Hysterectomy - the Experts Speak Out

Hysterectomy: Cathy Parafian, age 44, was Sentenced to Life without parole, relief, or remedy in 2006 by a gynecologist. This is her story.

hersfdn@earthlink.net (HERS Foundation) — Sun, 29 Nov 2009 21:40:00 +0000

In 2006, two days after I turned 44 years old, with severe pelvic pain I was taken to the Emergency Room by ambulance at William Beaumont Hospital in Royal Oak, Michigan. Approximately eight hours later, I was hysterectomized and castrated by Robert A. Delp, M.D., without my consent and against my expressed directive. I overheard Katherine Damm, M.D., tell the radiologist that at the order of Dr. Delp that I was being taken up to pre-op for a total hysterectomy. I was shocked, began to cry and refused to go into surgery. When I refused and asked, “why?” about a dozen times, the only answer I received from Dr. Damm, Dr. McBride and other staff was that they could not give me an answer, and that I’d have to speak to Dr. Delp (who was not in the hospital). When Dr. Delp finally arrived hours later and I asked why he would suggest a hysterectomy, he only said, “something has to be done, doesn't it, you can’t stay in all that pain can you?” I had been given a lot of drugs for pain which made me feel overly emotional and confused. I think the worst part of it is that it took away my ability to perceive danger. While I was in severe pain, and after being up all night, Dr. Delp pressured me repeatedly to agree to surgery or we would lose the operating room. His exact words were “something has to be done, and the operating room is waiting and we could lose it.” I refused several times to consent to hysterectomy, and made it clear that I would only agree to exploratory surgery. I told him several times that I wanted all my organs saved, and the very least surgery possible to treat the cause of my pain. It turned into a standoff until he finally agreed and promised to do the least possible surgery. Even with all this going on, I never imagined the unthinkable, that Dr. Delp would intentionally plan to perform an unnecessary hysterectomy on me. However, with reckless disregard for me, my directive, and in contravention to the consent form I signed, Dr. Delp hysterectomized and castrated me. I believed that a doctor could only perform an emergency surgery without consent when it was a life or death matter, but I learned how Dr. Delp got around that when I received my medical records. My consent form was altered to show I consented to a TAH BSO, even though nothing could be further from the truth. It is important to note that it is clearly shown in the pre-procedure checklist that my consent form had not been completed prior to surgery, which means that it had to be filled in sometime during or after surgery.

Later I learned that I had a benign dermoid cyst on each ovary and that the conservative treatment for torsion of the blood supply to the ovary, and dermoid cysts, would have been to untwist my ovarian artery and perform a cystectomy (removal of the cysts, leaving both ovaries intact). Delp was the attending physician and the one in charge, but he was assisted by residents working under him who helped to railroad me into to pre-op and assist him in the unnecessary total hysterectomy and castration he performed on me. The names of the other doctors involved are Kristen McBride, M.D., Katherine A. Damm, M.D., and Sayeema N. Daudi, M.D.

Dr. Daudi was the only one who seemed to have any sympathy or ethics. She tried to get Dr. Delp to only do a minor surgery and just remove my left ovary, but after he yelled at her in front of me saying that “it would make no difference on my recovery time whether they just removed one ovary, or everything,” she never said another word and would subsequently assist him in hysterectomizing and castrating me.

I filed a medical malpractice lawsuit against Dr. Delp, and learned that he didn't carry any medical liability insurance which the jury would never hear. Delp only had a fund, administered by William Beaumont Hospital consisting of $100,000 of his own money which was to be used for his attorney's fees and costs if he was sued. Like me, most people think that doctors have to be insured to perform major operations, but I would find out that in most states, including Michigan, there is no law that requires medical malpractice insurance. I was prevented from suing the hospital because Dr. Delp was a subcontractor whom I had previously seen outside the hospital, therefore he was not directly employed by the hospital. With the laws stacked to protect the doctor and hospital, there are little or no repercussions and no legal remedy for the patients who are harmed.

I was very fortunate to find a great attorney to pursue my case when there was little money to be won, at best. I would get another devastating blow after a nightmarish trial that reminded me more of a circus than a serious legal proceeding. When the trial started, there was a woman sitting on the bench who would sneer, stare and give me dirty looks every time I had to pass her entering and leaving the courtroom as she sat there with a file with my name on it taking notes. I later learned she was from Beaumont Hospital. The jury found for Dr. Delp, rewarding him again for hysterectomizing and castrating me. In the process of jury selection, called voir dire, both the Plaintiff and the Defense attorney's can have possible jurors dismissed who they think will find against their clients. Of course, any juror who had a negative experience with the medical industry was dismissed either by Delp's attorney or by their own admission that their experience was so traumatic that they couldn’t be objective. One female juror who was dismissed had a large number of fibroids which she described to be all over her uterus and ovaries, and she had refused a hysterectomy for years waiting for them to shrink at menopause, and even stated she had been pressured to get a hysterectomy by her doctor. Another juror was dismissed when he said the same thing happened to his ex-wife and he felt he couldn’t be objective, that he would automatically find for me, and as he walked out of the courtroom he looked at me and said “I’m sorry.” Another juror was also dismissed when he stated that he would be on my side because he witnessed a doctor abusing patients who was later prosecuted.

I'm sure it's not easy for the general public to believe that these horrible things can go on in a major U.S. hospital. I would have found it hard to believe too had I not experienced it myself. As you see from this blog, this type of abusive treatment is not the exception, it is routine practice in gynecology. When you learn that 1 in 3 women in the U.S. are hysterectomized before age 60, it's easy to see that what was done to me was only one of the many ways women are given unnecessary hysterectomies. Part of the problem here is that the only remedy is to file a civil suit and then you have to prove that your treatment fell below the accepted standard of care (which, in gynecology is determined by a self-appointed group of gynecologists). The defense experts were hired and paid handsomely to testify, i.e., Robert Robins, M.D., $7,000; Stephen M. Olson, D.O., $5,050 and Raja Rabah, M.D., $4,000. A criminal prosecution would be more appropriate since there is fraud and bodily injury. However it is not considered a crime, nor is it against the law for an M.D., like Delp to take a knife and cut out a woman’s body parts without her consent while she is restrained by straps to an operating table and unconscious.

I have experienced many chronic health problems since this was done to me (most of those listed on the HERS website aftereffects data), and the stress of coming to terms with what was done to me has caused Post-Traumatic Stress Syndrome. I wake up every day and realize this is not a dream, it's not a nightmare that I will awaken from, it's a living nightmare. Dr. Delp probably didn't think twice about possible legal consequences of hysterectomizing and castrating me without my consent because he knew he would most likely be granted legal protection. Very few women win hysterectomy lawsuits and very few people win medical malpractice lawsuits of any kind. The cards are stacked against the victims right from the beginning. However, I would encourage other women to still pursue a lawsuit. Each and every woman this has been done to needs to speak out because it is the silence and anonymity that allows this to continue. Not only did all the women doctors listed above assist Dr. Delp in ruining my health, but Nurse Vicki Metcalf would testify at trial, that although she did not remember me, that I consented to a total abdominal hysterectomy. Nurse Metcalf's signature was on the consent form as a witness, but if she was truly anywhere near me, she knew for a fact that I adamantly refused. I don't know how any of these people sleep at night. Doctors do not do this alone.

This has all been horribly difficult and embarrassing and not easy to talk about, but I hope it will help other women stand up and speak out because this shouldn't be done to one more woman.

Ashley's Story

hersfdn@earthlink.net (HERS Foundation) — Thu, 12 Nov 2009 02:52:00 +0000

When a pregnant woman enters a hospital to give birth, she expects that she will leave there with her baby in her arms, and her uterus in her body. While most women do leave the hospital with their baby, many leave without their womb.

The mixture of joy when she looks at her healthy infant, and the pain and suffering of the loss of her reproductive sex organ, is irreconcilable. Well meaning family and friends try to be kind and comforting when they tell her how lucky she is to have a healthy baby, especially if she has other children. And because her loss is not visible, family and friends may not know or understand the profound physical and life altering changes she is experiencing. It is often lonely and isolating. It would help to listen when she talks about how she feels, and to validate her experience by telling her that you’re sorry this was done to her. The usual platitudes, “you’ll be okay”, or “you’re so lucky the baby is healthy” or “you’re lucky to be alive” are a denial of what she’s going through.

The following is the experience of Ashley Shewman, a woman who believes that if she had had better medical treatment during her pregnancy, and a C-section delivery, her uterus would still be where it belongs, in her body.

Ashley Shewman’s Story

Deciding to have another child was a hard decision for me, and my husband. At that time we had a very challenging four-year-old, and although the pregnancy was perfect, I hemorrhaged after labor and required a blood transfusion and a Dilation and Curettage (D&C). I remember the doctors telling me if the surgery didn’t work that they would have to give me a hysterectomy. My eyes filled with tears and within seconds I was sleeping – and undergoing surgery. I did not know if I would wake up with my husband telling me that we can not have anymore children or if the D&C was a successful treatment.

That time it was.

When we decided to have another child things were a little different. I was 29 years old. At the beginning of my pregnancy I started to bleed. I thought I was having a miscarriage and was ordered to bed rest for a week. My next doctor’s visit went fine and I heard a strong heartbeat.

Throughout my pregnancy I bled often and changed my OB to a high risk doctor. They found out that I had a condition called Placenta Praevia, where the placenta is attached to the uterine wall, close to or covering the cervix, which can cause massive bleeding during a vaginal delivery. It sometimes occurs in the latter part of the first trimester, but usually during the second or third. I visited the doctor more often than normal and was told that if it didn’t improve, I would need a c-section. During the second trimester everything seemed fine and I was back to normal.

I wasn’t even eight months pregnant and went into labor. I was seven weeks early - in the hospital dilating - and there was nothing they could do to stop or slow down the contractions. Ella May was born vaginally,on May 4, 2008 at 2:47 am and went straight to the NICU. The doctors decided to give me a D&C after birth just to be sure there was no more placenta. I remember feeling really sluggish and tired after going home. I thought that after a few days I would feel better physically but I never did.

Ella was a month old when I hemorrhaged again. Blood was everywhere and I remember thinking, “Does this happen to someone twice? Am I going to die? Is this it?”

I was rushed to the hospital by ambulance. That was the longest night of my life. In the emergency room I sat in the bed bleeding on and off, speaking to doctors, and worrying onlyabout my baby because I was breast feeding. After waiting a few hours, a woman doctor came in to speak about my options. She suggested we perform another D&C. As I sat on the cold hospital bed I asked her if I would have to have a hysterectomy if the D&C does not work. She said (and I still can remember her voice and every wordwas she matter of fact? Cold? Distant? Confident and assured so that you believed her?She seemed very confident about her decision to perform the D&C. “We will not have to go down that road.” With both of my children I heard the word hysterectomy and my heart went numb. I didn’t even know what to think.

The procedure was only supposed to take 10 minutes. After over an hour of the most annoying and exhausting surgery (I had a spinal, so I was awake). I was told it would take ten minutes and after more than an hour I was very annoyed and uncomfortable. the doctor came up to me and said, “We can’t get the entire placenta out. We will have to give you a hysterectomy.” By then I was so tired I think after she told me that I passed out from the surgery.

I woke up in the most excruciating pain I have ever felt in my life. My husband was at home resting at the time. I sent him home because I thought I was getting another D&C and when I was done I would call him. He didn’t even know I had a hysterectomy. We didn’t have the time to talk about this. I didn’t have the option. I had to have my mother call him and tell him what happened. No one else was with me at the time of the surgery. The recovery was very difficult and long. My husband and I didn’t get a chance to discuss my surgery until almost a year after. He thought I would be fine and things would go back to normal, little did he know. I was a monster. I didn’t like who I was, I just thought I was crazy. After numerous breakdowns and fights, I decided to talk to someone to get help. My husband decided to attend a support group so he was able to understand what I was going through. I recommend that to any husband or significant other.
I don’t’ feel I was examined correctly. I had a doctor that was supposed to be one of the best in the city, but he rushed through every scheduled visit with me. He said I was fine, but I believe that if I would have had the c-section I would have not had to have the hysterectomy. My doctor was pretty confident everything was going smoothly, but it didn’t. I went to see him on a Friday because I was leaking fluids. I thought my water broke but when he examined me, he said I was fine and to go home. He also said I was not going to go in labor that weekend. I started having contractions on Saturday night and had my daughter Sunday morning. My doctor was “out of town” that weekend so I didn’t even know who was going to deliver me. I am grateful to have had both my girls vaginally but after what I went through I would have wanted a C Section to save my cervix and uterus.

