In Defense of the Hysterectomy


First of all, let me go on record as saying that I have no vested financial interest in whether or not women have hysterectomies, since I confine my practice to surgical procedures that I can do in the office.

Second, let’s get our terms straight. A hysterectomy is removal of the uterus. Removal of the ovaries is called an oophorectomy. While it is true that sometimes both procedures are done at the same time, one must be careful to speak of these procedures separately, because they have different indications and different outcomes.

Okay, now that we have that settled, let’s talk.

It is estimated that in 1999, the last year for which we have data, there were some 600,000 hysterectomies performed in the United States.

Is that too many hysterectomies? I’m sure it is. Are there unnecessary hysterectomies being performed? I’d bet money on it. Are there non-surgical options for many of the conditions we use hysterectomy to treat? You bet there are.

But this does not mean that hysterectomies are bad operations.

That’s not what the HERS folks think. They want to see hysterectomies abolished. They tout data from uncontrolled studies and surveys to prove that hysterectomies lead to everything from decreased libido to impaired sexual function to obesity. And that anything other than a hysterectomy is better than the hysterectomy. The media don’t always help the discussion, especially when the only data they quote is the uncontrolled survery data from HERS. It’s all so simple for them. Hysterectomy = Bad. Anything else = Good.

What they do not tell you is that when it is indicated, a hysterectomy can save lives, restore sexual function, eliminate bleeding, resolve pain and improve the quality of life overall. But no one talks about the positive aspects of the surgery.

And no one talks about the many, many women out there who are suffering from heavy bleeding, pain and reduced quality of life because they have been led to believe that hysterectomy is a bad operation. They may spend years trying every other option under the sun so that they can avoid the dreaded operation that might give them back their lives. Some will make it finally to menopause with their uterus intact, but will have lost those years to pain and bleeding in return. Others will eventually give up the good fight and have the dreaded hysterectomy. And the most frequent comment I hear from these latter patients is this – “Why did I wait so long?’

It’s true. When hysterectomies are performed for indicated conditions, and when women make a well-informed decision to have the surgery, they tell me they would make the same decision over again.

This has not been my experience with my patients who have had myomectomies, the favorite surgery of the HERs foundation.

I have had more than a few patients regret their decision to have a myomectomy when, less than 5 years later, they are back with new fibroids larger and more symptomatic than their previous ones. “Why didn’t I just have a hysterectomy then?” they will say, or more disturbing to me “Why did I let everyone talk me out of a hysterectomy”?

Look, if you are 25 and have fibroids and haven’t had your kids yet, then absolutely a myomectomy is the operation you most likely will want. The surgery carries risks, but these pale for most women compared with the thought of not being able to have children.

But women who are done childbearing, and are taking the time out of their busy lives to have major surgery, should at least be given the opportuity to consider having the operation that will solve the problem forever – a hysterectomy.

As to the long term effect of hysterectomy, there are a number of well-done prospective studies showing that removal of the uterus alone does not impact sexual function. In fact, if reserved for women who really need it, sexual function in my practice experience, is often improved.

Is hysterectomy the only option for the conditions I listed above? For most benign conditions, the answer is absolutely not. But it is an option, and a very viable option. For many women, it is their best option.

Hysterectomy deserves consideration and discussion as much as any other procedure. To label it as being bad, or to try to convince women that they should not have this surgery is as much a disservice to women as performing an unnecessary hysterectomy.

Thanks to Kevin, Md for pointing me to the Time/CNN article on hysterectomy.

89 Responses to In Defense of the Hysterectomy

  1. If your uterus and one ovary are removed, and you experience intense orgasm, please contact the Pope, it is a miracle. Women no longer experience uterine orgasm, without a uterus. Perhaps? your sister never had a uterine orgasm.
    Please see the free educational video “female anatomy” at, herfoundation.

  2. I have no doubt that there are many people who regret their hysterectomies. And no doubt that many of those were unnecessary. The fixation on reproduction and “uterine orgasm”, though, those I have a problem with, as well as the idea that hysterectomy is to be avoided at all costs.

    My sex life is, if anything, better since my supracervical hysterectomy 6 years ago. I never had any interest in having kids. If that’s such a huge concern, why isn’t there some groundswell movement against tubal ligation?

    Given the choice between being unable to be more than 20 feet from a washroom for 3 days every month, waking up every hour during the night to change tampons/pads, and having surgery? You bet I chose surgery.

    It’s not the right choice in every case, but agitating against anyone having a hysterectomy is nuts. In many situations, it’s the right choice.

  3. Yes, let’s talk about sex, before we go all half-cocked (no pun intended.) If you make a comparison of removal of the uterus (just the uterus) to the remvoal of a man’s sexual organs, what are we talking about? Just his prostate gland?, or would it take the removal of both testicles, and a portion of his penis?, to equal the damage the removal of a woman’s uterus inflicts upon a woman and her sexual, hormonal, psycological and emotional health.
    The question is cold, but could a man have any portion of his male reproductive, or sex organs removed, without it seriously damaging his sexual enjoyment and hormonal, psycological and emotional health?
    Any doctors willing to take a stab at this one?
    Signed, Husband and Wife, Rural PA

  4. Jaye,

    Everyone seems to be posting to advocate for full disclosure of information, not against a fully informed woman making a decision about what she wants to have done to her body. Having said that, however, it is still the responsibility of doctors to “First Do No Harm”. A woman’s sex organs should not be removed under any circumstances except when she has been fully informed about her medical problem, all of the options in treatment, the risks of all of the options, there is no conservative treatment option, and she has been fully informed about the effects of having her hormone responsive reproductive sex organs removed. A woman will be equipped to make that important life-altering decision if she watches the video “Female Anatomy: the Functions of the Female Organs” at
    http://www.hersfoundation.org/anatomy. No information? No consent!

