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It’s vital to remember that mental healthcare is healthcare, and there’s no shame in asking for help when you need it, whether that means talking to a loved one or seeking therapy. Being vulnerable can be extremely difficult, and the process of finding a therapist can often make it more difficult. But there are organizations out there working to make mental healthcare more accessible, most notably BetterHelp. With 32,000 licensed therapists, the health app has facilitated over 350 million therapy sessions and connected over four million people with therapists—all while creating an environment where people feel comfortable to speak freely about their mental health. 

If the thought of seeking therapy is scary and overwhelming to you, you aren’t alone—one in four Americans has reported symptoms of anxiety or depression. Luckily, BetterHelp’s top priority is to connect you with a therapist who will support your specific concerns, taking the burden of finding the right therapist off of your plate.  Right now, BetterHelp is offering Marie Claire readers 25% off their first month (up to $70 in savings). The process is super simple: Fill out a brief questionnaire in order to get matched with a licensed therapist in as little as 48 hours. The app is designed to work around your schedule, with a personalization portal that helps you schedule weekly live sessions with your therapist and log your progress. 

At Marie Claire, we believe that taking care of your mental health is the key to living a happy and healthy life, and a conversation with the right person is the best place to start. 

I have a deep-rooted hatred for working out—always have. I strongly dislike getting ready for a workout (it’s a whole production), I actively despise sweating (RIP blowout), and quite frankly, I feel just fine, albeit in need of a shower, after the fact. It’s always been a chore that I would gladly neglect for weeks or even months at a time. Sure, I went through a SoulCycle phase in college, and I credit Melissa Wood Health exclusively for my sanity during the height of the pandemic. But overall I’ve never really been a fitness devotee or stuck to any form of a regimen. I maintain a healthy diet and walk everywhere, but getting my heart rate up has quite frankly just happened when it's happened. Am I proud of that? Absolutely not, but I’m writing this under the premise that honesty is the best policy—so don’t judge.  

But we’re here because my outlook on working out changed. The question you’re asking: How? Why? Allow me to take you back in time. January 2023 to be exact. All of my friends decided to get on the New Year’s resolution bandwagon and hand over $89 a month for ClassPass, a platform that partners with workout classes and studios to offer subscribers a discounted monthly membership in their area. 

Personally, I thought they were going through a ~phase~ and I was willing to die on the hill that paying to exercise was, excuse my language, a load of crap. YouTube has videos! MWH is $10 a month! Go for a run! Still, their ~phase~ persisted. They went to classes together and discussed ad nauseam how they planned to allocate their 43 monthly credits. (The primary subscription offers 43 credits per month, with most of the coveted classes between seven to 14 credits.)

Eventually, I caved. Chalk it up to jealousy or the momentary dedication to get toned for summer, but I signed myself up for ClassPass. I could be cheesy and say that I never looked back. But in reality? I eased into it—one class a weekend. I went to BK Pilates with my friends on a random Saturday afternoon. I begged my ClassPass friends to accompany me to a Taylor Swift Reputation X Lover SoulCycle ride (Eras Tour, here I come). I  somehow even let my old college roommate swindle me into doing a dance cardio class. For the record: I have negative rhythm and/or coordination. I reached a point where doing a class was more of a social interaction than an actual workout. 

As time went on, I found myself scrolling through the depths of the ClassPass app—exploring niche offerings. To my surprise, I was able to book massages (shout out Body Roll Studio), could get a manicure at Glosslab (just four credits, you guys!), or even book a personal training session. The opportunities? Endless. I slowly but surely got more daring with my selections. A solo Sunday evening acupuncture became my weekly reset ritual. I went rogue and signed myself up for whole body cryotherapy, aka standing in a freezing cold chamber. I embraced the credit allotment game.

I also decided to sign up for a boxing-meets-self-defense class. I took karate for years when I was younger (green belt at your service), and have always regretted giving it up. My flying front kick is by no means what it used to be, but something about exercising that skill, that once upon a time I loved so much, allowed a flip to switch in my head. I realized that these classes, treatments, whatever they may be, were actually just time set aside for me, myself, and I. They weren’t related to work, weren't social obligations I secretly dreaded, and, perhaps most notably, they doubled as a nice 45-minute slot of phone-free time. 

It was at this point that I started viewing my subscription differently. Putting time on my calendar for a class is now my top priority for the week—I schedule my life around it. It doesn't matter if I’m breaking a sweat or laying down like a bum during a massage, ClassPass has become my built-in excuse to just take a beat and a breather from everyday life. It’s become my back-to-center, pressure-free, me time. I’ve circled back on old hobbies, seen my friends more on weekdays than I ever thought possible, and, from a more literal perspective, am stronger than I’ve been in a long time. I'm able to approach my other responsibilities with a clearer head and am more thoughtful in how I spend my time. But most importantly, I no longer look at working out as a chore. I’ve actually come to cherish the time I dedicate to exercise—even if it messes with my hair washing schedule. 