I was not well educated about what would happen physically, emotionally, and mentally after hysterectomy, and I experience this every day since the surgery. I have two beautiful girls and I am so grateful I am alive, but having the hysterectomy changed my life. I just hope that one day I will get over the fact that I cannot have any more children -- we wanted, or hoped for a son.

It’s been a year since the surgery and I still struggle every day.

The only advice I have for women with Placenta Praevia is if you have any doubts about anything, get a second, third and fourth opinion. Go online, read and educate yourself on everything you should know about this subject. It might change your life.

She almost died, but the College of Physicians and Surgeons ruled no negligence

hersfdn@earthlink.net (HERS Foundation) — Sat, 03 Oct 2009 22:45:00 +0000

The rate of hysterectomies is five times greater in the south in the U.S. and in Newfoundland than in the rest of North America. And, as it is in the U.S., the fox is guarding the hen house in Newfoundland.

On September 21, 2009 just four days after Sharon Virginelli’s court victory (Click on the link on the right under Previous Posts) of a $5M award for an “unnecessary” hysterectomy, it was ruled that a gynecologist in Gander, New Foundland, was not negligent in performing a hysterectomy that left a woman with a colostomy, put in intensive care for a month, and in the hospital for two months.

But Annie Ralph has not yet had her day in court. The no negligence finding was by Newfoundland and Labrador’s medical watchdog, the College of Physicians and Surgeons. Annie has filed a lawsuit (called a statement of claim in Newfoundland), against Dr. Doug Torraville and The Central Health Authority.

Annie entered the hospital for a hysterectomy three years ago, in October of 2006, expecting to be home in a few days. She was in intensive care for 28 days and in the hospital for two months. On the day of the surgery it was evident there were complications. Three days later she became very ill, and exploratory surgery revealed that her colon had been perforated. She has since undergone three surgeries in attempts to repair the damage to her colon and reverse a colostomy.

When the College of Physicians and Surgeons investigated her complaint against Torraville they determined that he was not negligent. The College said Ralph was warned that colon damage could be a complication during a hysterectomy. However being warned of a possible risk does not make acceptable the damage that Torraville inflicted on her by perforating her colon, not repairing it during the surgery, and putting her life at risk by not responding timely to her symptoms. Furthermore, did Torraville inform her of the life long, permanent consequences of hysterectomy? Did he inform her that her sex life would never be the same? That her vagina would be shortened? That hysterectomy would increase three-fold her risk of heart disease? It is unlikely those consequences of hysterectomy will even be mentioned when she gets her day in court, because they are losses women are not usually compensated for. You cannot see them. Unlike the infection that almost killed Annie Ralph, and unlike her colostomy bag, they are not documented in the medical record, and the damage is not visible. The defense’s expert’s witnesses in hysterectomy medical malpractice cases usually say “She making it up, it’s all in her head”.

Gynecologists get away with performing hysterectomies by not admitting that it is a damaging surgery. Because the female organs are internal, it is easy to deny what is not visible to the eye.

HERS will be monitoring and reporting the outcome of her case. If you were involved in a medical malpractice lawsuit, please share your experience. We all know how difficult it is to bring legal action against a doctor, particularly when in hysterectomy cases. Please post a comment to let Annie know you support her bringing this action against Doug Torraville and The Central Health Authority.

Twenty-two Million Strong

hersfdn@earthlink.net (HERS Foundation) — Sun, 27 Sep 2009 03:47:00 +0000

There have been several recent comments on HERS blog arguing for financial compensation, or reparations, from the government for the damage caused by hysterectomy and castration.

Reparations do not become a consideration until the public at large acknowledges that harm was done to a select group of people, and the acts that caused harm are stopped. That group and their supporters, then form a coalition to press for compensation from governments that either participated in the wrong doing that caused harm, or failed to stop it.

Let’s pull together to educate the public about the damage caused by hysterectomy, and to support passage of a law that will compel doctors to provide HERS video, “Female Anatomy: the Functions of the Female Organs”, to every woman before she is told to sign a form consenting to hysterectomy or castration. HERS video is a powerful educational tool that has been viewed by close to a million people. Women scheduled for hysterectomies who watch the video cancel their surgeries and when they are told they need the surgery but doctors have not informed them of the information in HERS video, many fire the doctor and walk out.

Everyone’s voice and point of view is important and deserves to be heard. It’s imperative that our common cause brings us together in a positive way to accomplish our common goal of stopping hysterectomy and castration from being performed on women who have not been given the information requisite to informed consent. Please tell us what you think needs to be done, offer wise insightful criticism, and what you are prepared to do to help expedite changing the law. Email HERS at hersfdn@earthlink.net and tell us how you want to be involved in educating the public and supporting legislation. Tell us what you can and want to do:

Write letters to the editor of your local and syndicated newspapers
Call talk show hosts or their producers to tell them about the issues and the recently published book THE H WORD
Ask them to interview Rick Schweikert and Nora W. Coffey
Use Facebook and Twitter to tell people to watch the video and read the book
Hand out HERS Hysterectomy Pamphlet to people on the street and put them in the waiting rooms of doctor's offices and hospital's waiting rooms
Get people to sign the petition
Send THE H WORD to friends and family
Let HERS know when you have sent THE H WORD to gynecologists so that we can add their name to the growing list on HERS website of doctors who can never again say "I didn't know."

Donate whatever you can to help HERS with the challenging, time intensive, hard work required to change the law, and encourage others to support the growing movement to change the law. It requires dedication, commitment, and perseverance, and the funds to pay for printing, postage, travel to meet with legislators, research, writing, continuous updating of the website and blog, and more.

There are 22 million living women in the U.S. who have been hysterectomized, and 73% of them were castrated. We have all been hurt- primarily women who have been hysterectomized, and by extension their family and friends. Though many women have supportive family and friends, others do not. Each woman lives alone with the far reaching consequences of the surgery, coping the best she can, struggling with problems others have difficulty comprehending. Although each woman is alone in a profound way as she tries to find strategies to cope with a plethora of unsolvable hysterectomy caused problems, collectively we are powerful, 22 million strong. Hand in hand we can circle our legislators, and demand our government work with us and for us, and by working together we can accomplish our common goal of stopping this from being done to the next generation of women and girls.

Woman Awarded $5M After 'Unnecessary' Hysterectomy

hersfdn@earthlink.net (HERS Foundation) — Thu, 17 Sep 2009 03:19:00 +0000

What's a uterus worth if it's valued as a reproductive organ?

Verdict: $5 million dollars.

What's a uterus worth if it's valued as a hormone responsive sex organ that supports the bladder and bowel, and provides cardiovascular protection?

Verdict: $0.

A decade after 31 years old Sharon Virginelli was unnecessarily hysterectomized, she was awarded $5 million Wednesday by a Cook County jury against the doctor who performed an unnecessary hysterectomy after the delivery of Virginelli's first child.

Kudos to Sharon Virginelli and her lawyer, Keith Hebeisen of Clifford Law Offices, for waging this courageous court battle, where it is rare for unnecessary hysterectomy lawsuits to be brought, and even more rare for them to be won.

A Cook County jury deliberated for about four hours before reaching its verdict following a one-week trial in Cook County Circuit Court.

Sharon Virginelli, underwent a C-section in May 1999 at Northwestern Memorial Hospital. Her obstetrician, Dr. Pamela Lui, performed the surgery and determined a hysterectomy was necessary due to post-operative bleeding.

Experts testified that her bleeding was slowing down and that less drastic surgical techniques could have been performed to avoid the hysterectomy.

Press releases and articles have focused on the fact that she is now unable to have children. Unfortunately the many other critically important, life long functions of the uterus as a hormone responsive sex organ that provides structural support and cardiovascular protection, appear to have been ignored.

Unquestionably, this is a legal victory. But as all hysterectomized women know only too well, no amount of money can compensate for the loss of their health, sex, sexuality, and vitality.

New study shows link between female castration and lung cancer

hersfdn@earthlink.net (HERS Foundation) — Sun, 26 Jul 2009 18:52:00 +0000

Ovary Removal May Play a

Role in Lung Cancer

A new Canadian study reports that castration (removal of the female gonads, the ovaries) almost doubles a younger woman's risk for developing lung cancer. "It's possible that vulnerability to lung cancer is caused by early and sudden decrease in estrogen levels or potentially long-term use of hormone replacement therapy, and further research is needed to explore these hypotheses." said study co-author Jack Siemiatycki, a professor at the University of Montreal's Department of Social and Preventive Medicine.

The report was published online in the International Journal of Cancer in May 2009. It is based on a study of 999 patients from hospitals in Montreal including 422 women with lung cancer. "A major strength of this study was the detailed smoking information which we obtained from all study participants," said study co-author Anita Koushik. "This is important because of the role of smoking in lung cancer and because smokers generally have lower estrogen levels than non-smokers."

"Although smoking is the dominant cause of lung cancer, we know other factors can play an important role in enhancing the impact of tobacco carcinogens." Koushik added "This research suggests that, in women, hormonal factors may play such a role."

________________

A note from Nora W. Coffey

This important discovery should alert every woman and man to the fact that removal of the female organs creates a higher risk of life threatening health problems including but not limited to heart disease, stroke, dementia and lung cancer. Although not considered a "health" or life threatening problem, the loss of sexual feeling and loss of vitality associated with sexual energy are serious adverse effects of hysterectomy and/or castration. There are many more permanent consequences that have either not been discovered, or if known, they have been denied or not reported.

Hysterectomy? Slow down!

hersfdn@earthlink.net (HERS Foundation) — Thu, 09 Jul 2009 02:44:00 +0000

Hysterectomy: Putting On

The Brakes

The highest risk factor for hysterectomy is not the presence of disease. Women with intact female organs who have "routine" medical exams and public or private medical insurance are most at risk for hysterectomy.

When hysterectomy is recommended, most women respond by telling the doctor that removing their uterus is too drastic for the reason given for the operation. A small number of women think it would be freeing to not have menstrual cramps, bleeding, and PMS, but most women want to put on the brakes and slow down the rush toward surgery. Nonetheless, one out of every three women undergo hysterectomy by the age of 60, without the information required for informed consent.

The reason so many women are hysterectomized without informed consent is remarkably simple...as is the solution.

Many of the functions of the female organs - such as cardiovascular protection, pelvic support, and uterine orgasm to name a few - are not visible. On the other hand, because the male organs are visible, as are many of their functions, men would never consider the amputation of their male organs to be freeing. The solution to preventing unnecessary hysterectomy, then, is providing women with information about female anatomy and the functions of the female organs.

THE H WORD, the book co-authored by Nora W. Coffey and Rick Schweikert, tells the story of how and why the HERS video "Female Anatomy: the Functions of the Female Organs" was produced, and why it is at the heart of a legislative solution to end unwarranted hysterectomy and female castration. The video, vetted by gynecologists and an anatomy professor, includes the anatomical facts every woman requires to be fully informed. 98% of the women HERS has referred to board certified gynecologists after being told they needed hysterectomies discovered that, in fact, they did not need the surgery. With this video, women come to understand the information needed to put the brakes on the doctor's rush toward surgery, or to understand why they feel the way they do after the surgery.

The "Female Anatomy" video is an essential, low-cost, highly successful educational model that provides the information women need to make an informed decision about hysterectomy and castration. It is available for free on the HERS website and has been viewed by more than a million women and men.

