Surgery More Arduous for Women Than Men

March 23, 2001 -- Going under the knife is never fun for anyone, but new research confirms earlier suspicions that it might actually be a little more unpleasant for women than for men. Australian investigators have shown that while women often wake up more quickly after being put under, they are also more likely to suffer the unpleasant side effects of general anesthesia.

"Women wake up faster [after being under anesthetic, which] suggests they are less sensitive to the intended effects of anesthetic drugs," study author Paul S. Myles, MD, tells WebMD. "[However,] they recover more slowly, [which] suggests they are more sensitive to the side effects of the drugs or recover more slowly from the effects of surgery itself. We have known for some time that women have higher rates of nausea and vomiting after surgery. Our ... study has found they also have more headache and backache. Importantly, their overall quality of recovery is worse." Myles is an associate professor and head of research in the department of anesthesia at Alfred Hospital in Victoria, Australia.

John Daly, MD, tells WebMD that women and men react differently to a whole host of things, including diseases and medical treatments. There is even evidence that women's reactions vary depending on where they are in their menstrual cycle, suggesting that hormones may play a role in these differences. Daly, who was not involved in the study, is a professor and chairman of the department of surgery at the Weill-Cornell Medical Center and surgeon in chief at New York Presbyterian Hospital in New York.

Myles writes that besides the hormonal differences between men and women, women also have a "higher incidence of migraine and tension headaches generally, a risk factor for postoperative headache." Also, he writes, backache after surgery can result from immobility of the base of the spine during surgery, "and there are anatomical differences between men and women."

To reach their conclusions, Myles and colleagues observed 241 men and 222 women for three days after surgery. All of the participants had surgery under general anesthesia, which means the patients were put to sleep. The researchers found that while women generally wake up sooner than men, they are more likely to suffer from side effects of anesthesia such as nausea, vomiting, headache, backache, and sore throat. It took women longer than men to recover fully from surgery, and they also had a higher rate of complications, although typically minor ones. The results are published in this week's British Medical Journal.

Beverly Hills plastic surgeon Garo Kassabian, MD, tells WebMD that the results of this study mirror what he sees in his practice.

To help you optimize your recovery from surgery, Daly and Kassabian recommend the following:

  • Tell your doctor before the surgery not only about any medications you are taking but also about any nutritional or herbal supplements you use regularly. Some, such as ginger, garlic, and ginkgo, may increase the amount of bleeding that occurs during surgery and have to be stopped before surgery and for some time afterward.
  • As much as possible, maintain a positive attitude before and after surgery.
  • Try to be in the best health you can be before surgery. Under a doctor's supervision, couch potatoes should get up and take a short walk every day. Smokers should quit or at least cut down, as smoking can discourage healing. Kassabian suggests using surgery as an excuse to quit for good.
  • Ask your doctor how soon you should be up and about after surgery and get up as soon as you are allowed. Moving about as soon as possible after surgery not only quickens recovery but also reduces the risk of surgical complications, such as the development of blood clots or lung congestion.
  • Kassabian believes in getting his patients up and about right away. "I do big, 12 pound liposuctions, which is pretty much the maximum liposuction you can do, and [my patients] are back to work in three days," he says.
  • After some types of major surgery, it is a good idea to perform deep breathing exercises. This helps clear your lungs and prevent lung congestion, which can lead to pneumonia. Your doctor may give you a special device, called a spirometer, to blow into in order to encourage deep breathing.

Kassabian uses herbal and homeopathic remedies both before and after surgery to help speed healing and reduce the side effects of anesthetic in his patients. If you are interested in using natural or homeopathic remedies to optimize your surgery experience, discuss it with your doctor, who may suggest some supplements or refer you to someone who can. Never take a supplement right before or after surgery without first telling your surgeon or anesthetist. And follow your doctor's advice on getting into shape before surgery and getting back your health and fitness afterward.