Call me a cliché, but every year, come January, I get reignited to work on my health. Sure, maybe I fall into the wellness-kick marketing trap that every retailer puts out in the new year, but nonetheless, I always take the time to consider my goals for the year and what it would take to achieve them.

It was during this period of reflection that I realized something wasn’t clicking with what I was doing health-wise. So I got sucked into an internet rabbit hole, researching all the latest health supplements, gadgets, and programs, before I eventually discovered the Oura Ring. But before I get into my review of the small, but mighty health tracker, let me take you through exactly what led to my discovery. 

I’d like to think that on paper, I’m a pretty healthy girl. I work out every morning to get my day started, I drink lots of water, and I try to get away from my desk every once in a while. Plus, I eat most meals at home and tend to get in at least 8,000 steps a day. But even with these habits, I still wasn’t feeling healthy. Some days, I felt ready to take on the day during the morning hours, but was dozing off at my desk by 3 p.m. Other days, I felt so sore and groggy that just getting out of bed was a struggle. All in all, I knew something was keeping me from feeling like my best self. Maybe I wasn’t getting enough sleep, or maybe I wasn’t letting my body recover from the gym. Whatever the case, I was on a mission to find out. 

After doing some digging, I came across a ring seen on the likes of Kim Kardashian, Jennifer Aniston, and Gwyneth Paltrow that wasn’t just any ol' piece of jewelry—it was actually a fitness tracker called the Oura Ring, which prides itself on its accuracy. Built with tiny sensors and accompanied by an app, this ring measures different health metrics, from resting heart rate to body temperature and more, to provide you with a set of three daily scores: sleep, activity, and readiness. Over time, the ring starts to learn your body and its patterns and provides actionable advice on how to improve your health. I thought that this little gadget might finally reveal the missing link to reaching my goals, so I had to test it out for myself. 

Well, after a little over a month of wearing the ring day in and day out, I can definitely say I’ve learned a lot about my body. 

Let me first go into the ring’s sleep function: I thought I was OK in the sleep department. I average just under seven hours of shut-eye a night, which, compared to some of my friends, is fantastic. However, according to the Oura Ring, I wasn’t getting enough sleep to recover from my workouts. It then set a bedtime frame for my optimal amount of sleep, taking into consideration my average wake-up time. Lo and behold, on days when I'm able to fall asleep during Oura's suggested time frame, I wake up feeling like a million bucks and stay alert throughout the day. No joke. 

Another aspect of the Oura Ring that's changed my lifestyle is the gadget's readiness score. Every day you wear your ring, it provides you with a score, scaling from one to 100, that reveals how “ready” you are to take on the day, based on the activity and sleep you logged the day before. I ignored this score one fateful day, and, let me tell you, I’ll never do it again. I'd woken up feeling a bit tired, but thought, nothing out of the ordinary—then saw that I had a readiness score in the forties. Did I let that deter me from my morning workout? Of course not! Flash forward an hour later, and I found myself struggling to finish my workout because my body felt so achy and congested. As it turns out, I'd spent the previous night tossing and turning in bed. My body had come down with a cold, but I hadn't realized it yet. I was amazed that this ring knew me better than I knew myself, and now I check my readiness score each day as though it were the morning news.

The third aspect of the Oura Ring that stands out is its activity meter. While I find it has the tendency to over-inflate the number of steps I take, I love Oura’s activity notifications. I’ve heard that sitting still is the new smoking, and working a desk job for eight hours a day means that I’m doing a lot of it. Oura reminds me to move when I’ve been sitting for an especially long time, and these little nudges always manage to get me out of my chair. 

Plus, the Oura Ring provides so much more than just those three features. The ring also unlocks access to an in-app library of guided meditations for sleep and relaxation, plus tons of guides on various health topics, all of which make for quick, interesting reads. And for a monthly subscription of $5.99, you can access even more content, including in-depth features like sleep charts and period prediction. Given that $5.99 is the price of most people’s coffee order, I'd say it's pretty worthwhile.

As far as fitness trackers go, the ring is also a huge winner in terms of style. I’m not a big ring girl, but I do wear my grandmother’s gold wedding rings every day, and I’m pleasantly surprised by how well the Gold Horizon style fits in. Worn on my index finger, it looks like a statement piece, and is so much more chic than those bulky fitness trackers that instantly kill outfits.

Of course, the Oura Ring is by no means the end-all-be-all to solving your health woes. But it does make you more conscious of your body’s natural patterns. After some wear, you’ll learn when to go to bed, when to take it easy, and when to get up and move—all of which help you feel your best. I myself have learned all of these things from the Oura ring, and while I don’t feel 100 percent every single day, I definitely feel like it more often than I used to. Nowadays, you can catch me checking the Oura app every morning to see how ready I am for the day. Plus, you'll always be able to spot me by the smooth gold ring on my finger. 

