HYSTERECTOMY — THE ALLEGED QUICK FIX WITH LASTING CONSEQUENCES

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(Repost)

 

http://www.redflagsweekly.com/cloutier_steele/2003_june10.html

 

 

June 10, 2003

 

HYSTERECTOMY — THE ALLEGED QUICK FIX WITH LASTING CONSEQUENCES

 

A closer look at why millions of women opt for unnecessary surgery instead of

less invasive alternatives

 

By Lise Cloutier-Steele

 

Our bodies are marvelous creations with each organ or part playing a significant

role in our physical, emotional and sexual well-being. It makes perfect medical

and scientific sense to think that our body parts are indispensable, and I

believe that most people would agree with me on that one. Most people would also

agree that there are serious risks linked to any kind of surgery. For the

record, an elective procedure doesn't make it any less dangerous. Yet, every day

in North America, thousands of women surrender their non-cancerous reproductive

organs to gynecological surgeons. In many cases, without having given it much

thought.

 

Consider this: Why are Westerners shocked by reports about female castration and

mutilation in other countries when the same thing is happening in our midst? The

only difference is that it isn't done as part of any ritual or belief, but as a

quick fix for a variety of women's problems.

 

Why is this happening? That's the burning question, and the first place to look

for an explanation is the medical specialty of gynecology.

 

Doctors Withhold Information

 

According to a recent study published in the December 2002 issue of the American

Journal of Obstetrics and Gynecology, the rate of hysterectomies performed each

year is on the rise. In his comments for a print interview made public at the

time of the release of this study, Dr. Ernst Bartsich, a New York gynecologist,

attributed the increase to his colleagues who continue to withhold information

about the aftereffects of hysterectomy and ovary removal. He added something to

the effect that if women knew the truth, they wouldn't agree to these surgeries

as readily. And I would like to add that if women aren't given all the

information they need to decide, how can it be informed consent?

 

Risks are Downplayed

 

Gynecologists have traditionally downplayed the risks involved with the

operation itself and its many lasting consequences. Side effects include hot

flashes, depression, anxiety, osteoporosis, generalized fatigue, stress and urge

incontinence, masculinization, insomnia, bowel dysfunction, mood swings, just to

mention a few. More importantly, the removal of the uterus and the ovaries can

lead to loss of sexual desire, diminished orgasmic response and pain with

intercourse.

 

One would think that when a surgical procedure involves the alteration of a

woman's sexual anatomy, it would be discussed at great length. It's not. But

sexual functioning is an important part of the discussion with men undergoing

surgery for prostate cancer. As is the case with men, " a woman's sexuality is as

important as her blood pressure " said Dr. Judith Reichman of California, in one

of her 1998 interviews on The Oprah Winfrey Show.

 

Lack of Training in Women's Sexual Health

 

Though hardly an excuse, part of the reason why post hysterectomy sexual

dysfunction is rarely discussed prior to surgery is because gynecologists are

not taught much about women's sexual health in medical school. Dr. Yvonne

Thornton, representative for the American College of Obstetricians and

Gynecologists (ACOG), raised this point in her interview on Good Morning America

in November of 1999, after admitting that she couldn't define the term " orgasm " .

A sad statement coming from a female gynecologist whose profession involves the

excision of organs affecting sexuality. Perhaps this would explain why some

women claim to have great sex following a hysterectomy. If they never

experienced a deep uterine orgasm, the big O in layman's terms, how can they

miss it?

 

Since post hysterectomy sexual dysfunction is almost always left out of the

discussion, I think it warrants some special attention here. This outcome is

often the result of nerve damage caused by the cutting with surgical instruments

around the organs being removed (uterus, cervix, fallopian tubes and ovaries),

which in turn, results in diminished orgasmic response. If a woman's vagina is

made too short at the time of the removal of the cervix, it can make intercourse

either painful or impossible.

 

The ACOG admits to vaginal shortening at hysterectomy in its 1999 pamphlet

Understanding Hysterectomy. It states clearly that if the hysterectomy procedure

requires vaginal shortening, deep thrusting with intercourse may become painful.