It also represents the turning point in THE H WORD, where education meets political action. And as Lee Rothberg said in her review, "THE H WORD is the beginning of the end...the silence is over!"

HERS Honored With Women's Way Award

hersfdn@earthlink.net (HERS Foundation) — Tue, 12 May 2009 16:37:00 +0000

Amid the applause of 1,100 guests, the Women's Way 32nd Annual Powerful Voice Awards were presented in Philadelphia on May 6, 2009. The awards honored the accomplishments of Women Organized Against Rape (WOAR) Director Teresa White, community organizer and HIV/AIDS awareness advocate Waheedah Shabazz-El, and women's rights advocate and activist, Hysterectomy Educational Resources and Services (HERS) Foundation President Nora W. Coffey.

Women's Way Executive Director Melissa Weiler Gerber says of the award, it "serves as a call to action to women everywhere, encouraging us to increase women's influence in the media and make a difference in the community."

Women's Way is the first major women's organization to publicly acknowledge the importance of educating women about the damaging effects of hysterectomy and the lifelong functions of the female organs. The award is recognition that hysterectomy is one of the most serious health issues facing women today. As demonstrated in Nora's book THE H WORD, co-authored by Rick Schweikert, the hysterectomy rate is on the rise, and every woman with a uterus is at risk.

Women's Way presented HERS with an excellent opportunity to talk about the issues, but the award presenter was a pharmaceutical company representative. Nora's first thought was, "I can't accept an award presented by someone from the industry." HERS is an independent women's health education organization with a policy of not accepting support from the medical industry.

"Because there was no opportunity to address this issue publicly at the banquet," Nora said, "in keeping with HERS' mandate of education, I presented a copy of THE H WORD to the pharmaceutical rep as she handed me the award. That way, she could educate herself and her pharma colleagues about these issues."

Since 1977, Women's Way has been the country's oldest and largest women's funding federation. This award brings into focus the imperative to provide women with the information required for hysterectomy informed consent.

We welcome any ideas you might have about getting exposure for HERS and THE H WORD. Each time someone reads the book, it's another person who has been educated about these issues and someone who may educate others and join us in changing the law. Each time the book is in the media, in a bookstore, on a blog, or on a library shelf, the number of people who have access to this vital information is magnified many times over.

This is an opportunity to put hysterectomy information into the hands of those who need it...to save a girl, to save a woman, to save a family. To prevent hysterectomy from becoming the legacy of another generation of women and girls.

Fraud and Hysterectomy

hersfdn@earthlink.net (HERS Foundation) — Mon, 13 Apr 2009 20:27:00 +0000

Fraud in the inducement is a legal term used to describe a scenario where one person has tricked or deceived another into a harmful situation they would not have entered into if they had known they would be harmed.

In the example of hysterectomy, a woman is induced into signing a consent form under the guise that she needs the surgery, there are no alternatives to hysterectomy, and she may die without it. But that is rarely the case. She is also induced into signing the consent form by being told she will be "better than ever after the surgery," or that she will be a "new woman." She is then drugged, strapped to a table, and her female organs are removed, because of erroneous information supplied by the inducers.

No woman is unharmed or undamaged by the removal of her female organs, but that is really not the point. The point is, women who are provided with the information required for informed consent, such as the information provided in the HERS video "Female Anatomy: the Functions of the Female Organs," decide against undergoing hysterectomy.

As we make clear in our book The H Word: What gynecology doesn't want you to know about 100 years of hysterectomy and female castration in America, whether the surgery might be one of the 2% that are lifesaving or not is irrelevant. It's every woman's right to know the information that is requisite to informed consent prior to being asked to sign a hysterectomy consent form, whether she has a mere annoyance or a true health problem.

Fraud in the inducement for hysterectomy requires proof that 1) a false statement of material fact was made, 2) the doctor/hospital knew or should have known the material fact was false, 3) the false statement induced the woman into signing the consent form, and 4) the hysterectomy caused injury to the woman who relied on the misrepresentation as fact.

False statements of material fact on medical websites are more the standard than the exception. A survey of doctor, government health agency, and hospital websites demonstrates that not only do doctors remove sex organs without providing the information required for informed consent, the information they do provide is often erroneous and unsupported by anatomical fact, as was confirmed on the blog post, "Hysterectomy and Female Castration: the Enablers Part II." Most of the false statements are authored by doctors and hospitals that claim to be sources of medical expertise, who should know that the information they publish runs contrary to anatomical fact. Women are encouraged to use this information to make a decision about hysterectomy. The adverse effects then cause injury to more than 621,000 women in the U.S. each year.

For more on this subject, see the article "Sanctioned Violence Against Women," published in The Women's International Perspective (The Wip).

We are interested to hear how your experience with hysterectomy fits the four requirements above for fraud in the inducement. Would you take part in a class action lawsuit against doctors and "patient education" institutions that supplied the erroneous information used to induce you to sign a hysterectomy consent form?

Please be brief in your comments about how your experience fits the four legal requirements of fraud in the inducement.

Hysterectomy Causes Heart Disease

hersfdn@earthlink.net (HERS Foundation) — Sat, 21 Feb 2009 15:24:00 +0000

The American Heart Disassociation

Heart disease was once thought to be less of a problem for women than for men. Research now indicates that heart disease is the No. 1 cause of death among women in the US (Centers for Disease Control and Prevention, Heart Disease Facts and Statistics, 2008), while confirming that women with an intact uterus have a lower incidence of heart disease because they benefit from the uterine advantage.

In his article, "Prostacyclin From The Uterus And Woman's Cardiovascular Advantage," James D. Shelton writes, "Prostacyclin emanating from the uterus is proposed as a major contributor to the reduced risk of coronary disease among women." He refers to the uterus as a "systemically active organ whose removal significantly increases subsequent risk of myocardial infarction" (Prostaglandins Leukotrienes and medicine, 1982).

The American Heart Association reports that in 2006 there were 16.8 million cases of coronary heart disease in the US. About one in 18 Americans suffers from heart disease. This number would be much lower, if not for hysterectomy.

Studies reveal that premenopausal removal of the uterus is associated with a three-times-greater incidence and prevalence of heart disease (Brandon S. Centerwall, "Premenopausal Hysterectomy and Cardiovascular Disease," American Journal of Obstetrics and Gynecology, 1981) and that women who undergo a bilateral oophorectomy (surgical removal of the ovaries, castration) have a 5.5 times greater cardiovascular risk (Jacqueline C.M. Witteman et al, "Increased Risk of Atherosclerosis in Women After The Menopause," British Medical Journal, 1989). Other studies demonstrate that women who are castrated before age 35 are hospitalized for myocardial infarction 7.2 times more often than women with intact uterus and ovaries (Lynn Rosenberg et al, "Early Menopause and the Risk of Myocardial Infarction," American Journal of Obstetrics and Gynecology, 1981).

Hysterectomy is the most commonly performed non-obstetric surgery in the US, and there is general consensus even among the medical community that a majority of hysterectomies are unnecessary. Hysterectomy rates are subject to variations that do not necessarily correlate with health factors. Statistics from the Centers for Disease Control and Prevention (CDC), for example, tell us that women in the South are 50 percent more likely to be hysterectomized than in the Northeast. And the hysterectomy rate among black women is 20 percent higher than among white women.

Some researchers and medical writers attempt to explain the higher incidence of hysterectomy and removal of the ovaries in black women by demonstrating that they have a higher incidence of fibroids. As the Hysterectomy Educational Resources and Services (HERS) Foundation makes clear in the online educational video, "Female Anatomy: the Functions of the Female Organs," fibroids are benign growths that rarely cause symptoms or problems, until a doctor spots them incidentally during a routine exam.

Although less than 1 percent of fibroids are cancer (William Parker et al, Obstetrics and Gynecology, 1994), fibroids are the leading reason doctors perform hysterectomy. But women who are told they need a hysterectomy for fibroids may merely have the wrong doctor. Not surprisingly, not only are black women more likely to be hysterectomized, heart disease is the No. 1 cause of death among black women.

The CDC's Division for Heart Disease and Stroke Prevention reports that 870,000 people died in 2008 - 2,400 each day - from heart disease. "The cost of heart disease and stroke in the United States," the CDC concluded, "is projected to be more than $448 billion in 2008, including health care expenditures and lost productivity from death and disability." The financial burden and tragedy of heart disease as a result of hysterectomy is largely avoidable.

According to the US Department of Health and Human Services, one of every three women is hysterectomized before the age of 60, while the American Heart Association reports that nearly one out of every three women dies of heart disease.

Visitors to the "Go Red For Women" web site are encouraged to tell the American Heart Association "about the choices you've made to improve your well being." Women can avoid much of the risk of heart disease by retaining their uterine advantage - cardiovascular well-being that depends in large part on the lifelong functions of the uterus.''

Drastically reducing cardiovascular risk, circumventing much of the staggering cost of heart disease charged to medicaid and Medicare, and avoiding the tragic toll of thousands of strokes and deaths may be achieved by helping women avoid hysterectomy.

Published February 16, 2009 in Truthout.

PAYING FOR THE BAILOUT

hersfdn@earthlink.net (HERS Foundation) — Sun, 18 Jan 2009 20:36:00 +0000

As we tighten our belts at home and abroad, we are all accountable for the burden of national debt we pass along to future generations. Local and international relief efforts for the poor are also feeling the pinch, which makes the search for ways to heal our broken economy a humanitarian effort.

Although medical profits continue to soar, there have been rumblings lately that the next "industry" to show up in Washington hat-in-hand will be medicine ("Disappearing Credit Forces Hospitals to Delay Improvements," Reed Abelson, New York Times, October 14, 2008). Meanwhile, evidence abounds that an increasing portion of our tax dollars that fund Medicare and Medicaid are the most lucrative revenue stream for the medical industry, and a large portion of those expenditures are going toward unnecessary, even harmful surgeries, not unquestionably-needed emergency care.

Any savings to be realized, without causing more people to become disadvantaged, must be embraced immediately. So-called port barrel federal expenses, and those that can be revealed to cause more damage than good, must be the first to go.

A staggering number of surgeries have been proven in study after study to be medically unwarranted and cause more harm than good. Rob Stein of The Washington Post reports, "One of the most common surgical procedures performed in the United States - arthroscopy to treat arthritis in the knee - is useless, researchers reported yesterday." So let's take a look at the two most over-utilized, most commonly performed surgeries in America - cesarean sections and hysterectomies.

When a doctor and a hospital get involved in the natural process of childbirth, time is money. "Spontaneous deliveries," as they are often referred to (where there is no surgical intervention), are time-consuming for doctors. In rare instances, such as when the placenta happens to block its own exit by attaching to the uterine wall close to or covering the cervix (placenta previa), C-section may be lifesaving for both baby and mother. Also, when the placenta does not detach from the uterine wall (placenta accreta), sometimes a hysterectomy is the only way of saving the mother's life. But placenta previa can often be managed conservatively and occurs in only 1 in 200 pregnancies. Placenta accreta occurs in only 1 in 2,500 pregnancies. Combined, they account for only one half of one percent of C-sections, which means that as many as 99% of C-sections may be medically unwarranted.

A study published in the New England Journal of Medicine reports that nearly 1/3 of all births in the U.S. are surgical, with up to a four-times higher risk of complications ("Caesarean Section Before 39th Week Poses Extra Risk, Study Finds," January 7, 2009.) Judith Reichman of NBC News reports that more than 30% of the 4.3 million U.S. births each year are surgical deliveries. However, Dr. Mayer Eisenstein, an ardent advocate of home birth and the founder of Homefirst Health Services in Chicago, reports that Homefirst's C-section rate is only 4.1%.

Depending on the severity of C-section complications, each surgical delivery taxes Americans anywhere between $2,000 and $200,000, in addition to the cost of an in-hospital birth. As reported by Rita Rubin in the January 7, 2007 USA Today, "The average initial hospital cost of a planned C-section for a first-time mother was 76% higher than that for a planned vaginal birth." A conservative estimate of C-section expenses burdening American families would top $3 billion each year for additional doctor and hospital charges alone.