    • This person is a troll. The HERs foundation are trolls. Beware. It was the first website that I encountered when I was given a cancer diagnosis and it left me desperate, in tears, and wary to get an operation that I needed to save my life. There are many challenges I face as a 43 year old 1.5 years post hysterectomy and oophorectomy. I am no friend of the medical world and I would have opted for anything else if they had not found cancer with metasis but I do not blame a woman who chooses this method for a condition they can no longer live with. Since the HERs organization focuses more on how you will look in your jeans and and that there is no possible way you will ever have an orgasm again (two hints for other survivors out there, love your body in any form and view masturbation as the most fun you will ever have exercising your muscles back to health) I cant believe that they really care about anything more than being exclusionary and self righteous. Instead of supporting this hateful group, check out hystersisters for more inclusionary points of view that do not try to scare you into their ideology.

  5. Jaye:

    The status quo is that unnecessary hysterectomy is being done at alarming rates. Most women are not given any choice, they are told they need it and they are scared into it without being told of the side effects and life long repercussions. There are many women who did not consent to a hysterectomy who end up with one. Even those who consent are not told of all the risks and complications.

    Given that, even if you believe it was the right thing for you, do you think that it’s okay or doctors to keep doing this to women by the carloads without giving them the proper information to make an “informed decision?”

    • All the negative debate is not helping other women. No matter what, it’s the woman who makes the final choice in the end. She showed up for the surgery. Doctor didn’t bully her into it. If a woman feels bullied, it’s time to find another doctor. Any woman can say no and seek other options. I’ve gone through a total hysterectomy with ovaries intake and my quality of life is much better now. I was scared but I talked to other women who’ve had hysterectomies. I did my own research. It was ME who drove to the hospital, signed in and had the surgery done! There was nobody beating down my door and forcing me to show up for my surgery. If I thought it unnecessary, I’m a mature woman that can say the word “no”. I’m pain free and I love not having heavy, gross periods! I’m in my forties and my sex life is perfect with my husband. For me, it’s about passion, without it… Sex is just sex. To the lady who has sex once a week even though your drive is low, hats off to you and your husband. You are an inspiration so keep sharing your story!

  6. The uterus, cervix, and vagina can be viewed as a continous piece. Going back to this blog’s uterine diagram, if you study it, you will see that there is no way to remove the cervix without also cutting and sewing the vagina into a closed, (and subsequently scarring) pocket at hysterectomy.
    Much as the vagina is considered an organ separate from the uterus, so did dated gyn texts consider the cervix to be a separate organ from the uterus. It is my feeling that this terminology was changed to make it easier for gyns to get so called “consent” for the removal of a part of woman that she might well be intimately familiar with. You see, the cervix likes to be touched and can contribute greatly to a woman’s desire for penetration and to her enjoyment. Additionally, her partner may enjoy the perfect fit that the cervix brings to him. In my opinion, words are often used against the lay patient. Witness castration becoming “surgical menopause”.
    Someone commented on how the male/female parts compare. The uterus is to a woman as the prostate is to a man, the ovaries are to a woman as the testicles are to man, and the clitoris is to a woman as the penis is to a man. Men are not told that they can have their prostate removed without the risk of impotence and incontinence, so why are women not afforded the same consideration? Especially given that the medical community has had this certain knowledge from the first of these operations.
    And, while I am commenting on the clitoris, two considerations. One, dated gyn texts do not show the clitoris pictured as it usually is today. Rather, it is shown as a larger organ that I can best describe as an internal penis (hmm…like a woman’s internal gonads, her ovaries). Two, allow me to quote from Te Linde’s Operative Gynecology, 8th Ed.,edited by JA Rock and JD Thompson, pg. 83, “The uterovaginal plexus lies on the dorsal (medial) surface of the uterine vessels, lateral to the sacrouterine ligaments’ insertion into the uterus. It has continuations cranially along the uterus and caudally along the vagina. This latter extension contains the fibers that innervate the vestibular bulbs and clitoris. ”
    (sigh) The uterus does not exist in a vacuum alone to itself. Its’ physical support, endocrine function, nerves and blood supply are very much a shared resource.
    For further enlightment, read the article, “Vagal afferents from the uterus and cervix provide direct connections to the brainstem” by JJ Collins, CE Lin and RE Papka, Dept. of Neurobiology, Northeastern Ohio Univsities College of Medicine
    (ISSN: 0302-766X).

  7. For easy reference:

    Here is a copy of the (ISSN: 0302-766X) article referred to in the above blog by anonymous

    Authors
    J. J. Collins1, C. E. Lin2, H. R. Berthoud3, R. E. Papka1

    1Department of Neurobiology, Northeastern Ohio Universities College of Medicine, PO Box 95, 4209 State Rt. 44, Rootstown, OH 44272, USA Tel.: +1 330 325 6636; Fax: +1 330 325 5916; e-mail: rpapka@neoucom.edu

    2Department of Anatomical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73190, USA

    3Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA

    Abstract

    Previous anatomical studies demonstrated vagal innervation to the ovary and distal colon and suggested the vagus nerve has uterine inputs. Recent behavioral and physiological evidence indicated that the vagus nerves conduct sensory information from the uterus to the brainstem. The present study was undertaken to identify vagal sensory connections to the uterus. Retrograde tracers, Fluorogold and pseudorabies virus were injected into the uterus and cervix. DiI, an anterograde tracer, was injected into the nodose ganglia. Neurectomies involving the pelvic, hypogastric, ovarian and abdominal vagus nerves were performed, and then uterine whole-mounts examined for sensory nerves containing calcitonin gene-related peptide. Nodose ganglia and caudal brainstem sections were examined for the presence of estrogen receptor-containing neurons in ”vagal locales.” Labeling of uterine-related neurons in the nodose ganglia (Fluorogold and pseudorabies virus) and in the brainstem nuclei (pseudorabies virus) was obtained. DiI-labeled nerve fibers occurred near uterine horn and uterine cervical blood vessels, in the myometrium, and in paracervical ganglia. Rats with vagal, pelvic, hypogastric and ovarian neurectomies exhibited a marked decrease in calcitonin gene-related peptide-immunoreactive nerves in the uterus relative to rats with pelvic, hypogastric, and ovarian neurectomies with intact vagus nerves. Neurons in the nodose ganglia and nucleus tractus solitarius were immunoreactive for estrogen receptors. These results demonstrated: (1) the vagus nerves serve as connections between the uterus and CNS, (2) the nodose ganglia contain uterine-related vagal afferent neuron cell bodies, and (3) neurons in vagal locales contain estrogen receptors.