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“Milk has had a long history of supporting athletes—in some ways we say we’re the OG sports drink, because we’ve been supporting athletes for 7,000 years,” says Rani. “But it was amazing for me to discover that only 7 percent of global sports sponsorships go to female athletes—7 percent of a $30 billion pool. They put in the same effort, they have to run 26.2 miles just like everybody else, but their odds of being sponsored by a major brand or any financial sponsorship is much lower. We really wanted to support their journey.”

Through 26.2, everyone who identifies as a woman that will be running the next NYC Marathon is invited to join #TeamMilk and be a part of something big. Running with #TeamMilk means getting world class training advice from the pros, essential gear for race day, and support in post-race recovery. Plus, it gives runners the chance to connect with other women in the #TeamMilk community, who will be cheering each other on during the race. 

But what makes 26.2 really special is that every woman who joins #TeamMilk will see their registration fee matched—up to $600,000—in aid of Girls on the Run, a nonprofit that offers athletic youth development programming to girls of all backgrounds and abilities. 26.2 isn’t just supporting the women who will be out there on race day, but ensuring that girls everywhere are equipped with the resources they need to succeed in the future. “As we know, running the marathon isn’t something where you just show up and do it,” says Rani. “We want to use our dollars to shine a light on them, feature them in our advertising, and then additionally help encourage young runners through our donation to Girls on the Run.”

The opportunity to support women inspires Rani, both in her personal life and as MilkPEP’s CEO.  As a mother and an advocate for the Asian American Pacific Islander (AAPI) community, Rani is keenly aware of how important it is for girls to see other women in positions of leadership. “When I would speak at events, invariably at every single event there would be a young Asian American woman or two that would come up to me after and say, ‘It’s so amazing to see someone like you,’” she says. “I just started to feel like I had to do something to help those young women—be more of a role model and be more active.” 

Her efforts to get involved ramped up during the pandemic, which saw a spike in racism toward the AAPI community. Rani joined a group of senior Asian American marketing professionals, who not only provide mentorship to the next generation but form a support system for one another as well. “For me, an empowered community has been super helpful. I always encourage people to find a community they can attach to, [like] this group I joined during the pandemic,” says Rani. “I always say about it—and it’s a little heartbreaking in some ways—that I didn’t realize I was lonely until I wasn’t alone anymore.” 

That multigenerational support is also why choosing the 26.2 Program to sponsor Girls on the Run was a natural fit. “Girls fall out of sports,” says Rani. “More and more of them fall out of it younger and younger, and by high school the drop-off is really very frightening compared to boys, for all kinds of reasons. So every little bit we can do to keep a girl active and athletic in whatever she chooses to be is just good for mankind, frankly.” 

And like the runners who inspire her, Rani is no stranger to a challenge. As the CEO of MilkPEP, Rani is propelling the complex and dynamic milk industry forward by speaking to what modern moms like her actually care about. Rani recognized that milk’s immune system boosting properties, its ability to hydrate better than water, and its essential nutrients,   could position it as the ideal performance beverage. Plus, the learning experience that has come from her work in a once-unfamiliar industry has been a fulfilling journey all its own. “I was super impressed with the people I met in the milk business,” she says. “I’m a total city girl—I’m from Singapore, I lived in New York City. I am not from the agricultural sector at all. And I was just so amazed by the farmers and the milk companies themselves, what good people they were, trying to do the right thing by the customer and the stakeholder. This was the kind of environment I wanted to operate in.” 

From there, it was clear to Rani that the NYC Marathon was the perfect place for MilkPEP to showcase their commitment to supporting and empowering women now and in the next generation. “We really believe in action—not just ads,” she says. “It’s been a nice additional layer to some really powerful advertising to help an organization like Girls on the Run that is changing young girl’s lives.”

To learn more about MilkPEP’s 26.2 initiative and to join #TeamMilk visit gonnaneedmilk.com/26.2 and visit their Facebook. 

“You’ve locked the door,” my friend said patiently, already halfway down the stairs of my building. “And all the burners are off, and the iron is unplugged. But you can check again if you need to.”

“I have OCD,” I explained sheepishly, even though I’d told her many times before.

“I know,” she said, “so we can stay here as long as you need to.”

I like to tell people I have clinical Obsessive Compulsive Disorder pretty early on in our relationship for precisely this reason: It adds a layer of understanding and, ideally, patience to my behaviors that I’m not sure I’d be lent otherwise. It also explains why it takes me ages to leave the house; why I need reassurance about basic things; why I’m chronically late to everything. It’s difficult to run out the door when I need to check the doors, the windows, and the stove several times over. Sometimes, I even take photos of these things in anticipation of the inevitable moment I question myself later.

