
information to make the best informed decision.
Speaker 3 (16:34):
Thank you very much, Tony.
Speaker 1 (16:36):
We need to talk with COASTFMS Tony Street. If you
enjoyed the podcast, click to share with family or friends.
To get in touch, email, we need to talk at
ghost online, dot co dot MZ
We need to talk conversations on wellness with coasfm's Tony Street.
Speaker 2 (00:06):
Hello there, welcome to we need to talk. It's great
to have you with us today. We're talking hysterectomies and
there's a good reason for this. So I have just
turned forty, and I have a lot of friends that
have had a hysterectomy before they've even reached forty. They're
in their thirties. And I don't know if this is
a surprise to you, but for me, I always held
(00:27):
a notion that women over forty, possibly even in their fifties,
were the ones getting hysterectomies. I didn't realize it was
something that you got young, and I didn't realize the
reasons why you get a hysterectomy. And maybe it is
something that you should be looking into, but you don't
know much about it. So I thought I would get
an expert. And his name is doctor Pravenda Silver. He's
(00:50):
a consultant gynecologist working at Auckland Gynecology Group in Remaware
or Auckland. He's an OTAGO graduate who has done extensive
training in complex surgeries for women at Sintjo Hospital, which
is a prestigious center in Sydney. He also has research
interests in pelvit pain and nerve conditions that affect women.
If you want to follow him, his Instagram handle is
(01:10):
at doctor Pravene Desilver. It is so lovely preving to
have you here today to talk about this. Is it
common for women under forty to be getting hysterectomies?
Speaker 3 (01:21):
Yeah, thanks for having me Tony. It's a pleasure to
be here. Look, we are seeing it more and more,
and we were just having a talk before recording about this.
I do think that interestingly, if you look at the
stats in New Zealand, hysterectomy numbers are slowly declining since
the nineteen eighties. But you could contrast it with the
(01:42):
fact that I think it's a lot more in the
public sphere now. There's a lot more societal acceptance of
the surgery. I've had patients recently who they're very comfortable
telling workmates or colleagues that they're taking sick leave to
have a hysterectomy, or close family and friends, and so
I think with that, naturally there does come the information
(02:04):
out there that people do want to explore a hysterectomy
a discussion about it, So naturally I have got people
a bit younger than forty coming to talk about it.
Speaker 2 (02:14):
Yeah, what would be the average age do you think?
Speaker 3 (02:17):
So the average age in New Zealand is still in
their forties. Just to talk about what a hysterectomy is, Tony,
A hysterectomy is where surgically, the uterus and the cervix,
which is the bottom part of the uterus, is removed.
This is the organ that is present in females and
(02:38):
people assigned female at birth. It's the organ that's obviously
used for carrying children. Also the organ responsible for your periods,
and so it is a big decision to have a hysterectomy.
And I do think that the older age is because
a lot of people want to complete a family if
that's important to them before talking or having that conversation
(03:01):
about a hysterectomy.
Speaker 2 (03:02):
It's interesting you bring that up because I've got a
friend of mine who has actually needed a hysterectomy for
a while now, but wasn't comfortable entertaining the thought until
she reached forty. It was just a mental block I
think for her that she wanted to be of an
age where it felt right to be losing your reproductive organs,
because that's quite a major, I guess, psychological thing for women.
(03:25):
Would you say that, is that what you encounter with
the women you treat?
Speaker 3 (03:29):
Absolutely, Look, it is a big decision for many reasons. Firstly,
like you said, it is part of your reproductive system.
I think it's important that we don't confuse it with
removing your ovaries or losing your hormones, which is probably
the most common question that I get asked by people
when they visit me. Of course, there are some rare
(03:52):
situations where women do need to lose their ovaries during
a hysterectomy, but most of the time, overwhelmingly a hysterectomy
is just the removal of the uterus and the ovaries
continue to function. Obviously, like you said, it's the reproductive
thoughts as well. People need to be sure that they've
(04:12):
completed that, and I get if I ever have someone
who's on the fence, I always say, look, this isn't
the right time to entertain this idea. I think why
forty you ask, it's because people need to get to
a stage where they also have time to take leave
to get this thing done. I think it's quite empowering
(04:33):
for a lot of people. They get to forty and
they think, right, this is me sorting out my health,
sorting out my well being, and it's important and I've
put this at the top of my listener. A lot
of women in their thirties have young families, and it's
even if they want to do it, it's not as
easy as just taking time off because, as we'll talk
about today, there is a recovery involved as well. So
for many reasons, it's not super straightforward to just get
(04:56):
a hysterectomy at an early age.
Speaker 2 (04:58):
Right, Let's go back to the reasons why someone might
need a hysterectomy, and they are varied.