    Keywords
    Key words Vagus nerve · Nodose ganglion · Estrogen receptor · Nucleus tractus solitarius · Rat (Sprague Dawley)

  8. Geez…can’t we all just get along? How about we take what info we need and leave the rest and stop bashing TBTAM for opening up a riveting discussion. Thanks, TBTAM for allowing everyone to post their opinions and experiences on YOUR blog.

  9. I want to comment on TBTAM’s quote, “having the operation that will solve the problem forever – a
    hysterectomy.”
    (Now remember that in his blog he has already allowed that there are too many and often unnecessary hysterctomies that could be treated with non surgical options.)
    Well, here’s the thing. Absent cancer, a patient might have abnormal uterine bleeding from any number of causes (vitamin deficiencies, blood disorders, diet, stress, hormone imbalances, etc.), well, then a hysterectomy only solves a symptom –all the while leaving the patient with the original disorder to continue doing damage to their body. I would not say that that should fall under “problem solved”.
    Hmm, maybe the hysterectomy was for fibroids and abnormal bleeding? Again, if you simply remove the uterus, then the surgeon is not ascertaining the cause and potentially leaving the patient to further ravages from the original cause (as well as a host of consequences from the surgery itself).
    For example, we live in a world full of estrogens that are foreign to our bodies. Again, as an example, calves often are given estrogen pellets so that they will have around 50 more pounds of marketable beef when they go to slaughter. When we eat that meat, is it so inconceivable that those pellets do us as they have the calf? That is, fatten us.
    Could not so foreign an estrogen cause fibroids? enlarged prostates?
    Could not so foreign an estrogen later fuel a cancer?
    This is just one example of why women may have trouble and why treating only a symptom is so flawed and so dangerous.
    I have a black friend who had both fibroids and abnormal bleeding. We talked at length and she successfully resisted hysterectomy. Her physician finally found out that she had sickle cell factors. That was something that she -and her doctor-needed to know!
    Someone mentioned conspiracy and on that I need to comment. I bought a book that detailed a 1965 convention at John Hopkins. The book is titled, “The Social Responsibility of Obstetrics and Gynecology.” The book elaborates on how concerned the gyn profession is about the growing population. It sums up some people as being a second class human machine.( All the while noting that black children score lower on IQ tests.) The book concerns itself greatly with how to stop the population growth of this supposedly lesser segment so that the world will be a fit place for them, their children, and their grandchildren.
    The book even says that political man and theological man can do nothing about the population growth so it is left to their discipline.
    Wouldn’t you know? In my opinion, the book is advocating for abortion, for hysterectomy,for sterilization,etc.
    There is a picture of a uterus that has been nearly halved by an IUD and comments note abnormal cells in the halving…but it is stated that this is still an acceptable method of birth control.
    Do I think that there is any coincidence in black women having a higher incidence of fibroids and fibroids being the number one reason for hysterectomy? Oh, yes, I do! Far more than coincidence.
    But it is not just a racial matter. It is a gender issue. It was from the first when surgical teacher John Hunter envisioned hysterectomy and ovary removal with his belief that “women could bear spaying just as well as did animals.”
    It was from the first when an inexperienced Sims surgically experimented repeatedly on slaves without benefit of antiseptic or anesthesia.
    It was from the first when doctors proudly exhibited ovaries on silver platters. Ovaries that they had taken from their patients under the pretext of somehow making them cleaner — as well as to cure them of their desires.
    It was from the first when the “cleaner and cured of desires” argument became socially unacceptable that, the medical communities’ attitude largely changed to, “Oh, well, then it doesn’t do that — and get me my scapel!”

  10. Thanks for answering my question regarding the male and female reproductive sex organs, very informative, anonymous.
    Also, -the vagus nerves serve as connections between the uterus and CNS-? What does this mean?
    Signed, Husband and Wife, Rural, PA

  11. It is nearly a year since my uterus, one ovary and cervix were removed from my body, while I was in severe hyperthyroid. I knew nothing about hormones, as I was regularly menstrating (I thought men had testosterone)and have not had a mother in thirteen years. Current blood tests of my body show estrogen levels are within a normal range for a regularly menstrating woman. How amazing, one lone ovary, however, I am experiencing severe symptoms. (The doctor who removed my sex organs, sent me a certified letter dismissing me as a patient and had me view graphic vaginal photos on a web site called, ourgyn, and told me I had Vulvodynia, and that the “klebsiella pneumonia”, wound infection, was caused by sexual partners, or my partners,partners)
    The new gyn I am seeing in a different city, first appologized to my husband and me, for the experience we had, and has started me on a low dose of birth control pills, and a custom prescription of: estriol, benzocaine, aloe and base, to help with the severe, labia minor athrophy, burning pain in the vaginal pocket, and severe dryness. I did not use the internet, for information I thought was best coming from the very professional doctors office attached to a hospital. I was getting the correct information, not some horror stories on an internet, I did not trust, or use much. I also thought it would be good to find a first hand woman’s viewpoint on the surgery, my best friend put me in touch with another friend who said everything stayed the same in her vagina, and “it was the best thing I ever did”. Within weeks after my surgery she had the nerve to visit me and say, “Isin’t it terrible when it shrivels all up” and “my ovaries blew out within a year after my surgery”. My best friend told me after the surgery, “My sister had a fibroid removed, it never grew back, and she had two sons, afterward”. This betrayal has been difficult enough and with this the reliving of the extreme pain, and abusive comments coming from the doctors verbal and visual, for months, has firmly sent me into a state of, Post Traumatic Stress Disorder. There are more stories about this betrayal, but it would take too long, in this forem. Now I find myself looking for my womanhood all over this internet, day and night, in pain, friendless. Thank goodness I had private academy training when I was young and learned to type. I have felt suicidal since this surgery and now struggle with depression.
    “Vagal afferents from the uterus and cervix, provide direct connections to the brainstem”
    Now I think I know what this means,? but would appreciate an ellaboration.
    Signed, Husband and Wife, Rural, PA

  12. I post the below EXTRACT from website

    http://www.hacres.com

    with the hope that anyone interested in HEALING will visit this website.