As for hysterectomy, Ashley Montagu wrote in his book The Natural Superiority of Women about a House of Representatives subcommittee investigating the incidence of unnecessary hysterectomy. "Various sources," he writes, "put the percentage of unnecessary hysterectomies anywhere between 24 and 88 percent." Findings from more than 850,000 counseling sessions at the HERS Foundation in Philadelphia puts the percentage of hysterectomies that could be avoided with conservative treatment (or no treatment at all), at about 98%.

The Centers for Disease Control and Prevention (CDC) report that more than 1/3 of American women have their female organs removed by the age of 60. The CDC also reports that the incidence of cancer in the female organs and the male organs is virtually identical, while the incidence of male organ removal is statistically insignificant.

"'We have four times the hysterectomy rate of any industrialized nation, in this country,'" said [Ernst] Bartsich, a clinical associate professor at Weill Cornell Medical College. At age 60, one out of every three women has had a hysterectomy; and at age 65, one out of two women have had a hysterectomy. And 85 percent are not necessary" (Newsday, May 2004, Roni Rabin).

In a September 5, 2007 article published in Health Insurance Underwriter's magazine, Rick Schweikert reports that more than $17 billion each year is spent on direct doctor and hospital charges for hysterectomy. In 2007, the HERS Foundation released an educational female anatomy video on its website that was vetted by gynecologists and other medical and legal experts. Ninety-eight percent of the women who watch the video and call the HERS Foundation do not proceed with the doctor's recommendations for hysterectomy after learning about the unavoidable and irreversible consequences of removal of the female organs - facts that women are not informed of by doctors. The long-term cost of treatment and subsequent surgeries, and a lifetime of harmful drugs and treatments for the problems caused by hysterectomy and ovary removal, could easily top the $17 billion paid for the initial surgery.

According to their 2008 SEC filings, the largest hospital chain in the U.S., the Hospital Corporation of America (HCA) - founded by the family of former Senator and Majority Leader Bill Frist - reports that in 2008 about 49% of their revenues and 59% of their hospital admissions were Medicare and Medicaid "related." In 2007, HCA reported revenues of $26.9 billion, approximately $16 billion of which (according to HCA) was paid for by American taxpayers.

What most people may not know is that HCA "plead guilty to 14 felonies" and was hit with a $1.7B fine - far-and-away the largest such fine in history - for Medicare fraud, as reported by Kurt Eichenwald in the December 18, 2002 New York Times. These fines, it seems, were a minor bump in the road for HCA, on their way to grabbing hundreds of billions of American taxpayer dollars in the years to come. Doctors and hospitals reap the financial benefit of surgeries, whether they are warranted or not. American taxpayers, both in terms of Medicare/Medicaid payouts and higher insurance premiums, pay the price.

No mother or father whose child has a medical emergency should be required to answer any questions or demonstrate any ability to pay for medical services when they arrive at an emergency room seeking care. But as our government strategizes how to spend hundreds of billions of dollars in its economic stimulus package, we owe it to future generations to unshackle ourselves from doctors and hospitals performing medically unwarranted surgeries.

In a December 2, 2007 article titled "National Debt Grows at a Million Dollars a Minute," (published long before any talk of "bailout" packages), the Associated Press reports that, "retirement and health benefit programs now make up the largest component of federal spending. Defense is next. And moving up fast in third place is interest on the national debt."

Each million dollars saved today could save future generations tens of millions of dollars in interest on the national debt. As President Obama said in his inaugural address, "Our health care is too costly." In these trying times, Americans are not in a position to leave $17B a year of unnecessary medical expenses on the table. Especially when it will keep hundreds of thousands of American women off the operating table, with their female organs intact.

Published February 4, 2009 in The Women's International Perspective.

NAME THAT DOCTOR AND HOSPITAL

hersfdn@earthlink.net (HERS Foundation) — Wed, 07 Jan 2009 22:57:00 +0000

NAME THAT DOCTOR AND HOSPITAL

A TAKE-OFF ON "NAME THAT TUNE", BUT THIS IS NOT A GAME, THIS IS YOUR LIFE.

I'm Nora W. Coffey, president of the Hysterectomy Educational Resources and Services (HERS) Foundation.

When I was thirty-six years old, I was hysterectomized and castrated by Robert Giuntoli, at the University of Pennsylvania Hospital in Philadelphia, and his assistant Douglas Rabin. I was not informed by Giuntoli or Rabin of the consequences of the surgery, therefore I did not give an informed consent. The anesthesiologist and nurses who participated in the surgery were complicit. The hospital enabled them.

Giuntoli and I agreed that he would perform exploratory surgery to determine if the ovarian cyst that was symptomatic was malignant. If it was not, he would perform a cystectomy, removal of the cyst only. If it was malignant, he would remove my uterus and ovaries. The cyst was benign. In direct contravention to my expressed wishes and the agreement with Giuntoli, he proceeded to remove my female organs.

The removal of my female organs destroyed my health and well-being and ruined my family, professional, and social life. No longer healthy, strong, vibrant and sexual, I turned my attention to finding the answers to what was wrong with me that stumped the 25 or more doctors I saw in the first year after the surgery. I found answers in the medical library at the University of Pennsylvania, next door to the hospital where Giuntoli and Rabin collaborated. For the next two years I walked by the hospital every day to get to the library. After two years of research I understood full well what had been done to me. I have dedicated every day of my life since then to providing that information to other women.

Watch the female anatomy video on HERS website. Then, unless you are actively involved in a medical malpractice lawsuit, give your name and the name of the doctor(s) who removed your female organs and the hospital that enabled them. You have nothing to be ashamed of, nothing to hide from, you have done nothing wrong. By telling the truth you shine a spot light on the doctors and hospitals ruining the lives of another woman every minute of every hour of every day of every year. 621,000 hysterectomies are performed each year in the USA alone. That's not just a number, it's much more than a statistic - it's women's bodies, women's lives.

Do not let the doctor who ruined your body, your health, your sex life, your family life, your career, your professional life and your social life hide behind the good doctor persona and the hospital walls that shield them.

It's time to speak out, it's time to expose the doctors who failed to inform you of the consequences of hysterectomy and castration. By giving your name and the name of the doctor and hospital we can smoke them out of their protected environment. Together we can stop this from being done to another generation of women and girls.

It must be made unacceptable, it must be stopped legally. Sign the petition to show your legislators that you demand a law that protects women from the violent medical practice of hysterectomy and castration.

The Hysterectomy Marketplace - Research and Development

hersfdn@earthlink.net (HERS Foundation) — Sun, 14 Dec 2008 16:04:00 +0000

OBGYN.net - a hysterectomy survey titled…“Considering a Hysterectomy?”

The title is so casual it could be called… "Considering a Dessert?”

At first glimpse this appears to be a legitimate survey about the effects of hysterectomy. But it quickly reveals itself to be a device to obtain information for gynecologists and the medical industry to learn the most effective language they can use to promote hysterectomy to women. It’s a marketing tool whose purpose is to feed women into the surgical mill.

OBGYN.net’s approach seems to encourage our trust in their information.

OBGYN.net is vast, an ever growing and expanding

universe with over 1,000,000 pages of educational

content, discussion forums, videos, educational

tutorials, images, Ask the Expert, personal experiences,

career, job and product information, news, reports

from key conferences and social networking.

However, their website is littered with ads for the pharmaceutical and medical/surgical industry. Ads for physicians dominate every aspect of their site.

OBGYN.net was crafted by a company called Medispeciality, http://medispecialty.com/ which specializes in optimizing medical investment and marketing to the consumer market. They offer “tracking programs to cost effectively feed the sale pipeline” and their "flagship website OBGYN.net. “

In OBGYN.net’s newsletter dated November 25, 2008, their website beckons women to Ask the Expert asks women to fill out a hysterectomy survey, http://www.obgyn.net/survey/hysterectomy/. The survey begins as follows:

Help other women facing these decisions by filling out

this survey and we will send you the results of the

study so you can know what other women are saying.

Are you considering having a hysterectomy...?

Once you answer the question yes, that you are considering a hysterectomy, the survey begins. If you answer no, you will be told the following: "Thank you for your willingness to participate in this study. Unfortunately, we can only accept information from women who are considering having a hysterectomy." OBGYN.net only wants to pass along information about hysterectomy from women who are "considering" the surgery. They do not allow women who have been hysterectomized or women who have decided against the surgery to weigh in. It is not that they "can only accept" the information they are looking for. They are only interested in the information that is shaped to be beneficial to them, not you. This survey is a lead-generator for doctors.

If you answer yes to the entry question, you are allowed to proceed through the first 11 questions, regarding your age, employment status, why a hysterectomy is being "considered", ranking from 1-10 how you feel about being told you need a hysterectomy, how you define hysterectomy, and how well informed you are about why and how hysterectomies are performed. This demographic information about women helps gynecologists, device manufacturers, and the hospitals who benefit from the removal of your female organs to hone their sales pitch to women.

Question 12 asks, "If your symptoms warrant a hysterectomy, how difficult would it be for you to have your uterus removed after you have completed having children?" The implication is that the only thing that might make hysterectomy difficult is if you desire to have children, or if you do not intend to have more children, then hysterectomy should not be difficult for you. There is no mention of the well-documented adverse effects that result from removing the uterus - whether you have children or not, whether you want children or not, is irrelevant.

Question 13-16 ask how well informed you are of "the role" of the cervix and ovaries, how concerned you are about their removal, and who you turn to for more information about these issues. The question informs you that they have a "role", but the question is never asked about how well informed you are about the functions of the uterus. It implies that the cervix and ovaries have a "role", and that the uterus has none except for childbearing.

Question 17 asks, "If the physician currently caring for your gynecological health recommends a hysterectomy treatment or alternative, to what extent do you trust their opinion?" The only answers they allow to this question are A) "I trust my doctor completely," B) "I trust my doctor, but may do some research on my own," or C) "I basically trust my doctor, but would seek a second opinion or some outside counsel." If you don't trust your doctor, you're out of luck, that answer is not an option.

Question 18 asks you to rate from 1-7 different factors in deciding which method of hysterectomy you might choose. The last two "factors" ask how important choosing a type of hysterectomy with "no change in sexual satisfaction" and "no change in urinary control" might be. There is no mention of the fact that in order to amputate the uterus with or without amputation of the cervix, the nerves that are attached to the uterus that flow into the cervix must be severed. Removal of the body of the uterus compromises bladder support and often causes urinary problems. Uterine orgasm is not possible without a uterus, so for women who experience uterine orgasm, avoiding sexual loss is unavoidable after the uterus is removed, regardless of the method. Furthermore, the participant must respond falsely to some questions. In two sections you must rate the importance of your answers, with #1 ranked the highest importance. You cannot assign the same number twice. If any questions have equal importance, you must rate one higher than the others, which makes your answer, and the conclusions drawn from it erroneous.

Question 20 asks, "Are you willing to consider treatments that may temporarily relieve symptoms and delay the need for hysterectomy for a few years?" What might be inferred from this question is that A) only hysterectomy provides permanent relief from symptoms, B) alternatives only provide temporary relief, and C) once a doctor says you need a hysterectomy, it is just a matter of time, and within 1,3, or 5 years you will be hysterectomized, so why bother with an alternative.

Question 21 is hardly a question at all. "Leaving the cervix maintains pelvic support potentially reducing the risk of incontinence, and appears to play a role in sexual satisfaction. Generally, the risk of vaginal/cervical cancer is less than 1% regardless of whether the cerix is left in place." They then ask whether or not you would like to keep your cervix. There is no need to consider amputation of the cervix unless there is a life threatening cervical disease. Questions 4 and 5 list only benign conditions that they say might lead to hysterectomy (fibroids, endometriosis, heavy bleeding, PMS). Those "conditions" can be treated conservatively, without removal of the uterus or cervix. As OBGYN.net states, the risk of cancer in the female organs is statistically insignificant.

