Shouldn't we know more about the uterus? YES! Listen and learn as we break down what a uterus is and dive into a variety of topics and studies all surrounding this mysterious organ.
Hello Uterus and hello Uterinekind!
Grab a drink and settle into the first-ever episode of Hello Uterus! In today’s episode, we get right into the most common misconception about this mysterious organ: it’s not a roomy bowl just waiting to house an embryo. We’ll discuss the shocking reality of uterinekind’s involvement or lack thereof in scientific research and look at research uncovering the connection between your uterus and your brain. Because they talk. And that’s crucial to understand.
Prepare for more shock during our News Break on the recent draft leak from the Supreme Court stating the overturning of Roe V Wade, effectively rescinding constitutional rights from all uterinekind. Sir Matthew Hale makes an appearance. Unfortunately.
In our Hear Me, Hear Me! Q&A segment, we tackle a popular question regarding fibroids with more on these beasts to come in the future! Join us back here every Tuesday for all things uterus, in service to you, uterinekind.
Until next week, be well.
On today's episode of Hello Uterus. Nope, the uterus is not akin to an upside-down pear, Orange or other bowl-shaped fruit. This is misleading. We're going to clear this up right out of the gate. Then we'll talk about the direct connection between the uterus and the brain. Rats have stories to tell. In every episode, we'll feature your questions and Hear Me, Hear me. So in this inaugural episode of Hello Uterus, we pull a common question raised in our research over the last few years. Today's, Hear Me, Hear Me is a fast take on fibroids, but know this fibroids will be a large focus of upcoming episodes. We look forward to featuring your questions, so please send them to hello at Hello Uterus.com. Future episodes of our podcast will feature interviews with those who are breaking the trail on uterine research and advancements in technologies that will impact how we treat chronic debilitating conditions like endometriosis, fibroids, infertility, and more. We'll debunk myths with experts, tour technologies, advancing treatments, and keep you informed on current legislation and research affecting the uterus and uterine kind. You may be asking, who is uterine kind? Let's answer that by a process of elimination. Have a penis that would be mankind. Have a uterus that would be uterine kind. And me. I'm your host, Carol Johnson. This is Hello Uterus.
So let's set the record straight on the uterus. That seems like a pretty logical way to launch this podcast. I want you to close your eyes. Imagine a buttermilk pancake in the palm of your hand. Not a thin pancake, not one of those, like keto pancakes. The real deal. One that's about a half inch thick. Now imagine bringing your fingers towards your wrist, folding the pancake in half. Now look at it from the side. That is your uterus. It's not a bowl. It's not a roomy cavity. You can't host a party in it, and it's not a Whoopi cushion. There's a narrow, narrow space that's in between those two walls. It's more like a muscle, kind of like your calf muscle. Its elements are the fundus at the top of the uterus, the main body, which is called the corpus, and the cervix, which is the lower part of the uterus ligaments, which are tough, flexible tissue. Hold it in position in the middle of the pelvis. It's behind the bladder and in front of the rectum, and it leans over the bladder like an umbrella. There's not a lot of room around there for personal space for these organs in any way, shape or form. Stuff is pretty packed in there inside the uterus, lining the uterine walls. Again, not a cavity. But picture two vertical walls almost touching is the endometrium. This is what grows during the menstrual cycle and is what's shed if there is no pregnancy. Some people have a regular endometrial thickness, and some people have an overgrowth of endometrium. So looking back at our pancake and remembering it's not fluffy, but dense, like a muscle. That endometrial growth is going to cause discomfort. And for some, it blows way past discomfort and is downright painful. Pms can go from manageable to a monstrosity depending on many factors, one of which is the thickness of the endometrium. We'll get into these various conditions that impact the uterus. But what I want you to know is that the uterus is a dense muscle, and it does not have what you may imagine as a cavity. If you think about a cavity, I think one thinks about a space like an open space, probably kind of rounded in nature, like a cave, almost. Maybe that's not the case with your uterus. So how big is it? It measures three inches tall by two inches wide and one inch thick, which means that each wall of the uterus is half an inch thick. In between those two walls is a narrow space. And by narrow, I mean turn sideways. We can barely see you narrow hormones during pregnancy thin the uterus so it can expand to contain a fetus. But when not pregnant, the uterus. Well, like I said, it's not a whoopie cushion. It's a dense muscular organ. So that's the quick take on the uterus. That image that you see in the doctor's office not exactly representative. Now that you have a structural understanding of the uterus. When we come back, we're going to turn our attention to the brain uterus connection,