    Their ‘Archives’ of weekly Health Tips, include previous topics on Cancer, Salt, Water, Protein etc.

    The information on this website in my opinion, is likely to help with HEALING (prior to surgery, or post surgery).

    Their ‘Resourses’ section on the left of their homepage, has a ‘Testimonies’ section which needs to be read by anyone suffering ill health of any kind.

    EXTRACT PORTION OF today’s Health Tip below.
    (Health Tip Editor is Christian Minister, George Malkmus, founder of Hallelujah Acres):

    The Hallelujah Health Tip
    Issue #508: Fruits, Veggies Don’t Stop Cancer’s Return (Summary)
    August 14, 2007

    (5) Fruits, Veggies Don’t Stop Cancer’s Return (Summary)

    For the past three weeks, in Health Tips #505, #506, and #507, we have been providing information refuting an AP article, dated July 17, 2007, headlined: FRUITS, VEGGIES DON’T STOP CANCER RETURN. All three of these articles are available in the Health Tip “Archives” at http://www.hacres.com .The AP article told of a $35 million GOVERNMENT scientific research study that had appeared in the Journal of the American Medical Association, and subsequently in newspapers across America. Following are some of the highlights of that study:

    The research, according to John Pierce, head of cancer prevention at the University of California, San Diego, who led the research, calls the use of fruits and vegetables in the prevention of cancer “FOLKLORE.”

    The report reveals: “For now, the message for the 2.4 million breast cancer survivors…IS THAT THEY DON’T NEED TO GO OVERBOARD ON VEGGIES…this should lift the guilt if women are feeling, they are not doing enough.”

    The diet consisted of “eleven vegetable servings, three fruit servings, 16-ounces of vegetable juice and 30 grams of fiber. BUT THEY FAILED TO MEET THAT TARGET.”

    During the seven-year study, CANCER RETURNED IN EQUAL PERCENTAGES between those on the higher veggie, fruit diet compared to the control group.

    While increasing their fruit and vegetable intake, “THEY FAILED TO MEET THE FAT TARGET”!

    “They MAY NOT HAVE BEEN SO HONEST ABOUT THE CALORIES THEY ATE” because “the super-veggie group gained 1.3 pounds and the comparison group gained 0.88 pounds, on average.”. “THERE’S NO QUESTION THEY WERE UNDERREPORTING ON CALORIES…”

    FOLLOWING IS WHAT THIS EDITOR HAD TO SAY REGARDING THAT GOVERNMENT RESEARCH STUDY IN HEALTH TIP #505:

    WHAT WAS THE REAL PURPOSE OF THIS RESEARCH?

    “Well, let’s see who would PROFIT from this bogus “SCIENTIFIC” RESEARCH? This would include any business, group, or organization that derives profit from cancer! This would include the researchers, doctors, drug companies, hospitals, insurance companies, and even the American Cancer Society. What most folks fail to understand is that cancer is a huge industry into which BILLIONS of dollars are poured every year.

    “It would appear the these groups who have found cancer such a tremendous source of income, derived from research dollars, drug use, surgeries, hospital stays, etc., feel that too many people are turning away from traditional cancer treatments in favor of alternative and natural cures, and this is hurting their pocketbooks. Thus, in an effort to eliminate the competition, they spend $35 MILLION, mostly in taxpayer dollars, in an attempt to prove that natural remedies for cancer do not work.

    “If the public realized they could PREVENT AND ELIMINATE CANCER THROUGH SIMPLE DIETARY CHANGE, there would be no need for additional dollars to fund cancer research. In the past 30-plus years, over $200 BILLION has been spent on cancer research, and after spending all this money, more people are dying of cancer than before they spent that $200 BILLION.

    “Are we so naïve as to believe that these researchers are REALLY LOOKING FOR A CURE? Remember, that once a cure is found, they immediately lose their research dollars, jobs, and income! And if a cancer cure were found, the American Cancer Society would no longer have a reason for existing. Thus all those within the society, who derive their income raising money for cancer research (while being paid to do so), would lose their jobs also. In addition if a simple cure were found, hospitals and doctors would lose a high percentage of their patients and drug companies would lose BILLIONS in drug sales.

    “Don’t let junk science keep you from eating a diet comprised predominantly of the foods God told us we should eat in Genesis 1:29. THE WORLD’S HEALTH CARE SYSTEM DOES NOT WANT YOU TO BE WELL, as that would be unprofitable to them.”

    PROMINENT SCIENTIST SAYS SCIENCE IS NOT ALWAYS HONEST

    In Health Tip #506, I shared excerpts from Chapter 13 of Dr. T. Colin Campbell’s book The China Study. Chapter 13 is titled “SCIENCE—THE DARK SIDE.” I shared this to give our readers a better understanding of how a so-called scientific study could be released stating FRUITS, VEGGIES DON’T STOP CANCER’S RETURN. Dr. Campbell concluded Chapter 13 with these words:

    “Only someone familiar with the inside of the system can distinguish between sincere positions based in science and insincere, self-serving positions. I was on the INSIDE of the system for many years, working at the very top levels, and saw enough to be able to say that SCIENCE IS NOT ALWAYS THE HONEST SEARCH FOR TRUTH THAT SO MANY BELIEVE IT TO BE. IT FAR TOO OFTEN INVOLVES MONEY, POWER, EGO AND PROTECTION OF PERSONAL INTERESTS ABOVE THE COMMON GOOD.”

    “GOVERNMENT: IS IT FOR THE PEOPLE?”

    In last week’s Health Tip #507, we heard again from Dr. Campbell, with the following words taken from Chapter 16 of The China Study: “During the past two to three decades, we have acquired substantial evidence that most chronic diseases in America can be partially attributed to BAD NUTRITION. Expert government panels have said it, the surgeon general has said it and academic scientists have said it. More people die because of THE WAY THEY EAT than by tobacco use, accidents or any other lifestyle or environmental factor.

    “We know that the incidence of obesity and diabetes is skyrocketing and that Americans’ health is slipping away, and we know what to blame: DIET. SO SHOULDN’T THE GOVERNMENT BE LEADING US TO BETTER NUTRITION? There is nothing better the government could do that would prevent more pain and suffering in this country than telling Americans unequivocally to EAT LESS ANIMAL PRODUCTS, LESS HIGHLY-REFINED PLANT PRODUCTS AND MORE WHOLE, PLANT-BASED FOODS.