I was thrilled to see this information finally made public until I read the

recommendations. There were two: 1) Being on top during sex or 2) bringing your

legs closer together may help. Any woman will tell you that intercourse wouldn't

be pleasurable, if at all possible, if she had to keep her legs closer together,

and women living with the condition of a shortened vagina will tell you that

attempting the " on top " position would be excruciatingly painful.

 

Last, but not least, loss of libido is another form of sexual dysfunction, which

is the direct result of oophorectomy (removal of the ovaries). This is a problem

that is getting lots of attention lately and some medical experts are now

specializing in the treatment of female sexual dysfunction (FSD). The problem is

that their services are aimed only at women who still have their reproductive

organs, excluding oophorectomized women who probably need their help the most.

Sadly, when a woman's sexual anatomy has been altered by hysterectomy, without

prior consent, it is very hard to find help anywhere. Due to the " fraternity "

that continues to exist among doctors, it's equally difficult to be successful

with a complaint to a Medical Board or a College, or with a lawsuit. That's why

it's so very important for women to be aware of the risks and aftereffects of

hysterectomy and ovary removal prior to surgery.

 

Women's Vulnerability

 

Mary Anne Wyatt of Massachusetts, a researcher in molecular biology and

electrochemistry, says that there are a variety of reasons why intelligent women

wind up with an unnecessary hysterectomy. " They are vulnerable, scared,

uninformed of options or ignorant of the actual consequences. Their gynecologist

may not be skilled in a technique for preserving the uterus. From a surgeon's

point of view, the hysterectomy is an easier and cheaper operation than the

current alternatives. Re-imbursement from insurance companies encourages the

faster, less skillful approach, likely the reason why teaching hospitals train

hundreds of residents a year in hysterectomies instead of the less invasive

procedures requiring greater surgical expertise. "

 

Surgeons' Comfort Level

 

In addition to surgical skill, we must consider a surgeon's comfort in

performing a particular technique, and in some cases, the unwillingness to learn

a newer, less harmful procedure that could minimize the impact of the surgery on

patients. A perfect example of this was reported by Medscape in its April 2003

news release about a study suggesting that a new ligament-sparing hysterectomy

procedure proved to be better, with less morbidity than with the traditional

abdominal surgery. The new procedure is the brainchild of Dr. Daryoosh Samimi,

medical director of the U.S. Women's Institute of Fountain Valley, California.

Having performed it successfully on 43 women, Dr. Samimi believes that his

technique preserves the integrity of the ligaments surrounding the uterus. But

Dr. Bryan Cowan, professor and chairman of obstetrics and gynecology at the

University of Mississippi in Jackson, said he wasn't buying into this new

approach. Of greater concern were his remarks about surgeons'

preference to cut the ligaments to give them a more open field of surgery. A

review of operative gynecology textbooks indicated that the uterosacral

ligaments can affect bowel, bladder and sexual function, which makes one wonder

why a surgeon's preference for the wider field of surgery would take precedence

over a woman's chances at a better outcome.

 

Education and Social Class

 

Education and social class, are two additional important factors. These were

addressed in the Ontario Women's Health Council's 2001 report titled, Achieving

Best Practices in the Use of Hysterectomy. The report shows that the

hysterectomy rate is highest in poor, rural regions where the level of education

is low. Similarly in the U.S., the hysterectomy rate is highest in the southern

states. Those who are interested in a complete copy of this report can get one

HERE.

 

Women Misleading Other Women

 

Finally, women misleading other women is an equally significant factor

contributing to the overuse of hysterectomy. Some recommend the procedure to

others as a permanent solution for birth control, while others may paint a rosy

picture of post hysterectomy life because they themselves do not associate their

symptoms with the surgery. This is particularly true of senior women who remain

uncomfortable talking about their surgery and the difficulties they faced

because of it over the years, women who have just recently undergone the

procedure, or in the case of those who were able to retain their ovaries. But as

Winnifred Cutler, PhD, explains in her book, Hysterectomy Before and After, the

aftereffects of hysterectomy tend to surface over time, sometimes years after

the operation, and if the blood supply going to the ovaries was damaged at

hysterectomy, these organs will cease to function. According to Cutler's

research, it happens in a great many cases, and when it does, surgical

menopause follows with its nasty and unpleasant symptoms.