Snack on this. Clinical research trials in the US were not required to include women until 1993. Okay. Just going to let that sit for a second while my blood pressure rises. Clinical research studies enrolled only males, but our bodies from structural to chemistry are not the same. I mean, I just wonder, does anybody think this stuff through? Does anybody pause and for a second think, you know, maybe we should have female bodies in this clinical study on the effects of a heart attack. Right. We're different. We're made different. We operate differently. We have different chemistry, we have different organs. 1993 was far too late to realize that we ought to have had representation in clinical studies. But I bring that up because it highlights the disturbing fact that for decades, the effects of hysterectomy, which is the removal of all or part of the female reproductive organs, were never studied. These procedures, these surgeries, these invasive surgeries have been understudied. Approximately one-third of women experience hysterectomy or the surgical removal of the uterus by 60 years of age, with most surgeries occurring prior to the onset of natural menopause. I want to highlight that because it's going to be important for something that we're going to talk about later, with most surgeries occurring prior to the onset of natural menopause. And 68% of all hysterectomies are for noncancerous reasons or benign reasons. They use the word benign. I don't like to use the word benign because endometriosis is not benign. It's a monster so we're just going to say that 68% of all hysterectomies are for non-cancerous reasons. In some cases, a hysterectomy is literally a lifesaver. In most cases, it's unnecessary. Now, one person who has made an impact on our foundational understanding of the role of the uterus in the overall exquisite system that is the female body. Someone whose work I've followed and cited numerous times in my work over the last few years is Professor Heather Bimonte Nelson. Heather Bimonte Nelson is a professor in the Behavioral Neuroscience Program in the Department of Psychology at Arizona State University. For more than two decades, she has conducted preclinical evaluations of multiple domains of cognitive function as related to aging, with a special focus on transitional and surgical menopause. I'm delighted to say that Heather is committed to join us for a conversation on her team's research and what they've learned about the brain uterus connection after class is dismissed, and she becomes familiar with the outside world again later this summer. Till then, we're going to take a look at her research and be in the know the uterus is not a disposable organ. First, if you have endometriosis cancer adenomyosis, we'll dig into these in more depth in upcoming episodes. Hysterectomy may be your only option. In that case, you do what you have to do to get on the path to wellness. But for the person who would like to rip out their uterus, throw a party, shove it in a jars. You can swear it daily. It's likely not your uterus causing the problems. There are a few really important things you need to know before you press for a hysterectomy. One, the long term effects of a hysterectomy are wildly under-researched. Remember, it was only 1993 that female candidates were admitted to clinical research studies. The way that the uterus has been thought of by the clinical community over centuries is baked into how it's treated today. It's a baby percolator, and when non-pregnant, it is dormant, or in some cases also referred to as a useless organ. I don't know. Maybe they should study that before they declare it, like, dormant and useless. It just seems to be a leap to be like, oh, yeah, you know, no, that's useless. So here's another important thing to know. The vast majority of hysterectomies are for treatable conditions, most commonly fibroids conditions that can be treated without hormones and conditions that don't require the removal of your reproductive organ structure. We're going to talk about those in next week's episode. So just pause before pressing on with the hysterectomy and make sure that you understand these two key things that we don't know enough about the long-term effects of hysterectomies and that the vast majority of hysterectomies are for treatable conditions, conditions that don't require the removal of an organ. Now, Professor Bimonte Nelson and her team studied the effects of what they term surgical menopause in rats. So what has Professor Bimonte Nelson's research illuminated. You may want to sit down for this one. I've known this for a few years, and every time I reflect back on this study, I am both exhilarated and outraged. What was it? Four types of procedures on rats. These procedures represent the various types of hysterectomies one can have, along with what they refer to as a sham procedure or nothing at all. So four types of procedures on rats. One is do nothing. The second one is remove the ovaries only. The third is remove the uterus only, and the fourth is remove both the uterus and the ovaries. Then put the rats through various maze tests and observe. The published study is titled Hysterectomy Uniquely Impacts Spatial Memory in a Rat Model, a Role for the Nonpregnant Uterus and Cognitive Processes. It was published, as I said, in January 2019, not 1919. Note 2019. And what did they conclude? The uterus is tightly linked to the hypothalamic-pituitary-ovarian access loop and the potentially wide-reaching effects of this system. Okay, we need a definition break. Hypothalamic. Your hypothalamus is a structure deep in your brain, and it acts as your body's smart, control, coordinating center. It's essentially like the conductor to the Orchestra that is your body. Its main function is to keep your body in a stable state called homeostasis. And it does its job by either directly influencing your nervous system or by managing