    “IT IS A MESSAGE SOUNDLY BASED ON THE BREADTH AND DEPTH OF SCIENTIFIC EVIDENCE, and the government could make this clear, as it did with cigarettes. Cigarettes kill, and SO DO THESE BAD FOODS. But instead of doing this, the government is saying that animal products, dairy and meat, refined sugar and fat in your diet are good for you! The government is turning a blind eye to the evidence as well as to the millions of Americans who suffer from nutrition-related illnesses.

    “THE COVENANT OF TRUST BETWEEN THE U.S. GOVERNMENT AND THE AMERICAN CITIZENS HAS BEEN BROKEN. The United States government is not only failing to put out fires, it is actively fanning the flames.

  13. Thank you TBTAM for this wonderful opportunity for us all to share our opinions.

    I do recommend the two books below as essential reading for anyone seriously investigating the relationship between food and healing.

    These books each include bibliographical references and index.

    1)
    Healing With Whole Foods – 3rd Edition
    Author – Paul Pitchford
    (Asian Traditions and Modern Nutrition)
    ISBN 1-55643-430-8

    2)
    Eat Right 4 Your Type
    Author – Dr. Peter J. D’Adamo with Catherine Whitney
    Dr. D’Adamo, a 2nd generation Naturopathic practitioner, suggests that our blood type may play an important role in how our body interacts with different foods. He also looks at the possible effect our blood type may have on cancer and cancer treatments, suggesting there are notable differences.

  14. After watching the video on the HERS site, I think that what TBTAM took issue with were the “statistics” cited at the end of the video. While it may be true that of the folks who responded to the HERS survey, those percentages are accurate, consider the kind of folks that would seek information from HERS to begin with. Doctors will not, and SHOULD NOT distribute “statistics” that have not been gathered in a transparent, random, and systematic fashion and subsequently subjected to peer review.

    I agree with the basic premise that some patients experience negative outcomes from hysterectomies. That is true of all abdominal surgery. No one with any kind of medical training would likely say anything else about ANY abdominal surgery. Surgery carries risks.

    I also agree with the premise that patients should be informed of all risks. However, I would never agree with presenting information formatted in such a manner as the HERS video to any patient. As it is misleading and intentionally packaged in such a way to “persuede” rather than inform. Information should not have an agenda.

    Equating hysterectomy with, essentially, Female Genital Mutilation takes this from a Medical issue to a feminist issue.

  15. Dear Anonymous of Aug 14th,

    As I am a victim of the current status quo of what my doctor told me to expect after removal of both ovaries and uterus in what my doctor referred to as a ‘total hysterectomy’, 25 years ago, I need to let you know that you are obviously unfamiliar with the methods used by (some?) doctors to obtain consent forms from patients for the removal of their female organs.

    I was told that everything else would remain the same for me, and I should not notice the loss of my body parts except that:
    1)
    I would need hormone replacement therapy for the rest of my life

    2)
    I would no longer experience my monthly periods.
    (This was cited as a ‘plus’)

    My gyno/surgeon of course covered himself by adding that all surgery has risks, and he could give no guarantees regarding the possible outcome, or possible after-effects etc. of the surgery.

    THIS IS THE OUTRAGEOUS LIE BEING PERPETRITATED UPON INNOCENT PATIENTS, THEIR RELATIVES AND THE WORLD AT LARGE.

    HERS Foundation is asking for FULL DISCLOSURE of the KNOWN after effects of this surgery, especially to young women.

    Currently we have a cover-up in the medical ‘industry’ where the facts are being hidden to the detrement of the patients, their families and everyone at large.

    Your bashing of the HERS Foundation for doing ongoing research and surveys and their insistance for full disclosure before surgery/signing of consent forms, seems to be in the best interest of maintaining the status quo.

    Enough is enough. Time for the status quo to change. Time for full disclosure by doctors and the medical ‘industry’ to innocent victims at their mercy.

    I am thankful that during the past 35 years, my deep interest and study of health issues has led me to conclude that these types of female mutilation surgeries, and ill health generally may be avoided entirely. That is my opinion. There are simple, non-invasive, gentle modalities and life-style changes what will help to achieve this.

    I have known people who have had such outcomes. I have had some of my own also. I continue to see and hear people, in person, achieve this healing in their lives.

    I invite you to ‘open’ you mind and to think outside the box.

  16. Anonymous said on August 14: “I agree with the basic premise that some patients experience negative outcomes from hysterectomies. That is true of all abdominal surgery. No one with any kind of medical training would likely say anything else about ANY abdominal surgery. Surgery carries risks.”

    The reason that HERS Foundation exists is because your statement is sickeningly inaccurate and not realistic. This is a reality: The only thing my doctor, who practiced for 30 years told me was that I could be “totally” recovered in two weeks. He also said that if he didn’t take everything, I’d be back in a couple months to get the rest out. Even though I specifically stated I did not want a hysterectomy, it made no difference. All my life I had light normal periods, but within a 24 hour period, all my female organs were amputated and my vagina was sewn into a pocket. All because I had an ovarian cyst and nothing else wrong. That is the reality of what is going on in this country. He never mentioned any risks, or that I’d even have to take hormones. He never mentioned that I would have permanent sexual dysfunction. Zip. The trained medical professionals have a stake in keeping it going. If the majority of these operations were stopped, they would lose their status and income. What is their motivation to tell the truth? There are millions of women in the U.S. who have been sexually mutilated for no beneficial health or medical reason. If the HERS Foundation did not exist, then no one would care but all the individual women who have been butchered for the greed and profit of the trained medical community.

  17. It’s very telling that no doctor has yet posted the Standard of Care for the indications for hysterectomy on this blog.