Finally, question 22 cuts to the quick, and a probable reason for this survey comes into focus. It tells women that hysterectomy by laparoscopy is performed through a smaller incision, the cervix need not necessarily be removed, and that the hospital stay and "recovery" times are less. Then it asks women which one they want - abdominal, vaginal, or laparoscopic hysterectomy.

The adverse effects of hysterectomy are permanent and irreversible, so "recovery" is not possible. For most hysterectomized women, the size of the scar, whether the cervical stump remains or not, and the length of the hospital stay quickly become inconsequential when they begin to realize that the damage done to their bodies and their lives is permanent.

The survey then tells you "95% of women are candidates for a Laparoscopic Supracervical Hysterectomy." In other words, regardless of almost all conditions, you are a candidate, as if hysterectomy is a given, a rite of passage for all women, healthy or not, and the only issue is how it will be carried out.

The remainder of the survey is a sales pitch of LSH. You have learned almost nothing of value, and you have been bombarded with subliminal programming, pressure and misinformation.

At the end of the survey, OBGYN.net says, "Thank you for taking the time to fill out this survey. Your input will help other women as they face this difficult decision." They then request your name and email address. This survey is clearly not intended to "help other women," because it supplies erroneous information. You have just been led through a sales pitch for LSH that is posing as a helpful survey. In other words, you have just participated in medispecialty's "lead generation, qualifying, and tracking programs," and now you are in their "sale pipeline." This "survey" is a poll of their target market, women with intact sex organs, and your uterus is the bulls eye. It is research and development, designed to inform gynecologists about the most productive way they can increase their market share by selling hysterectomy to unsuspecting women.

Let the buyer beware.

Seeing The Uterus and Ovaries is Believing.

hersfdn@earthlink.net (HERS Foundation) — Sat, 22 Nov 2008 04:49:00 +0000

If the female sex organs were visible like the male sex organs, would they still be removed from 622,000 women each year?

Myth: "Only men have gonads."

Fact: A woman's gonads are her ovaries. Removal of the ovaries is castration, and the aftereffects are to women what the aftereffects of removal of the testicles are to men.

Myth: "Sex will be better than ever after hysterectomy."

Fact: Removal of the uterus causes the loss of uterine orgasm, one of the many irreversible consequences of hysterectomy.

Myth: "After the surgery you'll feel better than ever, and sex will be the same or better."

Fact: The most common problems women report after hysterectomy include loss of sexual feeling, loss of vitality, bone/joint/muscle pain, fatigue, and personality change.

Myth: "Doctors don't perform as many hysterectomies as they used to."

Fact: Less than 2% of all hysterectomies are life-saving. Most hysterectomies are performed for benign conditions, not medical problems. The rate of cancer in the female sex organs and the male sex organs is almost identical. The rate of male sex organ removal is statistically insignificant, and yet in the last decade an average of 622,000 hysterectomies and 454,000 female castrations were performed each year in the U.S. That's more than one every minute of every hour of every day.. There are 22 million women alive today in America whose sex organs have been removed.

Myth: "Doctors don't have enough time to provide information about female anatomy and the functions of the female organs before they tell women to sign hysterectomy consent forms."

Fact: It takes just a few seconds for doctors to hand women HERS' 12-minute "Female Anatomy: the Functions of the Female Organs DVD, available at www.hersfoundation.org/anatomy. And that's good news. HERS' 12-minute female anatomy DVD makes the female organs visible. It fills the information gap and can prevent about 610,000 unwarranted hysterectomies and 622,000 hysterectomies performed without the information required for consent each year, which would save more than $17B dollars a year in rising medical costs.

Tell us what you were told about the life-long consequences of hysterectomy.

Educate and Empower Yourself At Hysterectomy Conference

hersfdn@earthlink.net (HERS Foundation) — Sun, 02 Nov 2008 02:09:00 +0000

The HERS Foundation's Twenty-Seventh Hysterectomy Conference will be held November 14th-15th, 2008 in Atlanta GA.

Become informed about female anatomy, the life-long functions of the female organs, the alternatives to hysterectomy, and the consequences of the surgery. Learn about the common reasons hysterectomy is recommended such as fibroids, endometriosis, endometrial hyperplasia, uterine or bladder prolapse, bleeding, and pelvic pain. Find out about the most frequently reported adverse effects of hysterectomy and removal of the ovaries (female castration), and some coping strategies for women who have had the surgery such as diet, exercise, acupuncture, acupressure, massage and reiki.

The conference will be of interest to everyone who is interested in women's health. Everyone is welcome.

Conference details and registration

November 15th, 2008

On Friday November 14th at 7:30pm there will be a screening of "un becoming", Rick Schweikert's play about an artist who is faced with a medical decision that could forever change her life.

The ovary option

hersfdn@earthlink.net (HERS Foundation) — Tue, 29 Jul 2008 00:00:00 +0000

There has been a media blitz surrounding recent discussion of the pros and cons of surgical removal of the ovaries during hysterectomy (see Cochrane article below). But the most important issue has yet to be addressed: the uterus should rarely be removed in the first place.

The article below perpetuates a dangerous myth through the subliminal message that if your ovaries are left intact you’ll be fine if only your uterus is removed. Those who are unaware of the aftermath of hysterectomy, with or without castration, can join more than 400,000 others who have watched the HERS
12-minute video by clicking here: “Female Anatomy: the Functions of the Female Organs.”

If the analysis was a sincere effort to provide women with the information they need to make informed decisions about whether or not to allow a doctor to remove their ovaries, the article would have used the word castration, which conveys an immediate understanding of the gravity of their decision. The ovaries are the female gonads, the same as the testicles are the male gonads. The medically correct term for removal of the gonads is castration.

In the HERS Foundation’s ongoing study “Adverse Effects Data,” the experiences of hysterectomized women whose ovaries are left intact are strikingly similar to the women who are also castrated at the time of the surgery. Part of the reason for similar responses with or without castration is that in hysterectomized women whose ovaries aren’t removed, about 35-40% of the time the ovaries cease to function after hysterectomy, resulting in a de facto castration.

This information is public knowledge and has been published in peer-reviewed medical journals for more than a century, so neither journalists nor doctors who hold themselves out as experts in gynecology should get it wrong.

The response to these articles would be far different if the headlines read, “Should women be castrated during removal of other sex organs?”

Removing ovaries during hysterectomy: effects remain unknown

During hysterectomy operations, surgeons often remove a woman’s ovaries as well as her uterus. Cochrane Researchers now say there is no evidence that removing the ovaries provides any additional benefit and warn surgeons to consider the procedure carefully.

“Until more reliable research is available, removal of the ovaries at the time of hysterectomy should be approached with caution,” says lead researcher, Dr. Leonardo Orozco of the OBGYN Women’s Hospital San José in Costa Rica.

Of those women who undergo hysterectomies aged 40 or above, around half also have their ovaries removed. This amounts to more than 300,000 women a year in the US alone. The reason most commonly given for carrying out an oophorectomy at the same time is that it prevents ovarian cancer. However the ovaries produce not only estrogen, but also important hormones such as androgens that may have important clinical effects which have yet to be identified.

The researchers say there is little evidence to support the idea that removing the ovaries during a hysterectomy provides an overall health benefit. They identified only one controlled trial, involving 362 women. This compared hysterectomies with oophorectomies to hysterectomies without oophorectomies. Although this trial showed a very slight positive effect on psychological well-being when oophorectomies were performed, the team say much more data is required before any conclusions can be drawn.

“There could be a real benefit or harm associated with oophorectomy, but it has not been identified, more research of higher methodological quality is needed.” says Dr. Orozco.

Orozco LJ, Salazar A, Clarke J, Tristan M. Hysterectomy versus hysterectomy plus oophorectomy for premenopausal women. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD005638. DOI: 10.1002/14651858.CD005638.pub2. Cochrane Menstrual Disorders and Subfertility Group.

Hysterectomy and Female Castration: the Enablers Part III

hersfdn@earthlink.net (HERS Foundation) — Wed, 02 Apr 2008 23:27:00 +0000

Emory University Hospital, Atlanta, Georgia

This is the third part in a series of Posts to highlight omissions of fact and misinformation about hysterectomy currently being provided to women on hospital, doctor, and medical school websites.

In Part I of this series we investigated some of the errors, omissions, and contradictions on the University of Pittsburgh Medical Center’s (UPMC) website. To read Part I (and comments from women around the country) click here. And in Part II we highlighted the seriously deficient online patient education product known as “X-Plain” at Gundersen Lutheran Medical Center in La Crosse, Wisconsin. To read Part II click here.
Part III of this series highlights Emory University Hospital’s website. As you will see, Emory provides little of the basic information that women need in order to make informed decisions about hysterectomy, while directing them to visit other websites that contain gross misinformation that is potentially damaging to women.

This is a frightening trend in hospital websites all over the country. Hospitals and doctors point their patients to some other source of hysterectomy misinformation (such as the Patient Education Institute’s product X-Plain, obgyn.net, or acog.org), thereby washing their hands of accountability for omitting the requisite information for hysterectomy informed consent on their own websites. The stated purpose of these sites is to provide information to women who’ve been told they need the surgery, but they don’t inform them of the consequences that women need to know. Instead of providing correct information, they potentially put women into harm’s way.

“The Emory Department of Gynecology and Obstetrics,” they tell visitors, “is dedicated to providing health information and education to women in the Atlanta community, the region and the nation.” But we couldn’t find any hysterectomy patient education materials on their website that educate women about the consequences of hysterectomy—the most common non-obstetric surgery performed in the United States. The “.edu” suffix on their website URL indicates that Emory is in fact an educational institution, so what better place for them to do so than right on their own hospital website where they make the claim?

The reason we selected Emory, Gundersen, and UPMC as the three hospital websites to be investigated isn’t because they’re the only hospitals providing misinformation and omissions of fact. On the contrary, they were chosen because these three websites are typical of patient education information published on hospital websites throughout the country.

In the top right corner of the Emory University Hospital home page (http://www.emoryhealthcare.org/departments/), click on “SEARCH.” Type in the search term “hysterectomy” and then click on “search now.” You’re taken to a page with a long list of press releases and articles.

The first press release we came to on the list was dated June 2, 2004. It goes into great detail about how “vaginal hysterectomies are more advantageous” than abdominal hysterectomies without any reference to the consequences of removing the female organs. What they don’t mention is that many of the most devastating adverse effects are the same no matter how the uterus is removed. Click here to watch “Female Anatomy: the Functions of the Female Organs” for information that every doctor and hospital should provide to every woman who is told she needs a hysterectomy.

The next link on the list takes visitors to an online article titled Uterine Fibroid Embolization (UFE). Even the title of this article is misleading. First, it’s not the fibroid that’s occluded with embolic material, it’s the uterine artery. It’s convenient for doctors and hospitals to refer to it as UFE, because Uterine Artery Embolization (UAE) alerts and alarms women that something is being injected into the artery—their vascular system. The reason doctors began calling it UFE is to make it sound more benign than UAE. They don’t tell women that the embolic material injected into the uterine artery has been found to migrate to the ovaries, uterus, lungs, and other vital organs. For this reason UAE should be contraindicated for women who want to have children. When the embolic material and/or radiation causes the ovaries to cease to function, it results in a de facto castration.

Second, it’s odd that an article that seems to want to educate women about “What are uterine fibroids?” falls under the title of one of the most dangerous treatment options. Women might expect that the patient education materials of a teaching hospital would label this section “What are fibroids?” with UAE mentioned only as a treatment option with serious potential adverse effects, including death, loss of ovarian function, necrosis (death of the tissue) of the vagina, labia, bladder, bowel, and kidney.

Further obscuring the facts, Emory tells visitors, “Symptomatic uterine fibroids trigger approximately 150,000 hysterectomies each year.” In fact it’s the fear that doctors instill in women regarding benign conditions such as fibroids, along with misinformation about treatment options, that “triggers” hysterectomies. The number of hysterectomies performed for fibroids each year in this country is more like 400,000, but fibroids can’t pull the trigger on hysterectomies. Only doctors can pull that trigger.

