I see lots of different women in my clinic for different women's health issues. There's one woman who came to see me and her whole condition and what she'd been through really stuck with me. And it just highlighted a real bigger problem than just what she was struggling with.

So she had had a full abdominal hysterectomy. So she had a really large scar going vertically down her stomach.

and she'd also had her ovaries removed. So she was put into surgical menopause. But what got me was the fact that she had had no follow-up. She'd had this major operation. So not only the operation, but also being forced into menopause. And she had no guidance or support. She was given some HRT and basically told to get on with it. I think she might've had like a telephone consultation as a follow-up.

But she's been really struggling. She had pelvic floor issues, pain in her stomach, obviously the recovery from the operation, but also starting to get all of these menopause symptoms. And she came to me and she was struggling. Luckily, she found me and she herself says she's very grateful that she came and found me. Unfortunately, that isn't available to everybody. Not everyone can afford to get private help.

But this particular lady, she came to me, she's self-employed, she was really worried about going back, she had quite a physical job and she wasn't sure whether she would be able to get back to work, whether she would like longer term have problems and I'm still seeing her at the minute and we are making good progress.

But she was struggling no what exactly to do because she had had no support. And you can imagine how frustrating that was for her. But I was quite angry at the fact that she had been left with no support, nothing to get on with. She was just like, get on with it. And it's not just her.

That's the thing if it had been a one off like they've been busy and I didn't COVID there was issues because they couldn't get people in to follow up. But it isn't just her. This is a story and similar pattern that has been going on throughout my career. Now I've been a physio for like 20 odd years. And this is not a new thing. But you think it would have got better. But women are being left to get on with it.

it is a lack of education, they're not getting the follow ups they need. And also they're not told what to expect and what's normal. So they just go in, they say this is the surgery you need. Sometimes hysterectomies are given too readily. But people think because they are so common and things that have been done to many of their friends and family, that it is a small procedure. It is not and it depends, it could be vaginally, it could be

abdominally like this lady. It is not just hysterectomies that this goes for. It's all women's health surgery. Any gynae surgery, there's so many people that I have seen that have been, had the surgery, discharged quite quickly from hospital, told to get on with it.

If however, you'd had a knee replacement or a hip replacement or any kind of orthopaedic surgery, yes they are getting people out quicker and quicker these days. When I was a little junior physio and we were treating them on the wards, most knees would be in for at least five days and the hips would be at least three days. Now they're trying to get people out within the same day or a couple of days. However, if you've had an orthopaedic operation,

would get physio afterwards. So all knees got routine physio appointments, hips if they had any issues would get physio. They would be seen regularly. So all surgeries would be seen by the orthopaedic consultant to have a follow up and they're followed up later down the line as well. So not just initially, they're followed up like at six months and a year and they have clear outcome measures that they have to reach. So particularly with the knees,

they have to get over a 90 degree bend. So if they're not achieving that, then the orthopaedic consultants do other interventions in order to try and achieve that. And they are given all of the information, they're given education before, they're often given education afterwards. But if we contrast that with most gynae surgeries, which are still major surgeries, and often abdominal surgeries are harder to recover from,

than having certainly like a hip replacement. Knees, yes, they are more difficult, but certain surgeries are fairly straightforward to recover from, but they get lots of follow up. But yet, if women have had, hysterectomy or even a C-section. So after having babies, when women have had a C-section, again, there's little to no follow up.

They might, if they're lucky, get a six-week check, but that's normally for the baby. They're not bothered about what the wounds are healing, and they're just left to get on with it. But again, another major surgery that they are not giving that follow-up. And with any gynecology surgery, there's no routine physio. They don't have a structured rehab plan. They don't have clear recovery markers they have to reach, and if they don't reach, then they get more support.

But why? Why is the support for women so far behind any other surgery? So okay, women can have knees and hip replacements, but I mean, specific women's health surgery. And it is not just that short term impact of having a hysterectomy. So once we've recovered, it might take six months a year to recover fully from the surgery. If somebody is then be forced into surgical menopause,

if they've had their ovaries removed, or even if they haven't had their ovaries removed, their ovaries could still fail and then lead them into surgical menopause. Or even if they've gone past the menopause, it does potentially leave you at more risk for other issues such as incontinence, prolapses, other things that could lead from it.

