Ovary Removal Procedure In Abused Women

Introduction:

Women who have undergone physical, verbal, or emotional abuse are more likely to get their ovaries removed during their mid-forties than women without any history of abuse. These ovary removals are for reasons other than the genetic risks of developing cancer or the presence of ovarian cancer. However, experts suggest that these unnecessary surgeries put women at the risk of developing serious complications.

What Are Ovaries?

Ovaries are oval-shaped organs situated on either side of the uterus in women. Ovaries play an important role in producing and storing eggs. They produce hormones that are responsible for controlling the menstrual cycle and pregnancy. One of the ovaries releases an egg during ovulation, and pregnancy occurs when fertilized by sperm.

What Are the Functions of Ovaries?

The various functions of ovaries are as follows:

• Production of eggs for fertilization.

• Production of the hormones estrogen and progesterone.

• The ovary releases an egg around the middle of the 28-day-menstrual cycle and this process is known as ovulation. When this egg travels through the fallopian tube to reach the uterus, the progesterone level rises which makes the uterine lining get ready for pregnancy.

What Is Oophorectomy?

Oophorectomy is the surgical removal of one or both ovaries. Oophorectomy involving the removal of a single ovary is known as unilateral oophorectomy. Oophorectomy involving the removal of both ovaries is known as bilateral oophorectomy. Oophorectomy is also done as a part of a hysterectomy (surgical removal of the uterus).

What Are the Indications of Ovary Removal?

Ovary removal is commonly indicated in the following conditions. They are:

• Endometriosis.

• Ovarian cancer.

• A tubo-ovarian abscess (a pus-filled cavity involving the ovaries and fallopian tube).

• Non-cancerous tumors or cysts of the ovaries.

• Ovarian torsion (twisting of the ovary).

• Preventive surgery in people who are at risk for ovarian and breast cancer.

• Chronic pelvic pain.

• Ectopic pregnancy (a pregnancy in which the fertilized egg implants and grows outside the uterus, mostly in the fallopian tube).

Why Do Abused Women Undergo Ovary Removal?

• The sexual, physical, or emotional abuse undergone by women had long-lasting effects on them.

• Most of the women who have undergone abuse ended up going to the doctors with problems with chronic pelvic pain or excessive bleeding. However, most of them had these symptoms due to noncancerous conditions of the uterus like fibroids.

• The main reason for abused women to opt for ovary removal is that they consider their reproductive organs as a source of stress or burden.

• Abused women who have negative marital or reproductive experiences, substance or smoking abuse, lower education, eating disorder, and anxiety or depression are more prone to opt for ovary removal.

• Abused women who experience negative gynecological symptoms are not able to link these symptoms to the context of their overall life. They consider all such symptoms as physical aspects of the abuse. Sometimes the negative symptoms that are observed after an abuse may occur as a result of the body’s biological reaction to the stress caused by abuse.

• Most of the abused women who opt for ovary removal often complain about abnormal uterine bleeding and chronic pelvic pain as the trouble-causing factors. They often visit multiple doctors and ask for ovary removal surgery as a definitive solution for their problems.

• Few women link their gynecological symptoms with traumatic experiences of childhood. Research suggests that this is because these women are unable to recollect and process their past incidents which leads them to the belief that their distress could be reduced by the removal of their reproductive organs.

• Most of the abused women feel that their reproductive organs are responsible for their stress and unhappiness and hence end up going to the doctor to get it removed.

• In most cases, abused women who seek medical attention for gynecological symptoms like excessive bleeding or abdominal pain end up in the removal of their reproductive organs that are completely normal. Most of the time removal of the reproductive organs at a young age takes place under the support of a gynecologist. Some studies suggest that this is because gynecologists are unaware of the connection between the present symptoms and past life experiences of the patient.

• The inability to identify and discuss the past history of abuse leads to harmful and unnecessary surgeries.

What Are the After Effects of Ovary Removal?

Removal of ovaries without any underlying cause can make a woman susceptible to the following conditions. They are:

• Stroke (Reduction or interruption of blood supply to the part of the brain).

• Coronary artery disease (a condition in which the major blood vessel supplying the heart is narrowed or blocked).

• Osteoporosis (a condition in which the bones become brittle and weak).

• Dementia (a condition characterized by the loss of memory, problem-solving, and other thinking abilities).

• Depression and anxiety.

• Arthritis.

• Hyperlipidemia (a condition characterized by the presence of excessive fat in the blood which increases the risk of heart attack).

• Chronic obstructive pulmonary disease (common lung disease characterized by difficulty in breathing).

• Asthma.

How to Prevent Ovary Removal in Abused Women?

• The doctor should make the patient aware of the fact that ovary removal will not solve the emotional and psychological consequences of the abuse.

• Apart from not being beneficial, the removal of ovaries is going to cause various physical and mental complications for the patient.

• The gynecologist should understand the link between emotional and physical pain and should encourage the patient to undergo a thorough psychiatric evaluation that would help in identifying the actual underlying problem.

• A good conversation between the doctor and patient regarding the abuse suffered by the patient and the adverse effects of ovary removal can prevent the patient from ovary removal in the absence of any underlying conditions.

• Both the doctor and the patient should understand that ovary removal surgeries are not simple or without any consequences.

• By accepting an abused woman’s request for ovary removal in the absence of an underlying condition, a doctor is missing his chance to make the woman understand the emotional nature of her current symptoms.

• Hence it is important for the doctor to not just physically treat the body parts but instead understand the mental state of the women.

Conclusion:

Removing both ovaries, especially in premenopausal women can lead to many serious health complications. Hence a doctor should always prevent patients from getting their ovaries removed in the absence of any underlying condition. The doctor should understand the close connection between the traumatic experiences and the current gynecological symptoms of the patient before suggesting any surgical procedure. Hence the doctor and patient should have an open conversation with each other and limit the inappropriate use of surgical treatment options.