Book Description

The word “choice” in women’s health is synonymous with abortion. How to deal with an unwanted pregnancy has been the focal point of lengthy debates, psychological research, and significant policy changes. There is, however, another decision that hundreds of American women make every month but that is not recognized as an important health concern: the choice of whether or not to have a hysterectomy. Every year, 700,000 hysterectomies (surgeries to remove the uterus) are performed in the United States. The hysterectomy is the most frequently performed operation in the country, second only to the cesarean section. While advances in the medical field have made the experience more bearable in the last few years, it remains a major surgery with a long list of side effects and a heavy psychological burden. Many women report post-operative depression, bladder or bowel dysfunction, and decreased sexual interest. Women of childbearing age must cope with the reality of no longer being able to bear children, and for many patients the long recovery period interferes with their jobs and everyday activities. Still, the most disturbing fact is that of all these operations, only 15% are medically necessary. Of the 85% that could have been avoided, about 60% were performed because of fibroid growths in the uterus. These non-cancerous tumors develop in or around the uterine wall and are usually undetected until the patient begins to manifest typical symptoms. While 35% of all American women will develop fibroids at some point in their childbearing years, thoroughly checking for them is not part of a routine gynecological exam. The majority of women who have either large or numerous benign tumors in their uteruses are long unaware of it. The discovery of uterine fibroids is usually sudden and upsetting. Most women do not know that they are a common problem, and as a result are not prepared to deal with the situation. They know little about how fibroids behave, and even less about their treatment options. Most of the time, the doctors they consult will tell them that removal of the fibroids will only result in their growing back and further health complications. A hysterectomy seems at first to be the only alternative for completely resolving the problem and avoiding repetitious treatment. What many medical specialists fail to mention is that there are further alternatives. As a matter of fact, there are several. These other options are not only less invasive, but they are often less expensive, call for a shorter hospital stay, and in many cases do not require even partial removal of the uterus. The root of the problem is that many gynecologists adhere to the outmoded belief that the uterus is useless after childbearing age. Because most of the women are who are diagnosed with uterine fibroids are symptomatic (and by then nearing menopause), their doctors do not consider it a priority to preserve their reproductive systems at all cost. Another issue is that few gynecologists are well trained enough with the alternative procedures to hysterectomy to feel comfortable performing them themselves. These physicians spend more time performing unnecessary surgeries and less time mastering different techniques, all the while scaring their patients into a major operation. They avoid recommending procedures such as a myomectomy, opting instead to perform the more common hysterectomy “just to be safe.” The safest thing, however, is to select the correct treatment alternative, and preferably choose one that involves the least possible trauma to the mind and body. Lack of information and unnecessary surgery are cause enough for concern in the debate about hysterectomies. The problem runs even deeper, however. When a patient consents to having a procedure performed on her bod