So those long-term consequences, so particularly if you've been forced into early menopause, then we've got to think things like bone health, heart health, brain health. So it's not just the surgery. It is that ongoing lifelong issues that could be caused from it. So why are we not offering

long term support or at least education about long term management. So this particular lady she was given HRT, but again, with minimal guidance, she just chucked on a certain level of HRT. That's it, really. So if she wants to have that looked in, she's going to have to go and see her own GP. And we all know how difficult it is to get a GP appointment. We need women to have that education.

before they're having surgery, unless obviously it's an emergency and we can't change it, ideally you should have education about what the surgery is, what recovery looks like, what is normal, what is not normal, when should you seek further help, how can you manage certain symptoms if it's something like surgical menopause, then we need to look at bone health, you need to be doing some resistance and weight-bearing exercise.

If it's other menopause symptoms such as sleep and brain fog, how do we manage those? But we don't. I know the NHS is really, really stretched and we are lucky to have an NHS. We could be like some other countries where you're having to pay for your private medical healthcare and then if people can't afford it, they don't get any support at all. So I am not knocking the fact that we've got an NHS in the UK. We are very lucky. However,

We are having to wait a very long time to see people. We are not given the follow up and the support that we need to. And even if you look at it, at other conditions, now I know we've got limited budget, but certain conditions such as diabetes, thyroid issues, other conditions are supported. There's full on diabetes clinics. There is clinics for rheumatology and other conditions.

So there's so much support that is offered for many chronic conditions, which is fantastic. And they are monitored. But why is there that big gap with women who are struggling with endometriosis, having gynae surgery, menopause? So there's every woman will go through menopause yet. The support for that is, I guess it's getting better and we are more aware of that. But there isn't the same support.

as some of these other conditions. Whereas not everyone will have diabetes, but every woman, so 50, 51 % or 49, I'm not quite sure what the split is of men to women in the world, but roughly half of the population will be struggling at some point with menopause. So why do we not have that same support? It should be standard. I know funds are going to change what's available. However, this is

Why I feel so privileged to support these women because sometimes I am the last port of call that they've struggled to get support elsewhere. They've been left to it. They don't know where to turn and they come and see me and then I support them through their recovery and that to me is a privilege and an honour to help that. And I feel that nobody should be left without support. And the whole reason I started a lot of my business

I've been a women's health physio for quite a long time, but in terms of getting into menopause was the fact that my sister went through a stem cell transplant, which was age 37, 38, and was forced into menopause. She wasn't told that would happen. So therefore she had no education and she struggled for two years with symptoms that I kept on saying to her, that sounds like menopause. And she went back and forth to the doctors and after two years, they finally decided, okay, yes, you can have some HRT.

and support you longer term. But that's it, she doesn't give me any other education, she's just given the medication. So if you are struggling with any women's health condition, if you're struggling with menopause, if you've had a hysterectomy, I just want you to advocate for yourself. Don't be fobbed off. I know that's easier said than done when you're talking to a health professional, but try and have any questions that you have.

written down if you're going to see somebody. Ask to be referred on to a specialist if the GP is not giving you the support that you need. Look for other ways to get support. There are groups and support groups out there, but really try and advocate for yourself. And if you are struggling or you are unsure of where to start, support is available and you don't have to figure it out all by yourself.

And if you've had surgery and you feel like that you've just been left to get on with it, please don't ignore that. You deserve that support and guidance. If you're not sure where to start, then reach out to me. I can offer you support both in person and online, or I can guide you to who you need to see. So it could be that...

you want to find someone locally to you, but you're not sure who it is. It could be a women's health physio. It could be going to see the GP, but do reach out. If I can't help you, then I will give you advice on where you could go.

Please don't struggle by yourself. Please seek support, whether that is from your GP, someone like myself, or if you're in other areas of the world, seek out what is available in your area. Until next time, take care.