hormones. So that's the hypothalamic, the pituitary is the major endocrine gland. It's a tiny pea-sized body attached to the base of the brain, and it's important for controlling growth and development and the functioning of all the other endocrine glands and access loop. That's another way of saying a system of communication between glands, organs, and nervous system. So what they concluded, again, was that the uterus is tightly linked to the hypothalamic-pituitary ovarian access loop, and the potentially wide-reaching effects of this system. Another way of saying that is not disposable in any way, shape, or form, unless, of course, by leaving the uterus intact, the person will die. In that case, you make the common sense decision that the person and their life is more important than the organ that is within them. Right. We experience this all the time with cancer. People have to have kidneys removed and various organs removed for cancer. So back to the study, and I'm reading directly from this because you don't want me paraphrasing this. Indeed, despite the long-held dogma that the non-pregnant uterus is a dormant and useless organ, there is evidence that the uterus contains gonadotropin and steroid hormone receptors, as well as direct sensory and autonomic innervation from the central and peripheral nervous system, even in a nonpregnant state. In other words, it's busy even when it's not containing a fetus. And there's a direct connection between the uterus, the nervous system, the endocrine system, and the brain. That's super cool. We want to know more. Thus, it is biologically plausible and in fact, likely that hysterectomy itself, with or without ovarian conservation, sufficiently alters the hypothalamic pituitary female reproductive tract system and as a result, plays a role in altering the brain and cognition. I just have to settle my stomach because every time I read that, I get waves of nausea thinking about someone who has a big bottle of champagne on the counter and a lot of stars around a certain date on their calendar because they've had horrible, heavy periods which have ruined their life, and they are excitedly counting down the seconds to a hysterectomy. Back to the study. Along these lines, several recent retrospective clinical studies have reported an increased relative risk of early-onset dementia for women who underwent hysterectomy compared with women with no history of hysterectomy, particularly when the surgery occurred prior to menopause onset. Collectively, results showed that common variations in surgical menopause yield distinct effects on spatial working memory performance, and that hysterectomy with ovarian conservation. A novel surgical model, the one that they say, oh, it's like hysterectomy light has unique, detrimental effects on spatial working memory two months after surgery, spatial working memory, the ability to remember. Specifically, to our knowledge, this is the first preclinical study to methodically investigate the impact of hysterectomy with and without ovarian conservation on learning and memory. And I read that one more time. Remember, this was in 2019. Specifically, to our knowledge, this is the first preclinical study to methodically investigate the impact of hysterectomy with and without ovarian conservation on learning and memory on the brain. Oh, my gosh. Who wants to throw something? I do. I want to throw many things. Furthermore, using this novel experimental design, we report that the nonpregnant uterus itself is not quiescent. New word alert in a state of dormancy is not a quiescent organ. Rather, uterus removal, with or without concomitant ovarian removal can have significant effects on physiology and cognition, opening new doors for future investigations into the role of the uterus and behavioral outcomes across the lifespan. Thank you. Thank you. We need to throw those doors wide open right now. Without this study, we would not know this. I'm stating the obvious, but I'm kind of stating how crucial it is that we demand research, we fund research, we support research, and we talk about the research. I have actually had conversations with clinicians who were not aware of this study. That just frosts me, as my mom used to say. When something made her mad, she would say that frosts me. I really love that. We will talk about the small number of studies that we do have to reference and what they show. It's not good growing evidence that surgical menopause may impact negatively on future cardiovascular, psychosexual, cognitive, and mental health. So pretty much everything, right? Pretty much everything. It's amazing to me. It's both amazing and not amazing to me that you consider that the field of gynecology was largely male for the vast majority of its existence, and they wanted to make their patients happy when their patients were complaining about things that all seemed to involve the uterus. And so, hey, why not take it out? Five star review, right? If you just eliminate the problem. And it was short sighted, tragic, for anyone who has people in their lives who have had a hysterectomy for non cancerous reasons, when there was an alternative therapy for them, there isn't always. But there are a lot of therapies available out there. I'm sure that there is a level of anger that you experience when you realize we didn't know, we didn't know what the outcome was going to be. We just went and took all of those organs out. Just incredible. These complications, I want to point out to you, are not the result of the type of hysterectomy procedure, whether it's an open surgical procedure, meaning that they open your body or it's a laparoscopic