Finally, the only reference to hysterectomy in the UAE article is one that uses language reminiscent of the U.S. Army’s recruitment theme—Emory claims that their “goal is to help you to live the best as you can be.” We would no more recommend that you search for all that you can be on an operating table than on a battlefield. The best that you can be is whole and intact, far away from anyone who wants to damage or remove your sex organs.

Emory offers other online articles that focus on endometriosis and gynecological services, but none of them discusses the well-documented consequences of hysterectomy.

Back on the home page, if you click on “Departments” and then scroll down to the bottom right and click on “Gynecology & Obstetrics” under the subheading “Women’s Health Services,” you’re taken to a page titled “Emory Women’s Care.” On this page you’ll find the following ad:

It’s cruel irony that a website that women come to because they were told they need a surgery to remove their female organs (which they will have to pay for), are confronted with an ad offering to pay them to allow a doctor to extract their eggs. Rather than provide visitors with information about the adverse effects of the most commonly performed non-obstetric surgery in America and the fact that the ovaries will be removed from 73% of those women, they choose to give space to advertising their egg “donor” program. And here the medical euphemisms continue, because it’s nothing like a donation.

Women are paid a lot of money for their eggs because the process is invasive, risky, and often very painful. To stimulate egg production, women are given dangerous drugs to hyper-stimulate their ovaries. The side effects of the drugs range from thinning of the bones to cognitive loss. And once the ovaries are hyper-stimulated to produce an abnormal quantity of eggs, the hyper-stimulation sometimes continues after women stop taking the drugs. The result is that the drug-induced hyper-stimulation puts a woman at risk for ovarian cancer. Cancer of the female reproductive sex organs is one of the main scare tactics that doctors use to get women onto operating tables. And it’s one of the main reasons why women seek out websites like Emory’s only to be bombarded with advertisements for quick money. If women answer this ad they’ll be subjected to a procedure that will increase their risk of ovarian cancer.

People don’t get paid to donate. It’s not a contribution, it’s a business transaction, and the product is women’s eggs. It’s objectionable to disguise it as such…especially when Emory fails to provide the one thing they claim to make available to women—patient education. Why not simply ask visitors, “Are your eggs for sale? If so, we’d like to buy them. And we’re willing to pay a handsome price because it’s a frightening, painful, and potentially fatal procedure for both you and the woman who your eggs will be later injected into.”

For women who are about to have (or have had) the door shut on the option of having children, it’s extremely insensitive to advertise the hope of pregnancy and childbirth on a site where women seek information about hysterectomy.

As we said, this investigation into Emory’s website is Part III of a series. What was remarkable about Part I was that the University of Pittsburgh Medical Center (UPMC) website contained glaring contradictions. Although we informed them of numerous anatomical errors on their website, and although UPMC did drop one of their hysterectomy pages to eliminate the most glaring contradictions, they continue to provide potentially damaging information to women. What was remarkable in Part II of the series was the Gundersen-Lutheran Hospital’s patient education tutorial called X-Plain. X-Plain requires women to answer questions falsely in order to proceed through their error-riddled tutorial. They have ignored letters from HERS informing them of their misleading information, but they continue to misinform women with the same potentially damaging information. And now what stands out to us in Part III is that Emory claims to provide information about hysterectomy but actually provides almost none at all. What’s remarkable isn’t the startling misinformation we found on the other two hospital websites, but the extent to which Emory promotes invasive procedures while directing visitors to look elsewhere for facts that they obviously have no intention of providing to women on their own website that gushes with recommendations for surgery.

On that same Emory Women’s Care page mentioned above, there’s a list of options on the left. If you click on the fifth one titled Patient Education you’re taken to a page that claims that they provide health information, but you won’t find any information about hysterectomy, in spite of the fact that it’s called Patient Education. On the bottom of that page, visitors are given three options for information about hysterectomy:
1. the American College of Obstetricians and Gynecologists
2. the Universe of Women’s Health
3. a phone number at Emory

1. The American College of Obstetricians and Gynecologists’ website (www.acog.org) sounds reliable enough, but what do visitors to Emory’s website find if they follow the link and are redirected there? Researching ACOG’s site for hysterectomy revealed a list of links to printed “educational” materials. The first one is “Understanding Hysterectomy.” It can be purchased from the ACOG website, but the minimum order is 50…with a discount for ACOG members. Click on the link and it takes you to this brief summary:

“Understanding Hysterectomy Description"
"Hysterectomy—removal of the uterus—is a way of treating problems that affect the uterus. Many conditions can be cured with hysterectomy. Because it is major surgery, your doctor may suggest trying other treatments first. For conditions that have not responded to other treatments, a hysterectomy may be the best choice. It depends on the effect of the condition and the surgery on your life. You should be fully informed of all options before you decide."

"This pamphlet explains:
* Reasons for having a hysterectomy
* Ways hysterectomy is performed
* Risks of hysterectomy
* Recovery after surgery”

Although they may refer to women when saying “you decide,” ACOG offers almost no information to women about the lifelong consequences of hysterectomy on their website, which may leave you wondering why “college” is part of this organization’s name. In fact, their own website demonstrates that if ACOG is a college it’s a scalpel school with members who get rich by removing female organs.

2. The second option—the Universe of Women's Health—takes visitors to www.obgyn.net. At the bottom of each page of this website you’ll find pro-hysterectomy Google ads. On the “Select a Topic” drop-down menu on OBGYN.net there are three hysterectomy topics. First is the Hysterectomy Resource Center. Here, the pelvic anatomy lesson offered says:

"The uterus, sometimes called the womb, is a muscular organ located in the pelvis. It is approximately the size and shape of a pear. This is where a fetus is carried during pregnancy."

It doesn’t mention that the uterus is a hormone-responsive sex organ that supports the bladder and the bowel or that women who experienced uterine orgasm before the surgery won’t experience it after the uterus is removed. If they did mention those facts and the many other functions of the uterus then women would know that there’s a lot more to lose than the ability to become pregnant. But OBGYN.net, apparently, views the uterus as nothing but a pear-shaped baby bag.

The “Indications” link invites visitors to a page with a video to learn about the different types of hysterectomy. At the bottom of the page visitors are reassured that they’ll be in good company if they have their sex organs removed. They seem determined to make a surgery that is very damaging sound like a walk in the park—nothing to it. There is sometimes safety in numbers, but to suggest that women can feel good about hysterectomy and castration because that’s what OB/GYNs have been promoting to countless other women for years is appalling:

"It is important to remember that you are not alone. In the U.S.there are over 600,000 hysterectomies performed each year, about 1,643 a day. In fact, by the age of 60, 1 in 3 women will have had a hysterectomy. You may be feeling anxious, but remember that there are 599,999 other women this year who will feel like you. In addition, you can take comfort in knowing that recent medical advances have made this common procedure much less invasive."

Less invasive? No matter how it’s done, they’re removing female sex organs. There’s nothing non-invasive about it.

They then invite visitors to click on the link “What is a hysterectomy?” where they say:

"A hysterectomy is an operation to remove a woman’s uterus. Depending on the surgical approach and the woman’s symptoms, the ovaries, fallopian tubes and/or cervix may be removed as well. You should discuss with your physician what will be removed."

Whether the ovaries are removed or not shouldn’t depend upon the surgical approach or symptoms. A symptom isn’t a disease. OBGYN.net is a potentially dangerous website that lures women in by holding themselves out as a reliable source, but then they don’t provide the information that women need to make a decision about their own bodies. And once again removal of the ovaries is made to sound as trivial as a doctor’s whim, when in fact the ovaries are the female gonads and their removal is castration, the same as removal of the testicles is castration. The ovaries produce hormones all of a woman’s life. There’s no age or time in any person’s life when the gonads aren’t needed. It’s unconscionable that this website doesn’t mention those vital facts.

There’s also a subheading called “Conditions that may require a hysterectomy.” They then provide a list of “conditions” that should never require a hysterectomy. In fact, a hysterectomy is never required. If it was required that would mean that you have no choice, that it will be done to you whether or not you agree to it. But even if you have cancer it’s your right to say no to surgery. You have the right to refuse consent.

The link to “Patients stories” directs visitors to a blank page. This may be the best link of all, because on OBGYN.net no news about hysterectomy is good news. And the link to “Patient Brochures” has one brochure, and it’s about Laparsocopic Supracervical Hysterectomy. No helpful information there either.

There was no information about the devastating, predictable, lifelong adverse effects of hysterectomy. Many of the links funneled visitors toward the MedlinePlus website. Visit http://hersfoundation.org/docs/Medline-press-release.pdf to read the HERS Foundation’s press release titled “Medline Plus a Minus for Women.” MedlinePlus (a “service” of the National Library of Medicine) also points visitors to X-Plain which, as we have said, is rife with misinformation that is largely unsupported by anatomical fact.

OBGYN.net has far too many errors and omissions of fact to mention them all in this blog, but suffice to say that the OB/GYNs who wrote it have created a landmine of misinformation at best…which shouldn’t be surprising, because hysterectomy is the goldmine of gynecology.

3. The last option for visitors to Emory’s website who are looking for hysterectomy information is their suggestion to “please call” 404-778-7777. So HERS president, Nora W. Coffey did just that. In fact, Nora made three separate calls, during which she took detailed, verbatim notes.

The first call was made on March 20, 2008. A nurse answered the phone, but she seemed confused by simple questions like, “Can a woman have a uterine orgasm without a uterus?” The RN then put Nora on hold for several minutes so she could get some literature on the subject. When she returned, she read Nora the information that she had found on hysterectomy.

As the nurse read the hysterectomy information to Nora, it sounded oddly familiar. Some of the language she was using was uniquely HERS—it was coined at the HERS Foundation. For example, she referred to the uterus as “hormone-responsive” and referred to women who had undergone the surgery as “hysterectomized,” a verbalization of “hysterectomy” that was coined at HERS to describe the fact that women don’t get a hysterectomy the way that they get their nails done—they’re hysterectomized by doctors. Fortunately she spoke haltingly and slowly, so Nora was able to type up every word that the nurse said. This is verbatim from the nurse:

"The uterus is a hormone-responsive reproductive sex organ, and the ovaries produce the majority of estrogen and progesterone that is available in genetic females of reproductive age. According to the National Center for Health Statistics, of the 617,000 hysterectomies performed in 2004, 73% also involved the surgical removal of the ovaries. In the United States, 1/3 of genetic females can be expected to have a hysterectomy by age 60. There are currently an estimate of 22 million people in the United States who have undergone this procedure."

Most of this information is actually correct, but it slowly began to dawn on Nora where the nurse was getting this information from—Wikipedia.

Wikipedia is an encyclopedic website that is “written collaboratively by volunteers from all around the world.” They have an entry for hysterectomy, and because some other “volunteer” was supplying Wikipedia with erroneous hysterectomy information that was unsupported by anatomical fact and medical literature, Nora edited the hysterectomy entry to get as much correct information on there as the Wikipedia moderators would allow. But why was this Emory nurse, a medical professional from a teaching hospital, responding to a request for patient education information by reading from Wikipedia? It’s baffling, really. Although Wikipedia does offer some accurate information, it’s by no means a reliable source of information for anyone seeking medical advice. Even still, women who call Emory are ostensibly very likely to get information that is no more reliable than an online encyclopedia written by volunteers from around the world who may or may not know what they’re talking about.

And then, in one of her concluding comments about the impact of hysterectomy on female sexual pleasure, the nurse told Nora verbatim, “But um, uh, it’s always like in a non-medical way that I’ve always heard it’s like taking away the baby carriage but leaving the playpen.”

It’s a common refrain that women have told HERS they’ve been hearing from gynecologists all over the country for more than 50 years—“Don’t worry, I’m going to take out the crib, but I’ll leave the playpen.” In other words, you won’t be able to have children, and you won’t be able to have uterine orgasms, but a pouch will still exist for your husband to insert his penis. Thanks, Emory.

