A CENTRAL Victorian specialist is concerned about the number of women requesting hysterectomies without first exploring all their treatment options.
Obstetrician gynaecologist Dr Angelika Borozdina has been worried about demand for the surgery, which involves the removal of the uterus, for some time.
But she said interest had been huge this year, particularly among younger women.
The women Dr Borozdina was most worried for seemed to be declining any other form of treatment before they had even tried it because they were set on having a hysterectomy.
She and her colleagues encountered three women during recent consultations in the public health system, all of whom wanted hysterectomies before the age of 30.
All three were reluctant to consider alternative treatments, clinging to the hope that no longer having part of their reproductive system would bring an end to chronic symptoms like pain and irregular bleeding.
Dr Borozdina was concerned women weren't being presented with the full picture about what a hysterectomy involved and the implications it could have for their health in both the short and long term.
"It seems like not all medical practitioners are on the same page - it is not recommended to have a hysterectomy before we explore other options for treatment," she said.
Dr Borozdina said patients who were requesting the surgery often told her they didn't want to have children or periods.
But she said childbirth was not the sole function of the uterus.
"By removing the uterus, basically we are making this patient go on a pathway where her sexual function will be affected eventually," Dr Borozdina said.
"Not maybe in the nearest five years, but after 10 years it would be very difficult for her to be able to have normal, non-painful intercourse."
She said man of the patients she saw in her private practice were experiencing problems associated with sexual dysfunction, as a result of hysterectomies in their 30s and 40s.
Having a hysterectomy at an early age could result in vaginal atrophy, a condition typically seen in women who had experienced menopause.
The condition involved dryness, irritation and thinning of the vaginal walls.
The uterus also serves a structural purpose. Removing it means making anatomical adjustments to the patient's pelvic area, affecting the pelvic floor and potentially leading to further conditions requiring surgery.
"Every second woman who has a hysterectomy eventually will end up with some degree of prolapse," Dr Borozdina said.
"Again, it is not in five years - maybe after 10 years - but it will happen. So, therefore, she will be looking for another surgical treatment."
Dr Borozdina said some women sought a hysterectomy because they believed having the uterus removed would improve their endometriosis, which was not necessarily accurate.
"If the endometriosis is located outside the uterus, it has nothing to do with a hysterectomy," she said.
"Instead, it makes the endometriosis symptoms worse because we don't even know how the scar tissue is going to affect her.
"That's how they become a patient with chronic pelvic pain."
While there were some cases in which a hysterectomy was the best option, Dr Borozdina said they were relatively rare, accounting for no more than 10 per cent of the women she worked with.
"It is quite difficult to justify a hysterectomy before 30 years of age," the specialist said.
She would not usually consider the procedure appropriate for a patient under 30 unless faced with something serious, like a complete uterine prolapse, uterine cancer, a uterus that was significantly enlarged by fibroids, or significant bleeding that could not be stopped by any other form of treatment.
Bendigo woman Rachelle Anderson explored every option available to her for treatment of endometriosis and adenomyosis before having a hysterectomy in her late 30s.
She had numerous surgeries, tried contraceptives, twice had menopause chemically induced, and underwent endometrial ablation.
Still, the chronic pain persisted, coupled with the effects of some of the treatments. Mrs Anderson said the pain affected every facet of her life, including parenting.
She had begged for a hysterectomy in her early 30s, such was her desperation. But her specialist, who happens to be Dr Borozdina, suggested trying other treatments first.
She believes her specialist did the right thing.
"I don't regret not having it earlier," Mrs Anderson said.
She gained an appreciation for the risks associated with having a hysterectomy, like complications and developing further conditions.
"Apart from not wanting to experience anything new, I didn't want to complicate what I was already dealing with," Mrs Anderson said.
She was in too much pain not to consider a hysterectomy, by the time she underwent the procedure.
Mrs Anderson needed further surgeries and treatments after her hysterectomy. She was also diagnosed with conditions related to chronic pelvic pain.
"I'm still in pain most days, it's just at a lower level than what it was," the 42-year-old said.
She encouraged people considering a hysterectomy to seek as much information and support as possible before making an irreversible decision, including from medical professionals they trusted.
"It was a huge decision and honestly it made things better for me, but in a whole other way it made things very complicated," Mrs Anderson said.