Speaker 3 (05:04):
Yes, you're right, So there are many reasons why people
get hysterectomy. They can range from very serious things, so
about ten percent of hysterectomies will be for women facing
a female cancer and that's something that's thrust upon them
that they might not even be ready for. And then
(05:24):
following that, there are benign or non cancerous reasons why
people get hysterectomy. So the most common that I see
for this mainly bleeding issues, so difficulty with really heavy periods,
periods that are resistant to medication, that can't be managed easily.
(05:45):
They can go on for many weeks sometimes I've seen.
And also quite irregular bleeding can be really really hard
to manage and really can really cause despair for people.
And secondly, there can be can and diseases that cause
pain as well. So the most common is an inflammatory
condition we call adenomyosis. I call it the evil cousin
(06:09):
of endometriosis, where basically the uterus muscle can get very inflamed. Equally,
there's a there's a term called fibroids, which are where
women can get really solid growths inside the muscle of
the uterus and they can cause immense pressure, pain, heaviness,
bladder dysfunction. So, as you can see, there's a multitude
(06:31):
of reasons why people would consider a hysterectomy.
Speaker 2 (06:34):
Yeah, and so you mentioned that typically it's women in
their forties. What would be for you and your experience
as a surgeon, what would be the youngest women that
you have? Yeah, what do that operation on?
Speaker 1 (06:47):
Look?
Speaker 3 (06:48):
I do in my practice encounter people in their thirties,
and in some very rare situations even younger than thirty.
I think it is important to also have the discussion
that there are people having gender affirming surgery, and that
is something that we It's a multidisciplinary team and there
is a lot of thought and counseling that goes into that.
(07:10):
But but I respect that if people want that procedure done,
we can offer that. There are equally people who do
not want to have a family, and they're very clear
about that, and and I think we are seeing that
that insurgent certain situations as well, and I respect that
for adults who are sure that that they want the
(07:30):
hysterectomy for that reason. On some very sad situations, I
see people who have had multiple fertility attempts and they
realize that their health and well being is going to
take priority over repeated attempts. And it is a difficult
discussion to have, but still something that I really respect
people you know that that are in that position and
(07:52):
it must be very very tough for them.
Speaker 1 (07:55):
This is we need to talk with Tony Street.
Speaker 2 (07:58):
So the process of of having a hysterectomy, how long
is the surgery, what is involved, and what's the recovery like.
Speaker 3 (08:06):
As beneficial as a hysterectomy can be for people and
there's no denying that. I think a lot the attraction
for a lot of people is that it's a definitive operation.
So for people who are having really difficult periods and
horrible pain where they're almost on daily pain relief, the
idea that they can do something to really change that
(08:27):
and transform that is very enticing. But like you said,
it is a major surgery, and so it is done
more and more commonly these days by what we call
minimally invasive approaches, and that's something that I'm very passionate about.
So what minimally invasive means is that rather than in
the olden days where you could get a cesarean scar
(08:47):
or a rather large cut on your abdomen, these days
you can get small cuts through something called known as
keyhole surgery. In Sydney and even now in Auckland we're
doing robotics as well, which is very similar to keyhole.
What that surgery involves, Tony, is small cuts are made
on your tummy, which can be smaller than one centimeter.
(09:09):
Women usually get about three or four of them for
the surgery to be performed, and that does lead to
a much quicker recovery. And so I think that's quite
exciting for a lot of people. The surgery itself takes
about two hours, and most people would stay in hospital
for two nights before they can return home.
Speaker 2 (09:27):
It's not too bad, is it, when you consider that
you're getting your reproductive organs removed, Like I'm sure it
was a lot longer, you know, ten to fifteen years ago.
Speaker 3 (09:36):
Yes, certainly, And there are some situations where people still
need to get a large cut, and also a potential
complication from the surgery is needing to convert and do
a large cut during the surgery, so there are always
risks involved. I think you're right, two nights doesn't sound
too bad. It's still, in all honesty, can take a
few weeks to really start to feel normal again. I
(09:57):
do find for a lot of a lot of my
patients they've got a young family at home, and I
always tell them to stay the extra night because you know,
if you go home and you know, if your kid
just wants mum, especially jumping on their lap and things
like that, you know, I do really want people to
be a bit careful about that.
Speaker 2 (10:15):
Yeah, what would the time off work be?
Speaker 3 (10:17):
If you yeah, time off work? I always say a
blanket two weeks is appropriate. I at the same time
get a lot of people who are doing extremely busy
jobs and two weeks is not quite quite you know,
it's too much for them. And I've got a lot
of people working from home at the end of one week,
so it's only my job to advise. We also say
(10:38):
no driving for one week after this kind of surgery,
and so that that is mainly the recovery. Other important
things that people ask me, for example, Tony is exercise
and gym work, so I always say cancel the gym
membership for a month, no no heavy lifting, and also
nothing inside the vagina for one month. So returning to
(10:59):
have sex, swimming, things like that, you do need to
block it off. And it's interestingly because we've had a
lot of people wanting a hysterectomy over the summer but
then realized afterwards that that means no beach for the
month as well, which has been a bit.
Speaker 2 (11:14):
Yeah, that's hard, isn't it.