procedure where they use small, thin wands with instruments on the end that are put through tiny little incisions, or if it's a vaginal hysterectomy, that doesn't matter here. This is because that the system disruption in the body doesn't happen because of how it's removed. It happens because the organs were removed. So when Professor Beaumonte Nelson is on hello, uterus, we'll get into specifics of the study. But in short, don't believe the archaic take that the uterus is a disposable organ like tonsils. It's not. What it is is super, understudied, misunderstood, unfairly judged, and now under legislative assault. Next week, we'll dive into another study on the effects of hysterectomy that focuses on cardiovascular complications of joy. It's crucial that we're in the know on this. Not everything that we talk about is going to be a Downer, I promise, because there are really exciting things happening in the field of uterine health. We just have to be aware of all of it. Right. Knowledge is power. So when we come back, hear me, hear me. Our Q and A segment this week, are fibroids hereditary? But first, a Newsbreak. The Supreme Court of the United States has produced a brief that they feel justifies the repeal of Roe v. Wade. Oh, boy. The case, Dobbs versus Jackson Woman's Health, would explicitly overturn Roe v. Wade and end the constitutional right to an abortion. This brief was leaked. It was written by Justice Alito. And in it, Sir Matthew Hale, a 17th century legal expert and I would add, expert misogynist is remarkably cited in the leaked draft opinion written by Justice Alito, who's hail. Well, let's let him tell you. This is a quote from a letter he wrote to his grandchildren. Ah, that's so sweet. Women know the ready way to consume an estate and to ruin a family quickly, but neither know nor can endure to learn or practice the ways and methods to save it or increase it. And it is no wonder that great portions are expected with them for their portions are commonly all their value and commonly within a few years, nay, possibly a few months, they run their husbands into debt or spend as much money as their portions come to. And then they are sort of chargeable unprofitable people. They neither know how to house wife or manage what is left unspent. Goodness, could you imagine getting a letter from him? Yikes. But in all seriousness, how many times I was raised Catholic, I sat in Church and listened to homilies and readings that basically were like, you're a second class citizen. You're a second class citizen. Over and over and over again. This stuff is so damaging. And now it's coming back into the mainstream through the Supreme Court of the United States, specific to Roe v. Wade. Oh, boy. What else did Hale do? Well, he secured the executions of two women as witches and wrote the text for a marital rape exemption that said, husbands cannot rape their wives because by their mutual matrimonial, consent and contract, the wife has given up herself. Oh, my gosh, it's 2022. Uterine kind isn't backing down. People who couldn't pick a uterus out of an organ lineup are rewriting laws on the basis that the Founding Fathers didn't expressly permit abortion in the Constitution. That's the argument. Yes, they also didn't permit women to have credit cards. But you all want our cash, right? And it didn't permit women the right to vote. But we have that now, don't we? Oh, because no taxation without representation, we will continue to focus on this disgusting patriarchal rollback of rights that will literally cause people to die. I'm confident we'll fight, and this may be just the fight that ends the patriarchy. So do stay tuned. Hear me, hear me. Your questions answered while you're clothed and not laying on a table. Future episodes will feature your questions, but for today's inaugural. Hear me, hear me. We pulled out an often asked question from our research. Are fibroids genetic? Are they cancerous? My doctor said not to worry about them. They're normal. Look, words matter. We're going to stop using normal in place of common. It's a simple thing to do. It's not hard, but it would eliminate so many problems on the path to uterine wellness. So, no, they're not normal. They are common. Here's the short answer. We don't know if fibroids are hereditary, but we do know that if family members have them, you are three times more likely to have fibroids in the general population. We do know that they are non-cancerous growths and almost never, according to the Mayo Clinic, become cancerous. Whereas I want to point out polyps, which we'll get into in a future episode, can become cancerous. So that's the short answer. Here's your ally answer. We desperately need more research. Given women were not permitted in clinical trials until 1993, and we are only just discovering the uterine brain connection, it's completely safe to say we've got a lot to learn also safe to say that if hard masses of fibrous tissue growing in a penis was a thing, we'd know exactly what caused them. And studies would be underway to see if that fibrous tissue could be redeployed to make the penis bigger. Fibroids are dense, hard, and sometimes calcified. That means like a marble. Hard is a marble tissue growths that range from the size of a seed to a melon and larger. They are generally classified by their location, and there are three of those. Pay attention to these words, and this will be in the transcription and the show notes. And we'll talk about it more, and we'll have experts on to talk about them. It's really important that you understand not just that there are fibroids, but where are they located? Because it factors