Conservative Approaches Favored Over Hysterectomy for Gynecological Conditions

by Ella

In India, a dearth of data on women-specific health issues obstructs the understanding of the true extent of women’s health conditions, hindering funding and policy attention. Addressing this gap, a recent study sheds light on hysterectomy prevalence and reasons among women aged 45 and above across the country.


Published in Women’s Reproductive Health as ‘Reported Reasons for Undertaking Hysterectomy Among the Women Aged 45 Years and Above: Evidence From Longitudinal Aging Study in India (LASI) Wave-1 (2017–2018)‘, the study explores the prevalence and motivations behind hysterectomies. It utilizes data from the LASI Wave-1 to scrutinize hysterectomy rates within a sociodemographic framework.


The authors highlight the scarcity of nationwide statistics on hysterectomy prevalence, underscoring the need for comprehensive population-based investigations. For the first time, the National Family and Health Survey’s fourth wave included direct questions on hysterectomy and reasons for undergoing the procedure.


Hysterectomy, the surgical removal of the uterus, ranks among the most common surgeries globally. Although advancements enable minimally-invasive procedures, it remains a major surgery. Common reasons cited for hysterectomies include fibroids, uterovaginal prolapse, benign ovarian cysts, malignancy, and adenomyosis. The procedure aims to alleviate symptoms such as irregular bleeding, menorrhagia, pelvic pain, and discomfort, often enhancing women’s quality of life.


Despite its benefits, hysterectomy entails long-term health implications, including early menopause, cardiovascular risks, urinary incontinence, and hormonal imbalances. Studies also link hysterectomy to adverse effects on bone density, mental health, and cognitive function.

Analyzing data from the LASI Wave-1, the study reveals heavy menstrual bleeding or pain, fibroids or cysts, and uterine prolapse as the primary reasons for surgery. Notably, the prevalence of hysterectomies varies across regions, with southern and western India reporting higher rates.

In response to escalating hysterectomy rates, the Ministry of Health and Family Welfare issued guidelines to curb unnecessary procedures. These guidelines underscore the need to raise awareness among healthcare providers and communities about alternative treatments for gynecological conditions.

The prevalence of hysterectomies among younger women underscores concerns about overuse and inadequate exploration of conservative treatments. Some experts attribute the high rates to patriarchal norms and insufficient patient education, leading to unnecessary surgeries.

Experts emphasize the importance of exhausting conservative treatments before resorting to hysterectomy. Non-surgical alternatives, such as hormonal therapies and intrauterine devices, offer effective management for many gynecological conditions. The guidelines emphasize the need for cautious consideration of hysterectomy, advocating for its use only after exhausting less invasive options.


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