Delays in gynecological surgeries putting women’s health — and lives — at risk, doctors warn

At 51, Dr. Nili Kaplan-Myrth had been postmenopausal for eight years. So when she started bleeding again in May, the Ottawa family physician knew something wasn’t right.

“In medical school we were taught postmenopausal bleeding is endometrial cancer or uterine cancer until proven otherwise,” Kaplan-Myrth told CBC Radio’s White Coat, Black Art.

But Kaplan-Myrth knew from her own patients’ experiences that getting in to see a gynecologist — especially one who performs surgery — can take six months to a year or more in Ontario. Ontario Health, meanwhile, reports average gynecological surgical wait times of up to four months. Ten years ago, that wait used to be about a month and a half, according to a Fraser Institute study. 

Surgical wait times vary across the country, but a 2020 study from the National Library of Medicine found that a gynecologist consultation alone can take up to four and a half months on average.

Kaplan-Myrth says long wait times for gynecological surgeries are putting many Canadian women at risk. 

“These are women who are suffering over long periods of time, waiting for a surgery that is considered elective.”

Long delays in gynecologic care stem from systemic underinvestment, competition for surgical resources, and challenges unique to gynecology, says Dr. Nick Leyland, professor of obstetrics and gynecology at McMaster University and president-elect of the Society of Obstetricians and Gynaecologists of Canada (SOGC).

Leyland says the problem is being compounded by a lack of reproducible data on how many patients are waiting for surgery, the types of surgery involved and where the delays are occurring across Canada.

“If you’re not counted, you don’t count.”

It’s a problem Michelle Ganam knows all too well. Sixteen years ago, Ganam was diagnosed with endometriosis and adenomyosis, two gynecological conditions that cause pelvic pain and extremely heavy periods.

“I live daily at a pain level five and during menstruation, at a pain level 11,” said Ganam.

Now at 40, the Smiths Falls, Ont., resident says she was finally approved for a hysterectomy.

Before that, however, she must undergo an ultrasound in February to “assess how much damage the endometriosis and adenomyosis has caused.” 

Ganam says she was informed the hysterectomy could take another 18 months to book.