into how they're treated. So we have intramural fibroids intramural. They grow within the muscular uterine wall. Then we have submucosal fibroids, which bulge into the narrow space in the uterus and the interior of the uterus. Those are submucosal. And then subserosal fibroids, which project to the outside of the uterus. So intramural grows within the muscular walls of the uterus. Submucosal fibroids bulge into the narrow space inside the uterus and subs cirrhosa fibroids project to the outside of the uterus. According to the Mayo Clinic, doctors believe I'm making quotation marks. Word choice is important. What that means is they don't have the data. But doctors believe or theorize that uterine fibroids develop from a stem cell in the smooth muscular tissue of the uterus, which is called the myometrium. That's the thickest part of the uterus, and that's what the endometrium grows on a single cell. A single stem cell divides repeatedly, eventually creating a firm rubbery mass distinct from the nearby tissue. So they're rounded. They're rubbery. They can be super hard and dense. They can be on the inside of your uterus, in the walls of your uterus and projecting outside the uterus. So remember the pancake. Now think of that super narrow space between the two sides of the pancake. That's the so called cavity. It's more like the narrowest of spaces. Shove a couple of golf balls in there. And how's it feeling? If it's hard to imagine, think about what it would feel like if you had a hard knot in your calf muscle. Painful, right. These masses can grow slow, they can grow fast, and they appear to be impacted by hormonal fluctuations. What do fibroids impact? What don't they impact? Other organs and nerves, your spine, fertility work, play, sleep, your sex life, your ability to get out of bed, although you've probably had to get up to change the sheets because you bled through your super tampon and double pad with period panties. And no, that's not a normal period PS, by the way. Not at all. Normal. Common, yes. Normal, no. They can also cause abdominal discomfort. Constipation fibroids affect up to 80% of uterine kind during their lives with people of color experiencing more and larger fibroids. And we also know that people of color have different experiences accessing health care than white people do. So imagine that their fibroid condition is more severe and they also have less access to modern, comprehensive uterine care. Okay, so back to the fibroids because they can grow slowly, people may become accustomed to the physical symptoms. And we're going to get into symptoms of fibroids next week when we talk about them in more detail. It's important to pay attention to your symptoms and to understand that what you may have classified as normal right now or up until this time or overtime is not normal. So the largest fibroid ever moved weighs the same as my son. £140. This was a post-mortem removal in the late 1800s. I bring it up because it's not like they didn't know that fibroids were a thing, right? In the 1800s, they took a fibroid out of a body that weighed £140. That should have been a wake-up call. But instead of studying and determining what causes them and how we can eliminate those causes, fibroids are the most common reason for a hysterectomy. But they don't have to be. So like I said, next week we'll take a dive into the symptoms of fibroids, how to advocate for a diagnosis and modern fibroid treatments available today. So please come back for that conversation. I've heard routinely that people go to see multiple doctors over multiple years to try to get a diagnosis for their horrible, painful periods, and they don't receive one. And a lot of the times it's because of fibroids. We're going to make an impact on that at Uterine Kind. That's a wrap of our inaugural episode of Hello Uterus. We hope this podcast informs empowers Uterine Kind they can advocate for their uterine care needs will be here every Tuesday. So please subscribe to the podcast wherever you listen to your podcasts. Definitely visit our show page at Hello Uterus.com. That's where you'll find transcripts and show notes and the studies that we reference in every episode, plus additional resources. There's also a blog, and in the post for this week is our Genesis story. How did Hello Uterus come to be? And more on the Uterine Kind platform and a little bit about me. Please show your support by signing up for the periodic updates on our progress at Hello Uterus. We won't sell your information. We won't spam you with fundraising emails or otherwise be a pain. That's a commitment. Don't forget to send your hear me, hear me questions to hello at Hello Uterus.com. We'll get them answered by experts and report back. And thank you, angel, our show producer. We are so grateful to have you and the entire Uterine Kind team who are hard at work building the most comprehensive uterine health platform, which will debut in the fall of this year. Called Uterinekind, we promise it will improve the experience of uterine care for everyone. Those needing uterine care and those providing it. So please do go to hello uterus.com give us your first name and your email address. We will keep that protected and keep you updated on our progress. Thank you so much for being here. Thank you for listening. I hope you found the information useful know that you have a place to come to get uterine health information and definitely as we are in this fight to protect our right to body autonomy, we will be here every step of the way. So that's a wrap again. I'm Carol Johnson. Thank you for listening. I'll be back next Tuesday for more of hello, uterus.