Hysterectomy Hysteria: or .... How to hang
onto your uterus
by Carole Tashel, Clinical Herbalist
Imagine you were unlucky enough to be a menopausal
woman in the mid- to late-1800's, perhaps with irregular
painful periods, hot flashes and a dash of depression.
You most certainly would have been diagnosed with"hysteria,"
a catch-all diagnosis with a misconception at its foundation:
that the uterus (Latin hystera) was the origin
of women's physical maladies and psychological "neuroses."
The cure, then, for this distress was hysterectomy
(surgical removal of the uterus, cervix and ovaries).
Perfected in the 1870s, hysterectomy was eagerly adopted
by doctors as a quick fix for a variety of women's problems.
If you think that modern doctors in the late 20th century
would surely have jettisoned these old-fashioned misogynist
ideas, you're wrong. At a 1971 meeting of the American
College of Obstetrics and Gynecology, the prevailing
attitude toward the uterus was summed up by Ralph W.
White, MD: "It's a useless, bleeding, symptom-producing,
potential cancer-bearing organ."
But things are better now in the 21st century, right?
Think again. Hysterectomy is still the second most commonly
performed surgery in the US (after Cesarean section).
The most frequent recipients are women just approaching
menopause, age 40 to 44.
In 1988, the American Medical Association got curious,
did a study and found that about 50% of the 700,000
annual US hysterectomies were unnecessary. Perhaps more
accurate than the AMA's conclusion, the experience of
the Hysterectomy Education and Resource Services organization
reveals a much more chilling reality: Of the 110,000
women HERS has counseled and referred to board-certified
gynecologists for second opinions, 98% of them discovered
they didn't need a hysterectomy after all! The lesson?
Get a second opinion, and educate yourself about tests
(like laparoscopy and ultrasound) that can determine
whether you really need a hysterectomy.
Is Your Doctor Your Advocate?
Hysterectomy is not the simple, benign procedure many
docs make it out to be. For too many women, hysterectomy
is merely the beginning of a new set of problems. During
surgery, ligaments and nerves are frequently damaged
or severed, leading to problems such as constipation,
urinary incontinence and disturbed sexual response.
If you have fibroids (a common reason for hysterectomy)
you may be able to have only the tumors removed. If
you must have your entire uterus removed, find a doctor
willing to preserve your cervix and ovaries. Cervix
removal leaves some women with a shortened vagina resulting
in painful intercourse for the rest of their lives.
Few doctors know the important role the cervix plays
in urinary, bowel and sexual function; older MDs have
been trained to always remove it, which they do 98%
of the time.
And though women have less than a 1% chance of ovarian
cancer, 60% of hysterectomies also remove the ovaries.
Ovaries have an important function throughout a woman's
entire life, producing androgens, affecting her sense
of well-being, muscle strength and libido.
Beware of doctors who press their ill-advised opinions
on you and seem not to be your advocate. When one of
my friends planned a necessary hysterectomy, her doctor
recommended removal of her ovaries as well, because
they were "just a cancer waiting to happen."
(Are men encouraged to preemptively remove their prostates?
I don't think so.) This is not my idea of prevention.
And according to a 2003 survey of 700 gynecologists
in the Washington, DC area, women are rarely or never
counseled on the disadvantages of hysterectomy or their
choice as to the extent of the surgery. This is not
my idea of informed consent.
Ending the Medical Nightmare
There are some very good reasons to surrender your
uterus to the knife: Invasive cancer, trauma or damage
to the uterus, life-threatening bleeding or other long-standing
conditions that interfere with quality of life. Otherwise,
you have ample time to make a truly informed decision
while exploring viable alternatives to relieve symptoms
and/or correct your condition.
Two major reasons doctors suggest hysterectomy are
heavy or prolonged bleeding and fibroid tumors (which
are often the cause of heavy bleeding). Abnormal bleeding
is rarely caused by cancer, but it does happen, so it's
imperative to get a medical diagnosis before trying
natural alternatives. Uterine prolapse (descent of the
uterus due to weakened support) is less common, but
it is treatable by an ancient Maya uterine massage technique.
Bleeding is disruptive and can be pretty scary. Once
you determine your bleeding is not life-threatening,
work with a practitioner to identify appropriate remedies.
Since many women have only a couple of episodes of abnormal
bleeding while heading toward menopause, it's worth
treating it naturally to avoid hysterectomy. Susun Weed
puts it succinctly in her book Menopausal Years:
The Wise Woman Way, "Menopausal flooding doesn't
last forever; hysterectomy does."
Natural treatments might focus on addressing the anemia,
enhancing vitamin K production in the colon (helps clotting),
increasing bioflavonoids to strengthen capillaries and
balancing prostaglandins. Herbs can strengthen uterine
walls, regulate hormones and check abnormal bleeding.
Fibroids are firm, non-malignant uterine growths that
occur in the majority of women over 40; most remain
small and cause no problems. They develop in the context
of high estrogen levels, then shrink after menopause
as estrogen levels drop. Symptoms depend on the size
and location of the fibroid. Natural therapies such
as acupuncture, dietary changes, herbs, homeopathy and
compresses can frequently stop fibroid growth and alleviate
Avoiding Unnecessary Hysterectomy
It's important to deal with reproductive abnormalities
early, before they turn into full-blown problems. If
you have a small fibroid that's not causing any problems,
it‚s possible you can shrink it. If your cycles
are difficult or you have PMS, balance your hormones
before things get worse. Watchful waiting is not the
Reducing excess estrogen levels ("estrogen dominance")
is a critical part of any attempt to avoid unnecessary
hysterectomies, as well as other serious problems like
cancer. Approaches are varied and surprisingly effective
for many women.
* If you are overweight, do something about it. Because
fat cells convert other substances into estrogen, extra
weight increases estrogen levels. Fibroids in obese
women may not shrink after menopause. (What causes weight
gain is a complicated topic, and beyond the scope of
* Avoid foreign estrogens (xenoestrogens). Many chemicals,
pesticides and pollutants double as strong estrogens
in the body, skewing the balance. Hormones added to
commercial meat, poultry and dairy are definitely unwanted.
* Eating a variety of fresh, whole foods increases
your intake of compounds with weak estrogen-like activity
(phytoestrogens). These mitigate high estrogen levels.
There are many herbal phytoestrogens as well.
* Sometimes the problem isn't excess estrogen, but
rather, a compromised ability to clear estrogen. Fiber
can help (especially flax, rye, buckwheat, millet, oats
and barley). Your liver changes estrogen into a harmless
metabolite so it can be excreted. If you've had hepatitis
or taken drugs, your liver needs extra support (options
include Milk Thistle and increasing your intake of cabbage
* Women with hormonal problems are often advised to
reduce their intake of saturated fat from animal products.
I have no proof, but I suspect the real reason some
improve on this regimen is that they are not ingesting
the xenoestrogens concentrated in the fats of commercially-raised
In order for doctors to realize that women's body parts
are not dispensable, women will need to educate themselves,
then share what they learn with their doctors. It wouldn't
surprise me if proactive, menopausal Baby Boomers begin
to reduce the number of unnecessary hysterectomies.
Hysterectomy Education and Resource
Services, www.hersfoundation.com, 888-750-4377. An independent,
nonprofit, international women‚s health education
organization. Telephone counseling by appointment.
National Uterine Fibroids Foundation, www.nuff.org,
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