Before the end of the conversation Nora asked the nurse to send her the information that she was reading from. Two days later HERS received a package in the mail from the nurse patient-educator at Emory HealthConnection—it was a 7-page printout with the Wikipedia URL on the top and on the bottom of each page. She merely printed out Wikipedia’s hysterectomy web entry and added nothing else.

The next day Nora made her second call to the number listed under Emory’s Patient Education banner. Again she spoke with a nurse who Nora asked a few simple questions. And again the nurse seemed confused by Nora’s questions and put her on hold.

When the nurse returned she said, “Thank you for being so patient. I was just talking with Paula my supervisor and there is a certain area that I can go into and mail you information about the hysterectomy.”

“Okay,” Nora said, “but you can’t give me any information?”

“Well, it’s just that there’s so much information on it we really don’t have the time to be talking all about it. You see what I mean? We’d be on the phone for the next hour.”

“Really?”

This was a curious comment for a “health professional” to make, considering the fact that the HERS Foundation developed an anatomy lesson that is the minimum information a woman needs to make an informed decision about hysterectomy…and that video lesson is only 11 minutes and 45 seconds. The nurse then took the mailing address, after which Nora said, “But I’m disappointed that Patient Education can’t give me any information on the phone.”

The nurse’s response was a very disappointing, “Okay,” followed by, “What I’m going to give you right now is…let’s see. I’m going to ask you exactly what you would like.”

So Nora repeated her request: “I would like to know what the effects of hysterectomy are.”

Instead of Nora, the caller of course could’ve been any woman faced with the decision of whether or not to have surgery. The fact that the nurse asked Nora what she would like to know is baffling. After all, how does the patient know what they need to know? It’s like a woman asking a doctor, “Would you please tell me what the consequences of hysterectomy are?” and the doctor responding, “Okay, what would you like to know?” What’s obvious from these calls is that women need to know the answers to their questions before they ask them, which renders this Emory’s patient education meaningless at best…and potentially very harmful.

The nurse then repeated herself, saying, “There’s just so much information here,” but she never did talk about the consequences of hysterectomy. The best she could do was to define “abdominal hysterectomy” as a hysterectomy where the uterus is pulled out through the abdomen, and other self-evident information. She then said, “Okay?” as if that was all the information she had for Nora and she was prepared to end the conversation there.

As any woman seeking information from a teaching hospital might, Nora grew frustrated. She said to the nurse, “But we really didn’t talk about the consequences of the surgery!”

The nurse’s response? “Uh hm….”

Undaunted, Nora asked, “Are there any changes…are there any sexual changes…are there any other changes that are pretty common?”

“Well,” the nurse said, “I’ll be honest with you. If it was me having this surgery, I’d be talking with my doctor... A hysterectomy…takes care of any problems you may be having with your uterus… Truly it’s the surgeon’s responsibility to give you informed consent about what is going on with your surgery.”

Sure, but she’s a nurse taking calls on a number listed under patient education. So Nora said, “You know I didn’t get very many answers to my questions, which is why I looked on the website to see if you have patient education and this is the number on Emory’s gynecology website page.”

The nurse said only, “Yeah? Can you hold one second please?”

While Nora was on hold, she was subjected to ads for other treatments being advertised by Emory. Like most hospitals, Emory is about making people feel good about the drugs and treatments and surgeries they offer.

Finally the nurse returned. She explained to Nora that all women are unique, so she should talk with her doctor. Amazed that this final option on Emory’s website turned out to also be a dead end, Nora asked why, if they don’t have any information, Emory provides this number for Patient Education?

“Well,” the nurse said, “I do have information here that I’m going to mail off to you.”

About a week later Nora called the HealthcareConnection again.

The person who answered said, “Thanks for calling Emory HealthcareConnection, this is Helen, how may I help you?”

“Hi,” Nora said, “is this your patient education department?”

“Yeah…no…this is actually a doctor referral line?”

Now this was an interesting development—Nora had called twice before and was told that she had called the Patient Education number and that it was staffed by nurses. In each of those calls a nurse struggled to answer Nora’s questions, and now a week later this?

“Okay,” Nora said, “so are you aware that on the Gynecology and Obstetrics website for Emory they give this number for Patient Education?”

“Well, we answer a lot of things here,” the nurse said. “What were you trying to do under patient education?”

Nora was very soon placed on hold again. While on hold Nora listened to an ad for a free educational seminar on the effective non-surgical treatment of uterine fibroids. In other words, it’s a free opportunity for women to be told about the profitable treatment known as UAE, but none of the patient education options available to women would even mention the adverse effects of any of these treatments that have been well-documented in medical literature.

In the first two calls the nurses acknowledged that they knew that they were answering a Patient Education phone line, but now when this nurse returned to the phone she told Nora, “Well, see, we do a lot of the seminars as far as registering people who want to attend the seminars at Emory.” Then she said that health information isn’t really what they do, but, “We have information in our database where we can pull up the health library and under MedlinePlus…we can type in hysterectomies, but if women want printed information,” she said, “you know it would have to be printed off of there… Well, I mean that’s all we have to offer, apparently.” She then elaborated to say, “We’re actually under marketing… The department I’m with is the Emory HealthConnection.”

We are well aware of the fact that they heavily market their surgeries and procedures, but but Emory’s website says:

"Emory HealthConnection serves as your vehicle to access the world of knowledge and expert care encompassed within the many components of EMORY HEALTHCARE. The Emory HealthConnection staff includes registered nurses and consultation representatives who have a library of information at their fingertips and can provide you with the latest information on the services provided by EMORY HEALTHCARE."

A “world of knowledge,” they claim? The worldwide web, maybe, but you don’t need Emory’s help to wander around that endless landmine of misinformation. “Library of information,” they say? Their nurses and patient education materials couldn’t answer one simple question from Nora.

If you have undergone a hysterectomy at Emory or their affiliated hospitals after relying on information from X-Plain, contact HERS at hersfdn@earthlink.net.

Hysterectomy and Female Castration: the Enablers Part II

hersfdn@earthlink.net (HERS Foundation) — Wed, 23 Jan 2008 02:50:00 +0000

Gundersen Lutheran Medical Center, La Crosse, Wisconsin

*** ANNOUNCEMENT ***

Part I of this series was posted on January 1, 2008. Regarding the information below, HERS acknowledges that on or before February 6, 2008 UPMC deactivated the link to the “Hysterectomy” and “Preparing for a Hysterectomy” sections of their Patient Education Materials, thereby eliminating contradictions with the “Hysterectomy” section of their Procedures materials, which remains active.

This is the second in a series of Posts to highlight omissions of fact and misinformation about hysterectomy currently being provided to women on hospital, doctor, and medical school websites. In Part I of this series we demonstrated that the degree of accuracy of the information that women receive about hysterectomy from the University of Pittsburgh Medical Center (UPMC) depends in part on how women search their website. To read Part I (and the 176 comments from women around the country) click here.

Part II of this series highlights the Gundersen Lutheran Medical Center’s seriously deficient patient education product known as X-Plain. As you will see, much of the information provided by X-Plain isn’t supported by anatomical fact or what women experience after hysterectomy.

The reason that we’ve selected Gundersen and UPMC as the first hospital websites to be investigated isn’t because they’re the only hospitals providing misinformation. They were chosen because they’re both typical of patient education information published on hospital websites throughout the country.

Point your web browser to http://gundluth.org/. Click on “Health Information,” then “Interactive Patient Education.” Next, scroll down to “Hysterectomy.” Note that the first screen that you come to defines this tutorial as a “lesson.” Click on “Run Module” and follow the instructions.

The next screen that you come to under the Gundersen Lutheran Medical Center banner says, “Welcome to X-Plain,” which is defined as, “A series of health education programs published by the Patient Education Institute—the leading provider of interactive computer based health education!” According to the Patient Education Institute’s website, this lesson in health education is becoming the “standard of care” in the medical industry. The Patient Education Institute claims that this information will help hospitals like Gundersen to:

• “manage malpractice risk”
• “document patient education and informed consent,” which can be linked “to the patient ID”
• “saves staff 15 minutes per patient”
• and, “if needed, this completion data can be saved to your EMR” (electronic medical record) and used in “legal proceedings” to “counter any claims”

After the welcome page you’re then told, “For questions or problems with this module, please contact Gundersen Lutheran at 608-775-5441 or 1-800-362-9567, Extension 55441.”

Proceeding through the lesson, in the section titled “Anatomy,” the tutorial tells patients, “Menopause occurs when the ovaries quit producing hormones and releasing eggs.” However, this information incorrect. The ovaries continue to produce hormones after menopause. In fact, they continue to produce hormones all of a woman’s life.

Later we’re told that the cervix “opens in the vagina, which in turn opens to the outside…” This is confusing information to say the least. In fact, the uterus is continuous with the cervix, which is continuous with the vagina, and the cervix is the part of the uterus that is at the top of the vagina. The cervix is the opening to the uterus. The phrase “which in turn opens to the outside” makes no sense.

In the section titled “Treatment Options” patients are told that “fibroid tumors may shrink after menopause without the presence of estrogen.” While it is true that fibroids typically shrink at menopause, the rest of Gundersen’s statement is untrue because the ovaries continue to produce hormones—including estrogens—all of a woman’s life.

As it is with both UPMC and Gundersen, one of the most consistent potentially damaging omissions on the websites of America’s hospitals is the failure to inform the public that the uterus is a sex organ. And one of the most consistent false statements made on hospital websites is that sex will be the same or better after hysterectomy. If hospitals and doctors did inform women that the uterus is a sex organ, then women would immediately know that removing the uterus results in sexual loss. So when Gundersen claims that “your health” is their “passion” but then says in this patient education lesson that “hysterectomy does not affect sexual sensations,” what are we to conclude? This statement is false. It’s untrue.

The removal of sex organs certainly affects uterine orgasm, because uterine orgasm isn’t possible without a uterus. Furthermore, Gundersen claims, “Sexual activity can be resumed within weeks and can be as pleasurable as it was before the operation.” What they don’t mention is that the vagina is shortened during hysterectomy, it is made into a closed pocket, and it is sutured shut at the top when the uterus is removed. Most women don’t consider a shortened vagina, scar tissue at the top of the vagina, a loss of vaginal elasticity, loss of uterine orgasm, and diminished or lost physical sensation in the vagina and external genitalia to result in a sexual experience that is as pleasurable after the surgery as it was before the operation.

The reason that this information must be provided to women is that the functions of the female sex organs aren’t visible the way that the functions of the male sex organs are visible. In other words, the functions of the female organs aren’t self-evident the way that the functions of the male organs are self-evident. In telling women information about the uterus that is unsupported by anatomical fact, not only is Gundersen not informing women of the information that they need in order to make an informed decision, women are potentially misinformed. Gundersen has supplied a patient education lesson that omits the very information that women need to decide what they and will not allow to be done to their bodies.

In the section titled “Procedure” Gundersen goes on to tell patients, “The aim of the surgery is to take the uterus out. Sometimes the surgeon may decide to also take one or both ovaries out along with the fallopian tubes.” The message here is that clearly the doctor’s “aim” may also be to remove the female gonads as well. And if you acknowledge that you have completed the X-Plain tutorial, then in a court of law it can be demonstrated that you were informed that the surgeon may also castrate you without further discussion.

Gundersen fails to use clearly understood and informative language. The medically correct word for removal of the ovaries (the female gonads) is castration. The National Institutes of Health reports that about 75% of hysterectomized women are castrated at the time of the surgery, although the incidence of cancer in the ovaries and the testicles is nearly identical, at only .01% of the population. Gundersen then reinforces the fact that the doctor may decide to remove your ovaries when they say, “After the pelvis is entered, the uterus is taken out. The surgeon may also decide to take out the ovaries and fallopian tubes.” In other words, let the reader beware—you have now been informed. Without any further discussion, the surgeon (not you) “may also decide” to castrate you, and if you acknowledge watching this tutorial then you have consented to castration even if the doctor, nurse, and anesthesiologist verbally tell you that they won’t.