OCD, I explain to people, isn’t truly about cleanliness or organization. For me, the main manifestation of OCD is a near-constant chorus of negative, repetitive thoughts based on my fears. These thoughts tell me something terrible is going to happen if I don’t wash my hands, dump out that water, tap a banister on my way down the stairs, or double back to step on the same slab of sidewalk again. They tell me I’m terrible; that I’m irresponsible and therefore left the door wide open; that anything bad that’s ever happened to me was something I deserved.

Like many people with OCD, I started experiencing symptoms when I was around 11 years old (symptoms usually begin manifesting during early adolescence). I didn’t realize there was a name for my illness (or that I was even ill at all) until almost 15 years later, when I was diagnosed in my mid-20s. I long knew there was something wrong—that I didn’t think the way other people thought—but I’d attributed it to some innate emotional instability; some inner weakness that I could erase if I could just be better. After all, I wasn’t “hearing voices,” per se. The thoughts sounded just like any other thoughts (which is what made them so confusing), but these were far more frequent, far more negative, and I couldn’t gain control over them. And because I’d never heard of anyone experiencing intrusive thoughts, I assumed I was alone in my perceived madness, and therefore was better off keeping quiet about it.

It’s easy to feel lonely when you think there’s something inherently wrong with you, and that it’s entirely your fault, and that no one in the world is experiencing what you’re experiencing. OCD is exceedingly rare, impacting around 2 percent of Americans, which is, perhaps, why it’s so misunderstood. Explaining OCD to a world that believes the illness to be nothing more than a predilection for hand sanitizer and the Container Store is almost as frustrating as the disease itself. 

After I was diagnosed, I surfed through Reddit and discovered many people feel trapped by their OCD diagnoses. It is manageable but incurable, and it’s difficult to come to terms with knowing you have an incredibly invasive, hopelessly permanent condition. It’s sort of like getting the flu and being told you’ll have it for the rest of your life.

But for me, the diagnosis was a relief: I finally knew what the problem was and, though it was a rare one, I was still far from alone. As a writer, it’s important to me to be able to express myself, and having the words to communicate—both to myself and to others—the inner workings of my mind was like finally being able to exhale after more than a decade of unwittingly holding my breath. The term Obsessive Compulsive Disorder was the missing piece of the puzzle in my journey to understanding myself, and to helping others understand me, too.

And although I refuse to be limited or defined by my OCD, I do think it’s an important factor to take into consideration as I move through life. People with OCD are at a higher risk of developing eating disorders (which I’ve had), insomnia (yup), depression (been there), and substance abuse disorders. This is because OCD is about control—something life often robs us of—which can be enough to send OCD patients into a tailspin. Having the disorder is like seeing the world through hyper-anxious lenses, which can be tempered when life is calm, but increase in severity once something bad has happened.

An example: When I was 20, I developed PTSD after a violent rape. I wasn’t yet diagnosed with OCD and had no idea what was going on when, suddenly, my negative thoughts spiraled out of control, preventing me from sleeping well for years. There were times when I thought I’d need to be committed because I didn’t yet have the ability to make sense of what was happening to me, or the vocabulary to communicate my inner turmoil to my loved ones. I didn’t understand that I had a condition that magnifies the impact of states like depression, anxiety, and PTSD, so I thought that my sanity was slipping from me. And I was so baffled by and ashamed of my mental state that I refused to tell anyone, unsure of what I’d say if I tried to.

That experience, above all else, is why I’m so cavalier in speaking about my OCD today. By labeling my intrusive thoughts and exposing them to the world, I’m able to rob them of their power and reduce the compulsions that accompany them. OCD may be incurable, but having a logical reason for my illogical thoughts has enabled me to dismiss them more often. And the ability to communicate my anxiety to the people around me has made me feel infinitely more authentic and seen.

An OCD diagnosis is never good news, but for more than a decade, I felt like I was living in the dark, always afraid of some monster lurking in a corner. So it’s nice to finally turn on the light; nice to discover that I have the ability to turn that light on whenever I want to; and even nicer to find that the monster, in reality, was never  more than a coat rack.

In the month of August, Propel Fitness Water is headed to Detroit, MI, for the final summer tour stop. During every weekend in August (8/6-8/28), free fitness classes and product samples will be available to all exercisers who show up for a glow up. Propel's lead Detroit trainer, Amina Daniels, who is the founder of Live Cycle Delight (LCD) (two studios that prioritize body work and shared energy), will be one of the trainers leading workouts. 

Daniels is an avid cyclist and yogi, and her studios focus on enjoyment, awareness, and safety. She works hard to promote fitness in her community; LCD has been open for over five years, and their local events have included neighborhood block parties and teen wellness takeovers. 

The JOWO campaign also includes community giveback—Daniels received a donation to help support her fitness work. In total, Propel Fitness Water has donated $100,000 to trainers around the United States who embody the spirit of inclusivity and community that make working out joyous. 

Participants at these live events can look forward to a variety of exercise classes, ranging from running to HIIT and plyometrics, all taught by top-notch instructors. Get ready to sweat and bond with participants in the warm weather at a variety of outdoor locations. Even better? There are a ton of ways to connect and even win free gear. 

