A growing number of women in India are paying for expensive and medically unnecessary hysterectomies in order to avoid missing work as a result of their periods, according to health officials.

The disturbing trend is especially widespread in the western state of Maharashtra, where more than 4,600 women in the Beed District have undergone surgery to remove their womb over the past three years alone, state health minister Eknath Shinde revealed recently. The majority of these women work as sugar-cane cutters, and are employed by and in debt to contractors, reports multimedia web portal Big Think.

Every year, tens of thousands of poor families from Beed and neighbouring districts migrate to more affluent western areas of the state - known as “the sugar belt” - to work during the cane cutting season, which runs from October to March, says the BBC’s Delhi-based correspondent Geeta Pandey.

But many contractor are reluctant to hire women who menstruate, in case they miss a day or two off work during their periods. “Some even offer advances to women who intend to get the surgery,” adds Big Think.

Workers who miss a day or just part of a day are fined 500 rupees (£5.97) from the wages paid to each husband and wife team - a hefty levy given that the average female farmer in the state earns about 202 rupees (£2.39) a day.

As a result, “in the cane cutter community, menstrual periods are considered a problem and they think surgery is the only option to get rid of it”, Achyut Borgaonkar of the Tathapi women’s trust, which is investigating the issue, told The Hindu Business Line.

But this can have “a serious impact on the health of the women as they develop a hormonal imbalance, mental health issues, gain weight, etc”, warns Borgaonkar, who adds that workers in their 20s are among those undergoing the surgery.

Most women in the region are married young and will have had two to three children by the time they are in their mid-20s. Many believe that their uterus is of no use after childbirth, and doctors are failing to warn them about the problems they might face as a result of undergoing a hysterectomy, reports Al Jazeera.

One female worker told the news site: “It was better to invest in operation at once than keep spending over medicines.”

Even though hysterectomies can cost 35,000 rupees (£418) or more, increasing numbers of female workers are opting to borrow money to pay for the procedure - resulting in “villages of womb-less women”, says the BBC’s Pandey.

Menstruation causes major problems for women across much of India.

More than 150 million women in the country suffer from so-called period poverty - being unable to afford sanitary products. “Some women use cloth or rags with sand, jute, or even cow dung, which increases the risk of infections,” reports the BBC.

In addition, menstruating women are widely believed to be impure, with many forced to sleep separately beds from their husbands, and to avoid touching food to be eaten by others.

Meanwhile, an estimated 40% of girls miss school during their periods owing to a lack of sanitary products or private toilet facilities for female students, reports the Times of India.