Speaker 3 (11:16):
It is?
Speaker 2 (11:17):
So what are the benefits then? Does that then mean
I'm going to want it in black and white here
you don't get a period anymore.
Speaker 3 (11:25):
Yeah, I think we always have to be very careful
with the counseling about pain, and I think, like you
said in your introduction, I do have a really strong
interest in pelvic pain and a historyct toomy can help
a lot with pain, but it's very hard to guarantee
that that can fix pain because there are so many
things that can cause pain in the pervic area. But
with the bleeding, I can give one hundred percent money
(11:47):
back guarantee that you won't have a period ever again,
which for some people is an extremely empowering thing.
Speaker 2 (11:54):
What is the feedback from some of your patients been.
Speaker 3 (11:58):
It's been life changing for so many people. I just
I recount some women recently who had told me they
weren't comfortable going to their office because of the amount
of bleeding that they were getting since COVID. They just
stayed working from home. And you know, one or two
women recently told me that they can just go back
to the office now and it's not an issue for
them anymore. So that was an incredibly rewarding thing to hear.
(12:23):
I think people can be intimate to gain after hysterectomy
if that's something that you want to talk about, and
sometimes the bleeding and pain has got in the way
of that. As well, So that's a big positive and
just using it as a springboard to starting to work
on your health again, I think for a lot of people,
because people who are bleeding really heavily, it can make
(12:43):
you feel really run down and really awful. It's a
term known as anemia, which basically means that you're losing
your blood volume every month, and so that changes when
you don't have bleeding.
Speaker 2 (12:53):
Okay, so you recover from the operation, you're back to
potentially the gym, back to work. What is the ongoing
care look like as the medication you have to take
for the rest of your life.
Speaker 3 (13:04):
How does that look for each person? Things can be variable.
I know that your podcast has talked a lot about
menopause and about hit hormone replacement therapy, and again to Feeld,
a common question that I get asked, is am I
going to have to be on hormone replacement therapy or
on estrogen for the rest of my life? If I
have a hysterectomy and as long as the uterus and
(13:27):
cervix are the only things being removed, there is no
reason to be on long term medication such as that. Unfortunately, naturally,
every person is going to go through menopause at some
stage in their lives, and so having a hysterectomy does
not change that. And so generally speaking, people shouldn't need
to be taking long term medication after a hysterectomy.
Speaker 2 (13:46):
Yeah, what would your advice be to people like perhaps
my friend who has waited longer than perhaps she needed
to to get this hysterectomy. What would your advice be
in terms of any fear that women might have about
having this operation.
Speaker 3 (14:04):
Yeah, it's a really good question. I think it's healthy
and it's natural to have some some fear. A lot
of people that I meet Tony, they've been so well
throughout their whole lives and this is the first time
that they're having to think about a general anesthetic or
an operation, and so it can be intimidating. And my
(14:24):
advice is, do your research, make sure that you have
read about the surgery. There are really good avenues to
get accurate information. Definitely meeting with a gynecologist that you
feel comfortable with to ask all the important questions. And
I always say to people, write down the things that
are important to you and take them with you to
(14:45):
the appointment, so that you can know for sure that
this is the operation that you want, because while as
a surgeon, I do think it's a very helpful operation,
it isn't for everyone. And I have equally some people
who come and meet me talk through the whole thing
and then being very confident that that's not what they
want and that they're happier with other medical options, which
(15:06):
there are plenty of.
Speaker 2 (15:07):
This might sound like a bizarre question, but I think
there might be some hesitancy in the fact that you
are losing your reproductive organs, and for many women that
is what makes them a female. So are they any
feelings post surgery that you know you are there's something missing?
I mean, it could just be a mental thing.
Speaker 3 (15:27):
But it's a really good question, Tony. I think just
because you've completed your family doesn't equate to being happy
to lose your uterus. I don't think I've met anyone
who's happy to lose the uterus. I do have a
few personal anecdotes where women named their uterus because there
was annoying them so much, and you know, things like that.
(15:50):
But generally speaking on a serious note, there can be
psychological thoughts about no one wants to lose a part
of their body and it is an organ and it
goes back to the idea that I think people are
suffering so badly that they're willing to entertain that, and
there's no denying that it's a helpful operation for people
(16:10):
who are really suffering.
Speaker 2 (16:11):
Yeah, oh, doctor Previn, thank you so much for today.
Thank you for giving us all of that information. And
hopefully if you're listening to this and you fall into
the category where it could be something that might help
improve your life, or like you say, you're wanting to
get your health back on track, then a gynecologist is
absolutely the place to start and at least get the
(16:32):
information to make the best informed decision.
Speaker 3 (16:34):
Thank you very much, Tony.
Speaker 1 (16:36):
We need to talk with COASTFMS Tony Street. If you
enjoyed the podcast, click to share with family or friends.
To get in touch, email, we need to talk at
ghost online, dot co dot MZ
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