Hysterectomy Hysteria: or .... How to hang onto
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."
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
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
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
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
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.
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 best choice.
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 this article.)
* 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 family vegetables).
* 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 animals.
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, 800-874-7247
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