A new hysterectomy could increase the risk for women with dementia.
A hysterectomy to remove the uterus leads to a menopause. After the surgery, many notice that they notice a change in their perception or "brain fog".
Scientists have sought to establish a clear link between hysterectomies, menopause and mental functions.
The new Arizona State University (ASU) study, however, is the first to establish a direct connection between the womb and the brain.
In experiments with rats, the researchers found that removing the uterus alone – but not the ovaries – can cause short-term memory and cognitive problems.
A hysterectomy can lead to memory loss in a third American woman undergoing the procedure, a new study suggests
We are in the age of mind-body medicine, where mental health is ultimately accepted as part of general physical health and the composition of our gut is recognized as affecting our mood.
This revelation complicates old and new ideas – especially when it comes to women's health.
Some mental health issues, such as depression, which were once dismissed as "hormonal fluctuations" in women affected, are now considered more complicated.
However, as long as the mechanisms behind changes that women notice, such as postmenopausal cognitive problems, have remained unknown, doctors have been reluctant to treat them.
Similarly, research on both sides of the debate on whether hormone replacement therapy (HRT) poses a risk of dementia or not.
In light of these related but sometimes contradictory insights and uncertainties, "we wanted to investigate and understand if the uterus itself could affect brain function," says senior study author Dr. Heather Bimonte-Nelson, a psychologist at ASU.
While the uterus is an integral part of female anatomy during a woman's reproductive years, the theory that post-menopausal science has lost its function has long been prevalent.
But the new study, published in the journal Endocrinology, turns this term upside down.
"Our new findings indicate that the non-pregnant uterus is not inactive and is actually related to brain function," says Dr. Bimonte-Nelson.
"This statement is conspicuous."
Almost a third of all women in the US have a hysterectomy at the age of 60 – and some research suggests that most of them are not medically necessary and are being used preventively to treat conditions for which there are less invasive options.
So, an elective surgery can actually affect the minds of hundreds of thousands of women each year.
It seems that we do not know as much as we believed in the role of the female reproductive system in whole-body health – although we start to learn.
"There are studies showing that women who underwent hysterectomy but maintained their ovaries had an increased risk of dementia if the operation was performed before a natural menopause," says Dr. Bimonte-Nelson.
WHAT IS A HYSTERECTOMY?
A hysterectomy is a surgical procedure for removing a woman's uterus.
There are three types:
- PARTIAL HYSTERECTOMY: Removes two-thirds of the uterus.
- TOTAL HYSTERECTOMY: Removes uterus and cervix.
- RADISH HYSTERECTOMY: Removes uterus, cervix and vagina.
The surgery is most commonly performed in women between 40 and 49 years.
According to the Centers for Disease Control and Prevention, more than 20 million American women had a hysterectomy.
As women approach menopause, they are more likely to develop one of several serious health conditions of the uterus. Doctors may recommend a hysterectomy as a treatment for:
- Cervical cancer (endometrial cancer)
- chronic uterine pain or bleeding
- collapsed uterus
In some cases, physicians may suggest a hysterectomy as a preventative measure if a woman has significant warnings or early signs of one or more of these conditions.
If necessary, surgeons may also remove the ovaries and fallopian tubes if they have also been damaged or present a serious risk of damage.
The removal of reproductive organs brings the body of a woman into the menopause, no matter how old she is.
This causes unpleasant side effects such as hot flashes, and many women need to start hormone therapy and take estrogen to balance their own hormones.
But she and her team suspected that the uterus was also involved. So they tested their theory by performing various menopausal operations on rats.
The rats were divided into four groups in which either the uterus and the ovaries were removed, one or the other, or none at all, during a dummy procedure.
Six weeks after the operation, researchers have taught them how to navigate a water labyrinth that looks like a sunburn, with eight arms radiating from a circular center.
The labyrinth included four platforms that the researchers removed when the rats found them.
The fewer platforms were left, the greater the demand of the rats, as they had to remember where the missing platforms were and where there had never been a platform.
With two platforms and two before launch, the research team found that rats with only utero removed could not handle the increased memory load.
These rats repeatedly returned to places where there had never been a platform, indicating that they could not remember which arms of the labyrinth led to platforms.
The other types of surgery did not affect how many mistakes the rats made in the maze.
First-year author Stephanie Koebele, a student, said: "The surgical removal of only the uterus had a unique and negative impact on working memory or how much information the rats could handle simultaneously, an effect we saw after the rats learned to do so of the labyrinth. & # 39;
"We found that hysterectomy can affect short-term memory in rats," explains Dr. Bimonte-Nelson.
This suggests that the uterus and ovaries are part of a system that communicates with the brain for functions such as perception.
We know that they communicate for reproductive functions, but there are also direct connections between the womb and the brain through the autonomic nervous system of the body, which coordinates unconscious functions such as breathing.
However, the discovery of this more complicated link to knowledge suggests that the uterus may affect cognitive functioning and the age of women.
Dr. Bimonte-Nelson said, "We hope that these basic scientific insights will raise awareness of how changing operations during menopause can affect the brain and its functioning in women, ultimately affecting their quality of life."
Donna Korol, a professor of biology at Syracuse University, New York, who did not participate in the study, said her protocol added weight to the results.
She said, "This experiment tests the role of the uterus in cognitive changes that accompany menopause.
The researchers use several surgical approaches that are actually used for women who have undergone an oophorectomy (surgical removal of the ovaries), a hysterectomy or both. That alone is commendable.
"One of the beauties of this experimental design was the sampling of different measures of the same rat, allowing for comparison of animals within several animals across multiple systems."
The findings could also shed light on why women develop dementia twice as often as men.
"Although the ovaries were structurally similar in all groups, the hormones produced in the group that received only the hysterectomy resulted in a different hormonal profile," Koebele said.
"Hormones affect both the brain and other body systems, and a modified hormone profile can affect the trajectory of cognitive aging and lead to different health risks."
Exactly how the altered hormonal profile affects cognitive aging or causes health risks is complicated, yet very important for study and understanding.
Dr. Bimonte-Nelson said, "Complexity does not mean impossible."
Her laboratory is currently testing whether the memory deficit after hysterectomy is reversible over time or is the beginning of a more global memory disorder