Even if you don't live in the area, you can still get involved: Follow @PropelWater on Instagram and post a post-workout selfie using #JOWOGlow for the chance to win workout swag. Propel Fitness Water wants exercisers of all ability levels to participate in their campaign—and it doesn't matter how you like to work out, so long as you're channeling your JOWO.

@propelwater

♬ original sound - Propel Fitness Water

Propel Fitness Water is formulated for fitness and the perfect companion to all this exercise. Made by Gatorade, it’s the only zero-calorie, zero-sugar electrolyte water beverage among national enhanced-water brands with enough electrolytes to replace what's lost in sweat.

To find their own version of JOWO, people who live in Detroit can join trainers, including Daniels, for free fitness classes at the #PropelYourJOWO tour stops in August. Learn more and see the schedule at PropelYourJOWO.com. 

No purchase is necessary to enter the sweepstakes. It is only open to those 18 or older who reside in Michigan, and it ends 10/31/22. For complete details see the Official Rules.

This isn't your typical wellness issue. There are no fitness routines or recipes for losing weight. No, this issue is about being well in the well-rounded sense. About destigmatizing mental health in our culture, through pop culture. About breaking the patriarchal medicine mold. About considering the emotional and psychological impacts of something that seems very physical. We explore the body-brand paradox and identify what to download to actually feel better. This is a celebration of a new wave of wellness and we're so glad the tides are changing.

Through her rise to fame on The Office to creating some of streaming’s biggest hits, the actress, writer, and producer has transformed Hollywood. But her most fulfilling project yet is happening behind the scenes—as a mother, mentor, and mogul. 

For women whose livelihood is yoked to their physical self, the concept of wellness is highly complicated.

Removal of the uterus can have consequences that go far beyond the physical. 

The founders of these startups were unwilling to wait for the massive ship that is the American healthcare system to course correct for women.

This summer, spread the love of exercising.

Say goodbye to diet culture myths, expensive fads, and pseudo-science—and hello to frank, funny conversations about healthy minds and bodies.

Jacques’s doctors finally figured it out when she was 15—she had endometriosis, a disorder that causes cells similar to the uterus or endometrium to grow outside of it and which affects roughly 10 percent of women under age 50. But after attempts to treat the problem with birth control and a period of forced menopause, her doctor made his final recommendation—the removal of her uterus. A hysterectomy. Jacques was just 17.

“I felt like I had nowhere else to turn,” says Jacques, now 31. “I just wanted to be a normal kid going off to college without this pain. I was just like, Okay, get the surgery. Let me get my life back.”

Jacques’ life post-hysterectomy (she later found out that part of her cervix was removed, too) was far from what she expected. Within a year of the surgery, she began experiencing signs of endometriosis again (intense cramps even though she wasn’t menstruating, stabbing lower back pain, and dozens of ovarian cysts, many of which would rupture), which doctors dismissed as impossible, she remembers. Then another troubling symptom began to develop—a dip in her mental health. 

“I was down and at my wit’s end. I felt hopeless,” she says. She took medical leave from law school because of her symptoms. “It was a complete mess.”

At the time, Jacques didn’t understand the cause of her struggles. Since then, the reality of her situation has crystalized: Not only did removing her uterus not cure her endometriosis, as her doctors promised, it also led to a long list of harmful side effects, including a life-long struggle with mood issues and chronic pain. 

Though it may sound extreme, Jacques’s story is not unique. A hysterectomy may be prescribed for symptoms ranging from abnormal uterine bleeding and uterine fibroids to pelvic support problems and gynecological cancer. (Black women are diagnosed with fibroids nearly three times as often as white women, and tend to develop them earlier in their lives; they are more than twice as likely to receive a hysterectomy as their treatment.) Hysterectomy is the second-most common surgical procedure for women in the U.S., after the Cesarean section. More than 400,000 women get hysterectomies every year in the United States, according to an article published in the journal Obstetrics & Gynecology in 2014, and some estimates show that more than one-third of U.S. women will have one by age 60, although the rate that the procedure is performed declined significantly from 1998 to 2010. 

It’s important to note that many women who have hysterectomies are happy with their choice and do not report any negative side effects. It’s also important to note that there are some instances when a hysterectomy is life-saving. One is in the event of cancer, either cervical, uterine, or ovarian. Another extremely viable reason for hysterectomy is as part of gender confirmation for transgender men. 

Still, the vast majority of hysterectomies are performed for benign conditions. A 2015 study found that nearly one in five women who undergo hysterectomy may not need the procedure. The rate of unsupportive pathology post-surgery was especially high in women under 40, nearly 2 in 5 women. The study found that nearly 40 percent of women were not offered alternative treatments for a benign condition prior to surgery.