  18. I am sitting here listening to this thinking, wow, if you knew how profoundly this has hurt my life and my sexuality, the doctors would be speaking up. But you do know don’t you! I have been spayed, a beautiful woman with talent and a family, a giving person who loved to have fun and enjoyed my life my work and my sexuality.
    The written material I was given did not refer to my uterus as my sex organ, and the doctor used scare tactics and reasurances before the surgery to a master level.
    After the first telling comment by the surgeon, about a week and a half after the surgery, is when it was confirmed to me that I had been tricked. The doctor obviously enjoyed insulting me, in fact, it was like he couldn’t wait to insult me.
    That is when the other doctors in their practice come in with the comment “I never heard of that before”, “get some counciling”, you could have looked it up”, etc., it transfers the guilt, to the patient, while their colleagues confirm the patients guilt for the doctor.
    The doctor knows another doctor will not speak against them, because of the damage it would do to the accusatory physicians career. (I am not sure what this is called in the medical field).
    The energy it must take to fool a patient, while acting like a compassionate doctor must be exhausting for the doctor because what they really need is a fix, and fast money. They are addicted to the rush, inflicting harm on another person gives them and the release of their guilt and self loathing after they transfer their guilt on to the harmed patient.
    The damage to the doctors mental health becomes so severe that the doctor has developed a mental illness. After the doctor hears the painful cries of women saying the same comments about how damaged they are, so many times, they become damaged from repeatedly crossing the boundaries of inhumanity. Over and over these doctors hear about the physical, sexual, emotional and hormonal damage they have caused another human being.
    The doctors themselves can not function in a healthy caring manner at this point. The doctor has not received the proper medical help for the mental illness they have developed from their repeated harmful behavior.
    This will be the legacy of these doctors, it is a known fact, that women are being lied to and harmed in this way. Please stop this injustice from happening through another decade. It is the worst thing that could ever happen to a woman, and you know it. Imagine your sex organ being cut off, by deceit, it is a horrible thought isin’t it.
    Women who are too afraid of the damage to their self image perpetuate this cruel act of mutilation. All of the “best thing I ever did, everything stayed the same for me” women, wake up, you have been spayed like an animal, no different, tell the truth, you too are harming women and men with your own private shame.
    Rural PA

    • Please get some help. You sound like you are in so much pain, but I would venture to guess most of it is self inflicted. You think you are damaged, so you are. Please seek help.

  19. First @ Gail Sharpe:
    “Your bashing of the HERS Foundation for doing ongoing research and surveys and their insistance for full disclosure before surgery/signing of consent forms, seems to be in the best interest of maintaining the status quo.”

    This is actually not true. I do not necessarily agree that the status quo is okay. What I questioned was the method by which HERS had gathered their data, and the policy change for which HERS advocates. Certainly the very fact that this discussion is taking place is a tacit acknowledgment even by the medical community that changes in both how hysterectomy is viewed and the situations for which it is indicated may need to be reconsidered. What I specifically questioned though was the methodology for gathering the data and the framing of the information to be presented. The point being that presenting no information is no worse than presenting bad information.

    If you want policy change, and it is clear you do, try using the scientific method to gather some reliable data. Testimonials from women who have had bad experiences are the STARTING point for research, not the end point. While your situation may be the most important to you, it is not statistically significant enough to form the basis for a policy change. Write a research grant. Design a study. Publish some results. THEN present a position based on that instead of a biased collection of “women with stories” and “statistics” derived from them.

    Also, I think you are being dishonest about the policy change you want. You don’t want “full disclosure” and informed consent. You want to end hysterectomies. While I don’t agree or disagree with that position, attempting to design a video that tries to convince women, under the guise of “informed consent”, not to have a hysterectomy is a trojan horse. Informed consent is presenting reliable, scientifically tested research, of which your video contains none.

    @ Rural PA Et Al.

    You seem to believe that by indicting the research methods and agenda of HERS I am somehow denying your story. I am not. In fact, the shame of it is, at the heart of this is a very real issue. Certainly, everyone agrees that medical thinking regarding women and sexual function has evolved significantly over the past 20-30 years, and not just in the realm of hysterectomies. However, no amount of standing at the top of a tower and screaming your story is going to convince the entire medical community to agree to some sort of widespread policy change. A testimonial is not research.

    The best piece of advice I can give you is, if you want to be perceived as something other than extremists, and actually advocate for change in informed consent, gather some data, and do something other than argue generalizations from testimonials and skewed data sets. You will never convince clinicians to change the way they do things based on “your story”. However, if you were to find through peer reviewed, published research that women were being improperly consented for hysterectomies people might start to listen. I do not doubt that some bad consenting goes on. It may be widespread, but with the number of procedures that are being performed annually, do you really know how widespread the problem is? Answering that question is why research exists. Do some. At this point, I’m willing to bet that the number of people you are asking to change their ways (the doctors) far exceeds the number of women you have none randomly gotten data from.

  20. CORRECTION

    Line 3 of the first paragraph of my above blog dated Aug15, which reads:

    …”to as a ‘total hysterectomy’, 25 years ago, I need to let you know that you…”

    Should read instead:

    …”to as a ‘total hysterectomy’, 35 years ago, I need to let you know that you…”

    I apologize for my typing error.

  21. Dear Res Judicata,

    Re the portion of your blog dated Aug 16, addressed to me.

    Thank you for taking the time to address this issue.

    We will have to agree to disagree.

    A few of your statements to me in your said blog, including:

    1)
    “Also, I think you are being dishonest about the policy change you want.”

    2)
    “You don’t want “full disclosure” and informed consent. You want to end hysterectomies.”

    3)
    “Informed consent is presenting reliable, scientifically tested research, of which your video contains none.”

    My blogs posted at this site clearly state my honest positions regarding # 1) and #2). To repeat, I merely ask the question, if there are better alternatives to hysterectomy, why aren’t people like you spending your time doing so, instead of defending the status quo?

    Please feel free to believe that I am being honest in presenting my opinions, or not. That is your free choice, and will in no way affect my honesty and integrity. Spirit identifies with Spirit, and yours and mine apparently do not recognize each other.

    Regarding #3 above and your referring to “your video” etc.
    Clearly, you need to do a little soul searching regarding your semantics. You might discover there needs to be a little housecleaning necessary. I see through your game. All the best.

