The People News, a free newspaper serving Cleveland Tennessee (TN) and Bradley County Tennessee (Tn).

Of Bradley County Tn.


                            The People News, a free newspaper serving Cleveland and Bradley County Tn.

The People News
Special Report






Hysterectomy.... Not Always  Necessary

by Alexandra Edwards

Without a doubt, visiting the doctor when a serious health problem arises is the first and foremost thing to do. Once the problem has been diagnosed, the doctor will either write a prescription for medication and maybe suggest coming back at a later date for a check-up or recommend surgery. The decision to take the medication and keep the appointment for the next visit, is left entirely to the patient.  However, in more drastic cases, immediate surgery may be advised by the doctor as being the best remedy. In some cases though, surgery may not really be necessary but is the accepted standard treatment for a particular medical problem.

Thirty or forty years ago, especially in Britain, tonsillectomies were performed on thousands of children after being diagnosed with tonsillitis, an infection of the throat. The medical profession, convinced the public that the tonsils were an unnecessary organ anyway, therefore removing them would cause no harm. A typical tonsillectomy would require the patient to spend up to one week in the hospital, was extremely painful for the child and in many cases did not completely cure the throat infection. Today, tonsillectomies are rarely performed and tonsillitis is now treated with medication.

Alexandra Edwards

As in the case of tonsillectomies,  today thousands of unnecessary hysterectomies are being performed each year. A hysterectomy is removal of the uterus or womb. Many women, especially those considered beyond child bearing age, are given a "total" hysterectomy with bilateral salpingo-oophorectomy, which means not only the removal of the uterus but also the cervix, fallopian tubes and ovaries.  Depending on the medical condition, a  total hysterectomy may be the only option and in many cases saves lives or gives women freedom from long suffering pain and discomfort.

Each year 600,000 hysterectomies are performed in

the United States, at least 50% are patients diagnosed with Uterine Fibroids. Uterine Fibroids are benign tumors that are made up of the muscle and connective tissue from the wall of the uterus. They can grow from the size of a pea to the size of a grapefruit. The tumors, which are in the majority of cases non-cancerous, live entirely on estrogen so therefore disappear after menopause when estrogen levels drop. Less than 0.1% of all uterine fibroids are malignant.

A visit to the gynecologist could become a very traumatic experience for a woman, if after what she thought was going to be just a routine check-up, is told she will need immediate surgery to remove tumors that are growing inside her.  Many women are diagnosed with uterine fibroids when they reach middle age, when hormones are raging and estrogen levels escalating and dropping in preparation of  the many changes that will accompany the aging process. Fibroid tumors are often detected  by the gynecologist after a simple internal examination, the patient in many cases may be unaware of any problems or symptoms. However, in many cases, a "total" hysterectomy is suggested by many doctors as being  the only alternative for  women, especially for those beyond child-bearing age, simply because the organs to be removed  are considered by the medical profession to be no longer necessary.

A Report from the National Uterine Fibroids Foundation (NUFF) shows that as many as 80% of all women have uterine fibroids at some stage of their lives, but only one in four have symptoms severe enough to require treatment.  According to a 1998-2000 NUFF national survey,  the highest percentage of women who answered "yes" to having a hysterectomy were in Southern States. Among the top ten were Mississippi (30.8%), Alabama (30.2%), Louisiana (29.7%), Arkansas (27.8%)  South Carolina (27.1%) Tennessee (26.9%) and Georgia (26.4%). A report

published by Obstetrics and Gynecology shows "Every 10 minutes, 12 hysterectomies are performed in the United States, 9 of them probably didn't meet the guidelines set out by the American Colleges of Obstetricians and Gynecologists for a hysterectomy." An estimated one in three women in the United States has had a hysterectomy by age 60.

Many physicians  now consider the removal of "healthy" ovaries as part of a hysterectomy as being a form of castration, recognizing that the ovaries are a vital part of the woman's anatomy and should only be removed if absolutely necessary. Linda Bradley, M.D. a physician at Cleveland Clinic, Ohio, says, "If your ovaries are removed before you reach menopause, the sudden loss of your main source of female hormones will bring on menopause. This "surgical menopause" can cause more severe symptoms than a natural menopause. Ovarian cancer is relatively rare. Only one in 70 women develop it. In comparison, a woman's risk of breast cancer is one in 8, but we don't prematurely remove breast tissue."

There are several less drastic alternatives to a  hysterectomy to treat uterine fibroids if they are causing a problem. One is a "myomectomy" where only the fibroids are removed and not the uterus. A myomectomy is said to be a much more complex surgery for the surgeon to perform, which is why many opt instead for a total hysterectomy, which is easier and requires less skill. Another less invasive alternative to a hysterectomy is

uterine fibroid embolization, (UFE). By injecting a small particle into the artery that feeds the tumor it will restrict its blood supply, thus decreases the size of the fibroid. Dr. Bradley says of UFE  "I've witnessed high patient satisfaction. Studies show excellent recovery, no change in sexual function and libido, and no problems with bladder function or incontinence."

Many women, especially in Europe, let uterine fibroids take their course, assuming that they will eventually  disappear once estrogen levels decline during menopause. There are several vitamin supplements and herbal remedies for the relief of fibroid discomfort which can be found in health stores.

For a woman first diagnosed with uterine fibroids, of course take the doctor's professional advise seriously. If a total hysterectomy is recommended there is no need to rush into it without first doing some research. The local library will have many books on the subject or you can do a quick search on the Internet. It's your body and your decision, is this hysterectomy really necessary.

Some of the useful and informative websites used to obtain this information were:

The National Uterine Fibroids Foundation

The Cleveland Clinic