 

Living life as a boiling kettle is not something I would wish on my worst enemy,

and unlike Lauren Hutton's and Patti Labelle's personal claims in their

commercials for the makers of hormone replacement therapy (hrt), it's not a

problem that can be easily corrected by the conventional forms of hrt on today's

market, not if you've been castrated. Besides, conventional hrt can lead to

breast cancer, blood clots and heart disease, as confirmed in last year's

reports on the National Women's Health Institutes' halted study. And another

study released just last week showed that conventional hrt is linked to

dementia. Most women don't want to invite these risks into their bodies, however

minimal some doctors may claim that they are. Evidence to the contrary is in the

results of these studies.

 

We must not discount women with claims of a positive experience because their

hysterectomy rid them of the problem they had. In many of the women I

interviewed, it doesn't matter that the trade-offs have greatly affected their

quality of life, or that they can't find a hormone therapy to keep the symptoms

under control, they want others to know that their story is a " positive " one.

 

Lack of Outcome Studies

 

In May 2001, Charles J. Wright, M.D., released his study on the outcomes of six

surgical procedures in Western Canada. His study included hysterectomy and

revealed that very little information is available about the outcome of surgery

from the patient's perspective. Without more and better research into the

long-term effects of hysterectomy and female castration, women cannot truly give

their informed consent for these operations. Yet in a feature article by health

reporter, Paul McKeague, published on May 5, 2003, in The Ottawa Citizen, Dr.

Andre Lalonde, executive vice-president of the Society of Obstetricians and

Gynecologists of Canada, said that a large survey (commissioned by none other

than the society itself), indicates " that the satisfaction rate for hysterectomy

is very, very high. " Dr. Lalonde didn't offer any numbers or specifics about the

women interviewed for the internal study, and boasted that " the majority of

people answering us are saying, 'Why didn't I get it done

years before?' " Gail McFall of Kingston, Ontario, wrote to say that Dr. Lalonde

is a prime example of why unnecessary hysterectomies are continuing to occur.

 

According to Mary Anne Wyatt, and other experts I approached, there have not

been any significant patient outcome studies done in the U.S. either. Ms. Wyatt

said that no one knows how many divorces or suicides result from hysterectomy,

for example. Such a study would be a good place to start.

 

Awareness, our Best Defense and Key to Change

 

Now that we have an understanding as to why women continue to subject themselves

to unnecessary hysterectomy when alternatives do exist, what can we do to put a

stop to it? Charles B. Inlander, President of the Pennsylvania based People's

Medical Society, says " there is too much good information available for women to

be bullied or misinformed by doctors who make a living off of performing

hysterectomies. Women must take charge of their own health, seek out

information, discuss it with their physician, but ultimately make their own

informed decision. In this day and age, the old medical demand of 'Trust me, I'm

a doctor' should only be heeded based on solid evidence, not blind faith. "

 

Here are a few helpful internet resources:

 

Abdominal Hysterectomy: Trends, Analysis, and Sexual Function

 

The Hidden Power of Body Odors: Studies find that male pheromones are good for

women's health, John Lea (Time, December 1, 1986)

 

Hysterectomy and Sexual Orgasm

 

More on Sex after Hysterectomy

(type " hysterectomy " into the site's search function to get to this article.)

 

Alternative Therapy: The Uterus

 

 

Lise Cloutier-Steele is a communications specialist and a professional writer

and editor, who has survived a traumatic experience with hysterectomy. She is

also the author of Living and Learning with a Child Who Stutters. And she is the

recipient of a Canada 125 Award in recognition of a significant contribution to

the community and to Canada for her volunteer efforts to help the parents of

children who stutter. She has appeared on Canada AM, the Women's Television

Network (now W), The Phil Donahue Show, The Body and Health Show, and several

other media to talk about the important topic of unnecessary hysterectomy in

North America.

 

She is also the author of MISINFORMED CONSENT- WOMEN’S STORIES ABOUT UNNECESSARY

HYSTERECTOMY

 

*Lise Cloutier-Steele

 

 

 

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