The question of necessity becomes particularly important when considering that a total hysterectomy will result not only in early menopause and the inability to carry a biological child in the future, but also, as women like Jacques have reported, mental and emotional side effects. Women we spoke to say their doctors dismissed their distressing post-surgery symptoms with a patronizing “it’s all in your head.”

“I wasn't asking for the hysterectomy,” says Jacques. “It was very much pushed on me.”

In Ancient Greece, it was thought that the hystera, or womb, wandered throughout the body causing mental and physical problems. In the 18th and 19th centuries, female hysteria was a disorder diagnosed mainly in women—a Canadian psychiatrist even advocated surgically removing the womb to cure women of mental illness. Smelling salts used by Victorian women presumably snapped that errant womb back into place. In the 1968 Diagnostic and Statistical Manual of Mental Disorders or DSM-II, hysteria was listed as a mental health condition, only dropping from the DSM-III in 1980. In summary, wombs have long equaled a propensity for neuroses. 

It’s not an entirely preposterous assessment. The connection between hysterectomy and mental health issues is clear: According to Mayo Clinic research, women are at greater long-term risk for anxiety and depression following a hysterectomy; if they underwent the procedure between the ages of 18 and 35, that risk nearly doubles. Hysterectomy patients also have an increased risk for bipolar disorder; endometriosis and hormone therapy may add to the risk of bipolar disorder after the procedure.

While the term hysterectomy technically refers to the removal of the uterus, the procedure sometimes includes the ovaries, fallopian tubes, and/or cervix. In fact, 300,000 women in the U.S. have their healthy ovaries removed every year. But even when the ovaries are kept intact, a hysterectomy can cause them to eventually stop functioning. One study found that 25 percent of women lose ovarian function by six months post-hysterectomy. According to Dr. Philip Sarrel, professor emeritus of Obstetrics, Gynecology, Reproductive Sciences, and Psychiatry at Yale School of Medicine, and president and founder of the Advancing Health After Hysterectomy Foundation, this could be due in part to the loss of the shared blood supply between the organs.

There’s likely one major cause for this mind-uterus connection: hormones, or the lack thereof. Research into the function of female hormones beyond their role in fertility is severely lacking, but we do know that when a woman’s ovaries stop producing estrogen (a potential result of a hysterectomy), she can experience a bevy of negative side effects. One paper published in Menopause Review in 2018, for example, connects estrogen deficiency with depression, psychological tension, anxiety, mood swings, loss of libido, and decreased self-esteem. 

Some of these issues (plus memory loss and brain fog) occur with the natural lessening of estrogen due to menopause, which typically happens gradually and naturally around age 50. But when a woman goes into early or forced menopause, the likelihood of these symptoms occurring rises. For women still in child-bearing years, a hysterectomy can be a form of forced menopause. 

The connection between estrogen and mental health isn’t well understood. But we do know that the ovaries form a connection to our brains as part of the hypothalamic–pituitary–gonadal axis (HPG axis), a major signaling pathway that regulates the reproductive system. Even after menopause, this system makes hormones that keep women healthy for their entire lives. If the ovaries are removed entirely, those hormones are no longer being produced. 

Some experts also speculate that ovarian hormones modulate the serotonin system, and therefore mood. But the mechanism of that relationship has yet to be discovered. Dr. Sarrel thinks that the impact of a hysterectomy on mental wellness also has to do with the actions of estrogen on nerve transmission, as well as blood flow to the brain. He cites a growing body of research (including his own) that points to hot flashes having something to do with post-hysterectomy depression.

But even without a perfect understanding of why, Dr. Sarrel concludes simply: “Estrogen plays an essential role in biological existence. And it has for 600 million years.”

In Jacques’ initial surgery her doctor did preserve her ovaries. But not long after, she had to have one of them removed because it was covered with endometriosis. Her new doctor says the remaining ovary “isn’t that healthy-looking,” but has advised her to leave it in order to keep her hormone levels as steady as possible—and therefore her mental health.

Alternatives to hysterectomy for non-life-threatening disorders include laparoscopic procedures, medication, and a hormonal intrauterine device (IUD). OB-GYN Iris Kerin Orbuch, M.D., author of Beating Endo: How to Reclaim Your Life from Endometriosis, believes that too many doctors jump to performing a hysterectomy when they encounter a patient who is having pelvic pain. “You can’t be knife-happy,” she says. Dr. Orbuch describes patients who had a hysterectomy at 17 or in their 20s, who come into her office, “in tears because they're like, ‘My doctor said my pain was going to get better. I always wanted a kid. I'm still in pain…and my dreams are shattered.’ They never should have had a hysterectomy in the first place.” 

She advocates for treating underlying issues causing the pain before turning to surgery. Skipping right to a hysterectomy, she says, doesn’t handle other causes for pain, like tight pelvic floor muscles. “And now, you've shattered their childbearing dreams,” she adds. “It's devastating; you can’t just glue a uterus back in.”

