I'm not entirely sure what motivated me to write today about the disappearing American uterus. Perhaps it was this opinion piece in the
New York Times,
THE WEAKER SEX by Marianne Legato a physician who specializes in women's health care.
Over the past two decades, we've radically revised how we conduct medical research and take care of our female patients. And we've made valuable discoveries about how gender helps determine vulnerability to illness and, ultimately, the timing and causes of death. But I now believe that we doctors and researchers may have focused too much on women.
http://www.nytimes.com/...
She thinks women are overstudied, I disagree.
Let's take a look at hysterectomy.
Let me state for the record, that obviously I'm not a doctor, and these are simply my own observations, perhaps shared by other women--and some men.
Not all hysterectomies are bad--the question is, are they done too frequently?
Hysterectomy is the second most common surgical procedure in the United States. Did you know that about 90% of the time it's not for cancer?
Here are the statistics:
Hysterectomy is the second most common operation performed in the United States. About 556,000 of these surgeries are done annually. By age 60, approximately one out of every three American women will have had a hysterectomy. Yet it's estimated that 30 percent of hysterectomies are unnecessary.
http://www.healthatoz.com/...
The obvious question is why? I have my own explanations. I am an expert, I was offered--encouraged--to have a hysterectomy right around my 30th birthday.
I fought back. To this day, I am a complete female, with all my organs intact. But I am also lucky. I am white, educated and most people would consider me reasonably affluent.
I had the means to explore other options. I had the means to locate a doctor who could perform complex surgery. I hate to think this, but one reason hysterectomy may be so common is because, from what I gather, it's relatively easy to perform. Perhaps for some doctors it's a profit center. The estimated annual cost of these procedures is over $5 billion.
By the way, I didn't have cancer. Had I succumbed to the fear mongering of the many doctors I visited, I would have ended up another semi-butchered, sorry American statistic.
This seems to me to be the worrisome statistic, certainly from the point of view of a lay person. I emphasize, I'm not a doctor and I expect doctors may weigh in with very compelling reasons why, the lay understanding is crazy.
But . . .
About 10% of hysterectomies are performed to treat cancer of the cervix, ovaries, or uterus. Women with cancer in one or more of these organs almost always have the organ(s) removed as one part of their cancer treatment.
A handful of doctors are now even re-thinking the necessity of performing a hysterectomy on some women who have certain types of reproductive cancers and still may want to have children. I know one such doctor very well, he hopes to lead a revolution in medical thinking. Medicine moves at a glacial pace so his ahead-of-the-curve ideas may only bear fruit for young girls, but at least he's trying.
By the way, if anyone who is reading this is in the midst of a cancer and fertility struggle and wants to contact this doctor, please email me privately.
Back to the original question, if 10% of hysterectomies are performed for cervical cancer, what about the other 90%?
From the HHS Web site:
Uterine fibroids. Fibroids are common, benign (noncancerous) tumors that grow in the muscle of the uterus. More hysterectomies are done because of fibroids than any other problem of the uterus.
Endometriosis. This is another benign condition that affects the uterus. Endometriosis is the second leading reason for hysterectomies. It is most common in women in their thirties and forties, especially in women who have never been pregnant.
Uterine prolapse. This is a benign condition in which the uterus moves from its usual place down into the vagina.
Cancers affecting the pelvic organs account for only about ten percent of all hysterectomies. Endometrial cancer (cancer of the lining of the uterus), uterine sarcoma, cervical cancer (cancer of the cervix), and cancer of the ovaries or fallopian tubes often require hysterectomy. Depending on the type and extent of the cancer, other kinds of treatment such as radiation or hormonal therapy may be used as well.
http://www.womenshealth.gov/...
Back to the original question. Why?
The frequency with which hysterectomies are performed in the United States has been questioned in recent years. It has been suggested that a large number of hysterectomies are performed unnecessarily. The United States has the highest rate of hysterectomies (number of hysterectomies per thousand women) of any country in the world. Also, the frequency of this surgery varies across different regions of the United States. Rates are highest in the South and Midwest, and are higher for African American women. In recent years, although the number of hysterectomies performed has declined, the number of hysterectomies performed on younger women in their 30s and 40s is increasing, and 55 percent of all hysterectomies are performed on women 35 to 49.
Okay, flame away. Tell me why I'm practicing medicine without a license--not true.
I'm simply suggesting that frequently there are less life-changing medical options.
We're being told that we must be wise medical "consumers", that we must be "frugal" health care consumers, we must avoid "unnecessary and wasteful" health care spending--you can begin by educating yourself and understanding your options.