  22. Caring Carin said…
    In your post you said:

    You seem to believe that by indicting the research methods and agenda of HERS I am somehow denying your story. I am not. In fact, the shame of it is, at the heart of this is a very real issue. Certainly, everyone agrees that medical thinking regarding women and sexual function has evolved significantly over the past 20-30 years, and not just in the realm of hysterectomies. However, no amount of standing at the top of a tower and screaming your story is going to convince the entire medical community to agree to some sort of widespread policy change. A testimonial is not research.

    I say:

    There is no research needed to know that when a hysterectomy is performed the uterus is surgically removed and the vagina is shortened. Women cannot experience uterine orgasm without a uterus, and it is harmful and destructive to shorten the vagina. We have all the research we need to know those basic anatomical facts. What is really needed is a law that will compel doctors to provide the video “Female Anatomy: the Functions of the Female Organs” to every woman who is told she needs a hysterectomy.

    you say:

    The best piece of advice I can give you is, if you want to be perceived as something other than extremists, and actually advocate for change in informed consent, gather some data, and do something other than argue generalizations from testimonials and skewed data sets. You will never convince clinicians to change the way they do things based on “your story”. However, if you were to find through peer reviewed, published research that women were being improperly consented for hysterectomies people might start to listen. I do not doubt that some bad consenting goes on. It may be widespread, but with the number of procedures that are being performed annually, do you really know how widespread the problem is? Answering that question is why research exists. Do some. At this point, I’m willing to bet that the number of people you are asking to change their ways (the doctors) far exceeds the number of women you have none randomly gotten data from.

    I say:

    Your attitude that women are seeking your advice and that all you can tell them is their “stories” are not enough to change the minds and practices of doctors such as yourself exemplifies the need to legally compel doctors to do the right thing by fully informing women. The video has done more to educate and inform women about their anatomy than years of research have done.

    August 17, 2007
    \

  23. When obgyn surgeons see, Surgery Cancelled, at Patients Request & Records Transferred, that they can best bet an internet savvy woman was saved by, hersfoundation.org. Thanks, Hers Foundation, keep up the good work with your scientifically accurate, peer reviewed information.
    To date I have saved one young women personally from an unnecessary hysterectomy, with a Hers Foundation Pamphlet, and have spread the word to several other grateful women. I feel it would be inhuman of me not to tell my story, as gruesome as it is.
    Thanks for caring.
    Rural PA

  24. Who needs more studies? I could only question your motive when the fact that 1/3 of the women in the U.S. no longer have sex organs. Do you get that? UCLA did a study in 2002 concluding that there were no indications for 70% of hysterectomy performed. Not enough for you? As I sit here getting hot flashes and lower abdominal pain, I am reminded that my story is of no interest to you. If not for HERS Foundation, there would be no defense for the mutilation of millions of women. Maybe you should go have all your female organs amputated for no reason and see how you feel. That’s what has been done to millions of women.

  25. I think we need surveys that will ask the specific questions:

    1)
    What kind of human being could actually imagine that there could not be SEVERE negative impacts from removing a woman’s sex organs, at any age, and particularly in a younger woman?

    2)
    What kind of human being could expect a woman to wake up from such a surgery, and continue her life, uninterrupted, and unchanged, and with ‘life as usual’ ?

    3)
    What kind of human being could actually keep promoting the removal of a woman’s sex organs when they are aware that there are well documented and living proof of people who exist and who have been healed, and needed no surgery, from the same reasons some doctors use to suggest surgery to their patients?

    4)
    What kind of human being would not at least, suggest to their patients, that they check out the information about # 3) above, before concluding their information gathering and proceeding with their surgery?

    4)
    What kind of human being could actually keep ignoring all the scientific evidence, (independent and otherwise), that exists to prove that this type of surgery has SEVERE negative impacts on the women who have this surgery?

    5)
    What kind of human being could keep directing their patients away from the very information they need to know before having this surgery, and even after they have had this surgery?

    6)
    What kind of human being can ignore the significant, (very visible on every level of her life), life-altering changes that takes place in a woman and her quality of life, after this surgery, and not imagine that the surgery could be related in some way?

    Enough is enough. Time for a change.

    Women who are not happy, for any reason, after these surgeries, need to be in touch with each other, exchange information and ideas, gather together in ‘support groups’ and most importantly of all, seek counseling and help from ‘independent’ non-profit organizations like HERS Foundation, who offer free counselling, information and help.

    HERS Foundation gives help to the helpless victims, left non-equipped by their physicians, to start to find solutions to their VERY REAL problems.

    The fact that heartless physicians can dismiss our concerns as:

    ‘It’s all in your head’

    ‘There is no link between your symptom(s) and your sex organ surgery’

    ‘Pull yourself together, you just need to try harder to overcome this’ Etc., etc., etc.,

    should be a wake up call to those who have undergone any female sex organ removal.

    After all, we are all SUPERWOMEN and SUPERHUMAN aren’t we?

    Yeah, Right.

  26. If this crime upon women was being perpetrated by anyone else but an M.D., the general public would be horrified and outraged. What would people think if women were abducted off the street and then after a few days, dropped somewhere with their female organs amputated with a bottle of synthetic estrogen in their hand? Would you expect the women to feel better? Be happy? Say it’s the best thing that ever happened to them?

  27. Looks like I’m paying the price of not moderating this comments section.

    I’m going to let the discussion continue here, but am establishing a few ground rules:

    1. Please limit your comment to a short paragraph.

    2. Feel free to say your piece, but PLEASE let’s confine the conversation to the proceduree this post addresses, namely Hysterectomy. Not oophorectomy. I know that some of you who have had posted have had unnecessary removal of the ovaries and adverse outcomes as a result of that. But this post addresses hysterectomy alone.

    3. To those using this comments section as their new home (and you know who you are), it’s time to move on. You’ve had your say, many more times than once. While I respect your right to have an opinion, you are monopolizing the coversation and holding court in MY blog. It’s gone beyond polite behavior. If you have more to say,by all means say it, but on your own blog.

    4. No more anonymous posts. And to those few folks addressed in #3 above, don’t go making up new names and posting again.

    I will be moderating comments from now on, and deleting those that don’t fit the new guidelines.

    Sorry.