With endometriosis, cells that are similar to the uterus lining or the endometrium are found outside the uterus, explains Dr. Orbuch. The inflammatory changes caused by these cells can alter the structure of the pelvis, pulling things to the left or right or the back. “Unfortunately, too many women are being treated with a hysterectomy for endometriosis, but it doesn't make sense. Their pain is outside of the uterus.” 

A hysterectomy is, however, the definitive treatment for adenomyosis. It is “a cousin of endometriosis,” she says. “Adenomyosis is when you have those cells that are similar to the lining of the uterus or endometrial-like cells, but they're found within the smooth muscle of the uterus. So their location is in the uterus. Women with adenomyosis can have heavy bleeding. They tend to have a low sacral backache. They tend to have midline pelvic pain, a heaviness in their pelvis.” Many women have both endometriosis and adenomyosis, “not always, but very often,” she says, “so it gets a bit complicated.” 

When surgery is the best option, Dr. Orbuch discusses all eventualities, including, if the patient still has ovaries, using their eggs and a surrogate. “I spell that out to them. I spell out that it may not help their pain, we don't know. I spell out that they could develop scarring or lesions, which may cause more pain. So any surgery theoretically can beget more pain.”

Jenneh Rishe was 30 when she had her hysterectomy. She was in a serious relationship but not married, and the couple wasn’t sure about wanting kids. Her symptoms included pain with sexual penetration and constant pain in her back, hips, and groin; during a pelvic exam she “was jumping off the table” every time the doctor touched her uterus. Rishe had been diagnosed with endometriosis and later adenomyosis. “I didn't know what specifically was causing what. The surgeon asked if, when he was doing the endometriosis surgery, if he needed to, [could he] take [my] uterus?”  

Faced with a decision about her “forever fertility,” she didn't feel prepared to make such a permanent choice. “So I told my surgeon that if, when he's in there, he's very suspicious of adenomyosis, he [could] do a different procedure, which is called a presacral neurectomy. Basically he would sever the nerves that send pain signals to my uterus. So I wouldn't feel pain. So that's what we did.” That gave her relief for about six months. Over time, she started “feeling bad again,” she says, with terrible back pain and “pelvic spasms that would bring me to my knees.” She had brain fog and was tired all the time. She tried everything she could to avoid having a hysterectomy—an IUD, steroid injections, physical therapy. “You name it, I tried it. I really did give everything a shot before deciding to move forward with the hysterectomy,” says Rishe. Ultimately, it was about her quality of life. “I was functional enough to go to work and barely manage through my day. I was taking every kind of THC and CBD [I] could. I'd have, underneath my clothes, a heating pad and a lidocaine patch. That was my every single day.”

She and her boyfriend sat down and asked themselves, “‘Just what is the point of all this?’ We both didn't know if we wanted kids. We weren't married or engaged or anything. And so I had to make this decision for myself, but also for somebody else, essentially.” Her dilemma after a year of trying to manage: Hold out for something she’s not even sure she wants and “stay miserable” or have the hysterectomy?

In 2017, she decided on the latter. “And, of course, I felt a lot better,” she says. “As I expected to, physically, I felt amazing.” She was, however, unprepared for the wave of grief that hit her at about three months post-surgery. “I'm a nurse; I'm very calculated in my medical decisions. I weigh all the risks and benefits. I went in very, very confident in my decision and I still am. But I think that rational side of me didn't leave room for any emotions that were going to come with it,” she says. “It just hit me like, Oh my gosh, like I can never carry a child of my own.” One of her closest friends was having a baby shower and Rishe, who by this point had gotten engaged to her boyfriend, couldn’t attend. “I was going in circles.” 

Rishe, author of Part of You, Not All of You: Shared Wisdom and Guided Journaling for Life With Chronic Illness, was disturbed by society’s narrative that women’s utmost joy and fulfillment is through raising a child. “I'm probably hyper-focused on it, but I feel like it is everywhere,” she says. “I can't escape this idea that motherhood is the be-all, end-all of accomplishment for women. I think that's what I wrestled with even more so than my own decision: that society made me feel like I wasn't good enough.”

On top of this feeling of existential loss, Rishe went into early menopause. “That was a whole other nightmare,” she says. Since the operation did not remove her ovaries, “the idea was that I would not have any hormonal issues, but that's not the case. [My hormones] were a mess. They were so inconsistent.” Her doctor had not prepared her for this possibility. “I tried every type of hormone replacement under the sun, every patch, every cream, every insert and nothing works…I have talked to a lot of women who have had hormone issues, post-hysterectomy, but are told because they have their ovaries that shouldn't be the case. But it is for a lot of us.” She also has hot flashes, vaginal dryness, insomnia, and anxiety. “I never had any of that before the surgery, ever.” 

Rishe has seen at least five hormone specialists some of whom, she says, admitted that they’re not used to seeing younger patients; they're not used to seeing a 30-something having perimenopausal-type symptoms with ovaries. “No one really knew what to do with me. I had a really hard time with that.”