  28. The below study was done in 2000. Why would hysterectomy need to be defended?

    Department of Obstetrics and Gynecology, University of California, Los Angeles 90095-1740, USA. mbroder@ucla.edu

    OBJECTIVE: To evaluate the appropriateness of recommendations for hysterectomies done for nonemergency and non-oncologic indications. METHODS: We assessed the appropriateness of recommendations for hysterectomy for 497 women who had the operation between August 1993 and July 1995 in one of nine capitated medical groups in Southern California. Appropriateness was assessed using two sets of criteria, the first developed by a multispecialty expert physician panel using the RAND/University of California-Los Angeles appropriateness method, and the second consisting of the ACOG criteria sets for hysterectomies. The main outcome measure was the appropriateness of recommendation for hysterectomy, based on expert panel ratings and ACOG criteria sets. RESULTS: The most common indications for hysterectomy were leiomyomata (60% of hysterectomies), pelvic relaxation (11%), pain (9%), and bleeding (8%). Three hundred sixty-seven (70%) of the hysterectomies did not meet the level of care recommended by the expert panel and were judged to be recommended inappropriately. ACOG criteria sets were applicable to 71 women, and 54 (76%) did not meet ACOG criteria for hysterectomy. The most common reasons recommendations for hysterectomies considered inappropriate were lack of adequate diagnostic evaluation and failure to try alternative treatments before hysterectomy. CONCLUSION: Hysterectomy is often recommended for indications judged inappropriate. Patients and physicians should work together to ensure that proper diagnostic evaluation has been done and appropriate treatments considered before hysterectomy is recommended.

  29. Jeanne –

    For the hysterectomies that ARE appropriate, are performed only after careful consideration or trial and failure of non-surgical treatment, and are freely chosen by the women who have them.

    Those are the hysterectomies that this post is about. They are few and far between, but when performed in the right women, have great outcomes.

    These are the nuances of medicine when it is practiced according to the right standards and when there is respect for women’s choices. It is the medicine I practice. It allows for open discussion of options, and inclusion of the patient in the choice of options.

    One of those options is hysterectomy.

  30. I’m closing comments on this post, since the same folks appear to be commenting and the discussion has become repetitive.

    Peace to all.

  31. I have friends who’ve had hysterectomies, but they were final measures after years of flooding, cramping, pain etc.
    They all have improved health and a better quality of life. One friend has some sexual dysfunction, but then uncontrollable bleeding and pain didn’t do much for her sex life either. She still feels it was the right decision.
    I recall she couldn’t even relax when we were flying together on business trips, I was continually being asked to check her seat or the back of her skirt – what a way to live!
    The concern about the States is the NUMBER of hysterectomies and some of your women say that some doctors regard it as the next step after you’ve had kids.
    Some suggest it’s for money.
    I read that 1 in 3 of your women will have a hysterectomy by age 60, that’s concerning and needs investigating…
    I’ve also read on some of your health sites, young women contemplating a hysterectomy after “persistent dysplasia” – that’s crazy. Your women tend to greatly over-estimate the risk from cervical cancer – with early screening most have had an early false positive and biopsy so they’re scared to death.
    I think honesty has always been missing from our health care, but is a major problem in the States where the system seems coercive – doctors demanding cancer screening or you get no reliable contraception – that shocked me.
    I’m reading Gilbert Welch’s new book, “Over-diagnosis” and he says the lifetime risk of dying from cervical cancer is 0.02%, but that millions of women have treatment for “pre-cancer” every year – that represents vast over-detection and over-treatment for a very small risk.

    Anyway…
    It’s the gap between the number of hysterectomies happening in the UK and Australia and the States that needs to be looked at…alerting women to the risk and counseling/educating doctors might be helpful.

  32. What is really the cause.
    I am very glad I had the surgery it help me out with worrying why and what to do. I think the real reason these surgery are performed are because we used the birth control pills so long. I started at 16 and did not finish until I was 21. Stoping to have my children and resumming I think it throught my harmones balance off. I am glad I lived through it and got it out of the way.

  33. Goodness, these comments are all over the place so if I may let me inject mine also. Years ago I was diagnosed with invasive cancer. I had a RADICAL hysterectomy, not to be confused with any other type Hyst. in the world. For the record it involved removal of Uterus, ovaries bilateral, tubes, cervix, all pelvic lymph nodes bilaterally, and 1/3 of the vagina.

    This surgery was a no brainer. If I wanted to continue to live this was the trade off. One I willingly made. Not only was it a long recovery with many complications but it also involved instant menopause. I also lost every bit of my sex drive. I was certain that part of life was over as even the thought of it was very unpleasant. But, since I was married I knew this was a problem that had to be fixed.

    It took a long time and a lot of patience on his part and a lot of work on my part but we reached our happy place. Yes, I have incredible orgasms and yes my husband is satisfied. I do not feel mutilated or less of a woman. For a time I did, but that time has passed. I wont say it’s the same as it was before cancer but it’s pretty darn good. The biggest challenge is that I just don’t have the same sex drive and desire as I once had so that was definitely an issue we had to overcome and reach a compromise on and it has all worked out. But for goodness sake yes woman can have sex and have great sex after a hyst., even after a radical hyst for cancer. Maybe it takes needing a loving, patient partner who is willing to work with you, but I find it insulting for ppl to say such terrible things like we are being mutilated and losing all of our sex drive. If I can still find much enjoyment in sex after the surgery I had then I fail to see how woman having much less surgery couldn’t also find the same thing.

  34. @Res Judicata
    I initially got my information from The British Journal of Science and papers released from Brown University. On that information, I made the very clear decision to never, ever have a hysterectomy. I can honestly say that in my opinion, a bullet to the head is more humane. I found the HERS website 3 days ago. The information is exactly the same!

  35. I had a hysterectomy and total oophorectomy 5 years ago, and wish I had done it a couple of years sooner. No more heavy bleeding, no more abdominal pain, no more headaches. My IBS has eased up considerably, and my Restless Leg Syndrome is gone. I don’t take HRT at all, not even those OTC supplements. My surgery was the best thing I ever did. And by the way, my sex drive is fine, and since I don’t have a partner, or do casual sex, I am happy with the results. I’ll tell you right now that my sex life for the last couple years before my surgery were miserable, I am much better, and much happier now. So I hope other women will do the research and make and informed decision, instead of listening to a few people with an agenda.

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