If they are done having children, or don’t want them at all, hysterectomy patients may be told that their sex organs serve no purpose, and they might as well have them taken out. Even the American Cancer Society says that treatment for cervical cancer “depends on whether or not you want to be able to have children.” If you don’t, the plan for care is a hysterectomy, plain and simple. 

This line of thinking is sometimes continued when women approach their doctors with post-hysterectomy depression, or other psychological side effects. Anecdotally, women report doctors brushing off their symptoms and chalking it up to mourning their lost fertility. “I cannot tell you how many women who were depressed after hysterectomy with their ovaries retained who were told, ‘You're mourning the loss of your uterus,’” Dr. Sarrel says. “Women with depression really have a hard time being believed or being listened to.”

The impact of a hysterectomy on one’s fertility and sexuality is the subject of a new movie from Lena Dunham—her first feature film in a dozen years. Released just last month, Sharp Stick tells the story of a young nanny who comes off as frumpy and sexually naive due to having had a hysterectomy as a teen. After a fling with her charge's dad, the lead character embarks on a cinematic journey of sexual awakening. (A hysterectomy can result in loss of sexual response and desire, particularly if the cervix was removed, however, some women report an increase in sexual satisfaction after the surgery, perhaps as a result of reduction in pain during sex.) 

Dunham herself had a hysterectomy at 31, after a decade of battling endometriosis and several other surgeries. A known confessional storyteller, Dunham shared deep thoughts about her own infertility, surgery, and pain in an article she wrote for Vogue in 2018, "...something is wrong with my uterus. I can feel it, deeply specific yet unverified, despite so many tests and so much medical dialogue. I just sense that the uterus I have been given is defective." Dunham has openly mourned the fact that she’ll never physically carry a baby, saying she misses the pregnant belly she wore on Girls and the one she constructed as a child out of bunched up laundry. She talks about the "big stupid sobs" she cries over her lost uterus when she's alone in the bathtub. 

While Dr. Orbuch allows that most OB-GYNs are women’s health generalists and not specialists in, say, endocrinology or endometriosis as she is, which could contribute to the deficit in communication, one anti-hysterectomy activist, Nora W. Coffey, believes that doctors are deliberately not telling patients about the connection between sexual organs and mental health. “It's not that doctors don't know what they're doing. They know exactly what they're doing to women. They studied anatomy,” she says. “I’ve come to the conclusion that it's deliberate. They do not want the truth out.”

Coffey is the founder of the HERS Foundation, a nonprofit organization that has been educating women about female anatomy and the after-effects of hysterectomy since 1982. The impetus for HERS was Coffey’s own experience with the detrimental changes caused by her hysterectomy, which she underwent in her mid-thirties. Since then, she’s spent nearly 40 years trying to get medical school faculty to listen to her and to change their actions, to almost no avail. She’s also spent that time collecting stories from thousands of women with experiences like hers—and getting this information into the hands of as many women as possible.

To Coffey, there is absolutely no question about hysterectomy’s devastating effects on women’s psychological and emotional health. In addition to a long list of other side effects, data compiled by HERS through surveys and interviews has found that nearly 80 percent of women who had a hysterectomy with both ovaries removed have experienced a change of personality, 70 percent have lost the ability to socialize, 54 percent have experienced suicidal thoughts, and nearly 10 percent have made suicide attempts. HERS even has one woman’s suicide letter, which details her post-hysterectomy decline, posted on their website. 

“I don't think we realize how much the uterus has to do with who we are. How you walk, how you talk, how you dance,” says Coffey. “Every part of your body is affected, your brain. Everything.”

Whether research can prove exactly what that ineffable connection between the uterus and the mind is or not, Coffey says, the organ shouldn’t be cut out without a woman being fully informed about the potential consequences. In fact, she believes that one reason women become depressed after hysterectomy is that they’re not adequately prepared for what to expect. 

Jacques feels the same. Since her hysterectomy, she’s had three surgeries—the first two to mitigate the damage done by that initial procedure, and the last to finally rid her body of the endometriosis the hysterectomy was supposed to cure. While she knows now that her hysterectomy was unnecessary, she says she just wishes her doctor had told her something—anything—about what to expect. 

“I would have liked them to prep me a little bit,” she says. “My hormones were just beginning at that stage, so I would have liked more information about what could potentially happen, and if this would cause a hormone imbalance. Because it definitely did.”

Like Coffey, Jacques is using her experience to help others—she is currently a patient advocate for women and especially teenagers who may be pushed into a surgery they don’t need. Or, as Coffey puts it, give them the information to make that decision for themselves, whether “need” is part of the conversation or not.

“If you have a condition that you might die from and a hysterectomy would save your life,” Coffey says, “you still have the right to know the consequences and decide what you're going to do.” 

Additional reporting by Tessa Love