In the section titled “Risks and Complications” patients are told, “This procedure is very safe. There are however, several possible risks and complications. These are very unlikely, but possible. You need to know about them just in case they happen.” Again, these are strange and potentially damaging statements. While we always appreciate simple language that is easily understood, much of X-Plain’s language is vague, imprecise, and not supported by anatomical fact. It either doesn’t mean what it says, or it doesn’t say what it means. According to S. S. Meltomaa et al in their study “Incidence, risk factors and outcome of infection in a 1-year hysterectomy cohort: a prospective follow-up study,” which has been widely published since 2000 in the Journal of Hospital Infection and in the Journal of the American Association of Gynecologic Laparoscopists to name a few, “Infection is a common complication of abdominal and vaginal hysterectomy and may lead to prolonged hospital stay.” In the study, 19.2% of hysterectomy patients (one out of five) developed hospital-acquired infections.

One of the things that makes this hysterectomy “lesson” so potentially damaging is the fact that women who take part in it are periodically required to answer true/false or yes/no questions. If you don’t answer right away, a voice insists, “Please answer the question.” In order for you to proceed through the tutorial, you must provide the required answer, or the software program won’t advance the screen forward to the next section. If you answer incorrectly, you’ll be asked the question again and again until you get it “right.” This would all be well and good if their answers were correct and supported by anatomical fact…but some are not.

For example, X-Plain asks patients to answer the question, “Are heart attacks and other anesthesia related complications common during and after this operation?” The correct response to this question would be “yes,” because hysterectomized women have a three times greater incidence of myocardial infarction than non-hysterectomized women, and if their ovaries are also removed women have a seven times greater incidence of myocardial infarction. And precise estimates of anesthesia complications are difficult to come by, but about 1/10 women experience minor complications like bruising and headache; about 1/1,000 experience much more severe complications like lung infection or damage to the teeth, lips, or tongue; and about 1/10,000 will experience very severe complications ranging from impaired vision to death. But in order for patients to proceed through the tutorial they must give the “no” answer to this question. After patients answer the question falsely, that false answer is then reinforced by a pop-up dialogue box that repeats the false information. In a court of law, the fact that you have proceeded through the tutorial means that you must’ve answered their question as required, which could be construed as agreement. Documentation of your responses could then become the hospital’s protection to “counter any claims” that you might bring against them.

Next Gundersen asks patients, “Are infections very common after surgery?” As we have demonstrated and medical literature has made quite clear, the correct answer is “yes.” Infections are indeed common after surgery. But again, the patient must answer “no” in order to continue, thereby requiring women to agree with a false statement.

After repeatedly requiring patients to either end the tutorial or answer some of their confusing questions wrongly, Gundersen continues with more information that is unsupported by anatomical fact. They say, “Rarely, structures in the pelvis and abdomen can be injured during the surgery… It is very rare for the tubes connecting the kidneys to the bladder as well as the bladder itself to be injured.” Again, this is untrue. In a report presented at the American Urogynecologic Society / Society of Gynecologic Surgeons Joint Scientific Meeting, Barak Vakili, MD said, “The overall incidence of intraoperative injury is 5.1%, with the risk increased when patients undergo concomitant surgery for prolapse or incontinence.” With damage to the urinary tract occurring in more than one out of every 20 women undergoing hysterectomy, it’s not a rare occurrence. In fact it’s quite common. It occurs more than 31,000 times each year during hysterectomies performed in this country. In a more recent study published in the October 27, 2007 issue of The Lancet, Dr. Daniel Altman et al said that hysterectomized women “had a more than doubled risk increase for subsequent stress-urinary-incontinence surgery.”

Gundersen then goes on to say, “In extremely rare situations, the intestines and the blood vessels could also be affected, necessitating another operation.” Information that is supposed to inform women about the consequences of a major operation should be very clear, but this statement is too unclear to understand what it is that they’re trying to say. Are they referring to the blood vessels of the intestines? If so, then yes, it would be very damaging to lose blood supply to the intestines, which is rare. But if they’re referring to the rich blood supply attached to the uterus, those blood vessels are always permanently damaged during hysterectomy because the blood supply to the uterus that radiates throughout the pelvis must be severed to remove the uterus. Severing this vascular supply affects the flow of blood to distant organs and limbs, including the intestines. If X-Plain is discussing the vessels of the intestines, then the fact that they neglect to discuss the vessels of the uterus (the organ that is removed during hysterectomy, which is the topic of this lesson) is a blatant omission.

“Similarly,” Gundersen claims, “in extremely rare situations, small nerves in the pelvis may be injured resulting in decreased sensation in the sexual organs. Rarely, this can lead to sexual dysfunction.” What sex organs are they referring to? The ones that were removed? This is potentially a very damaging statement because, in fact, all of the nerves that attach to the uterus must be severed to remove it. Those nerves radiate throughout the pelvis, and supply enervation (feeling) to the nipples, clitoris, vagina, and elsewhere. But they obviously no longer serve that function after they’ve been severed to remove the uterus. What Gundersen refers to as “extremely rare” actually occurs in every hysterectomy. The uterus can’t be removed without severing those nerves, and they can’t be reattached. Furthermore, uterine orgasm can’t occur without a uterus. So, in fact, some or all of a woman’s sexual function is permanently lost, resulting in “sexual dysfunction” in every hysterectomized woman.

And now Gundersen’s patients are apparently ready for another quiz: True or false? “After a hysterectomy sexual pleasure is decreased.” Clearly, the correct answer is “true.” But once again, in order to proceed women must provide the false, incorrect answer that is unsupported by anatomical fact. And when patients provide the false answer, Gundersen reinforces that false statement by telling patients, “Correct. Women whose conditions caused pain during sexual intercourse, report a more enjoyable intercourse.” As we have said, most women don’t consider shortening the vagina, a loss of vaginal elasticity, loss of uterine orgasm, and diminished or lost physical sensation in the vagina and external genitalia to result in a sexual experience that is as pleasurable after the surgery as it was before the operation.

Later, women are asked another true/false question. “One of the side effects of a hysterectomy is weight gain.” True or false? The fact is, women who contact the HERS Foundation report that although their diet and exercise remain the same, on average they experience weight gain of 25 pounds or more in the first year after surgery. But Gundersen patients are required once again to answer this question falsely if they want to continue with the lesson.

In the section “After the Surgery” patients are told, “You can resume your sexual activities within six weeks. This operation will not change your sexual lifestyle or sensations.” Let’s be very clear here: The only way that the removal of sex organs won’t change your sexual lifestyle or sensations is if you never experienced them to begin with. In fact, it will always change your sexual lifestyle and sensations, because it will eliminate the possibility of uterine orgasm and some or all of your sexual feeling forever.

Gundersen’s hysterectomy lesson continues by saying, “Most likely, the operation will free you from the chronic pain caused by the uterine problem.” Once again, Gundersen and the makers of X-Plain appear to be unfamiliar with medical research and anatomical fact. Thomas Stovall, MD et al said in the journal Obstetrics & Gynecology, “Despite preoperative history and physical findings suggesting and histologic findings confirming uterine disease, nearly a quarter of the patients have persistent pelvic pain after hysterectomy for chronic pelvic pain. These findings should have a significant impact on the therapeutic choices recommended by gynecologists and may alter the informed consent that patients give in such cases.” Based on what women report to HERS, chronic pain is much more common after hysterectomy than even this report suggests.

In conclusion, Gundersen tells patients, “Hysterectomy is a very safe and successful operation. It can be a positive solution for many serious conditions affecting female reproductive organs and causing pain and bleeding.” And with that, Gundersen completes its tutorial on hysterectomy without addressing the well-documented consequences of this life-altering surgery. In fact, Gundersen might have mentioned, hysterectomy is widely considered to be the most over-utilized and medically unwarranted surgery in America. It is rarely used to treat actual medical problems that have no conservative treatment options, and the vast majority of hysterectomies are recommended and performed for benign conditions.

The mortality rate for hysterectomy is approximately nineteen out of every ten thousand women. In the last decade there were an average of 621,000 hysterectomies performed each year in this country, so about 3.25 women continue to die every day of every year in hysterectomy operating rooms or in the immediate post-operative period…almost 1,200 women each year. But the damage caused by removing the uterus and severing the nerves, blood supply, and ligaments that attach to it occurs in all women who undergo hysterectomy.

Hysterectomy represents more than $17B/year in revenue to America’s hospitals. Its aftermath is well-documented and available on the HERS Foundation website. Be your own judge, but what does “relatively safe” mean? It isn’t ever “relatively safe” for the woman whose body is cut into and whose sex organs are removed.

As a patient education tool, it would be far more informative and precise for Gundersen to say that hysterectomy is a dangerous operation that causes serious, permanent anatomical and physiological destruction and life altering changes. The surgery itself causes permanent pain, permanent sexual loss, and a host of medical problems that women who remain intact don’t experience.

Let the reader beware. Before you make any decision about female surgery watch the 12-minute video “Female Anatomy: the Functions of the Female Organs” at www.hersfoundation.org/anatomy.

Email HERS at hersfdn@earthlink.net if you know of a doctor, medical school, or hospital website that you think should be highlighted on this blog. If you would like to talk with women about the consequences of hysterectomy, HERS provides a network of women who will talk with you about their experiences.

If you have undergone a hysterectomy at Gundersen or their affiliated hospitals after relying on information from X-Plain, contact HERS at hersfdn@earthlink.net.

Hysterectomy and Castration: the Enablers

hersfdn@earthlink.net (HERS Foundation) — Tue, 01 Jan 2008 05:45:00 +0000

Hysterectomy and Female Castration: Who are the enablers?
Part I—University of Pittsburgh Medical Center

*** ANNOUNCEMENT ***
Part I of this series was posted on January 1, 2008. Regarding the information below, HERS acknowledges that on or before February 6, 2008 UPMC deactivated the link to the “Hysterectomy” and “Preparing for a Hysterectomy” sections of their Patient Education Materials, thereby eliminating contradictions with the “Hysterectomy” section of their Procedures materials, which remains active.

One of the most frequently asked questions at HERS is, “How do doctors get away with removing the female organs from more than 600,000 American women each year without informing them of the consequences?” The answer is complex, but the responsibility largely falls on doctors, medical schools, and hospitals. One hand washes the other in the 17 billion dollar a year hysterectomy industry built on the profits made from removing the sex organs from more than 22 million American women alive today.

The internet is a minefield of both helpful and harmful information on any topic, including hysterectomy and female castration. The fact that the University of Pittsburgh Medical Center (UPMC) publishes contradictory statements, for example, is easily demonstrated by comparing the information provided on their own website. As you will see, on the one hand UPMC claims that sexual intercourse isn’t affected by hysterectomy and that sex may even be improved by the removal of a sex organ, but on the other hand they say that the uterine contractions associated with orgasm aren’t possible when the uterus is removed. Both statements can’t be true. Therefore, the untrue information is contradictory and potentially dangerous.

We would rather believe that no hospital would put its name on contradictory medical information. But it’s irrefutable when, in their own words, UPMC publishes potentially dangerous information about the functions of the female organs. UPMC’s own website provides the proof that the information about hysterectomy is unreliable.

No matter how smart and savvy a woman is, if she isn’t accurately informed about the functions of the female organs before she sets foot in a doctor’s office she won’t be able to evaluate the validity of the information that a doctor or hospital gives her. Medical schools institutionalize and sanction an educational environment that uses advertising to attract customers to hospitals that provide professors and students with the live bodies of women to practice on. Teaching hospitals and large corporate hospital chains alike provide the equipment, staff, and facilities to implement hysterectomies on women. If those women rely on UPMC’s online “Patient Education Materials,” they may be misinformed of the aftermath of the removal of the uterus and/or ovaries. Medical schools, doctors, and hospitals who hold themselves out as experts form a circle of power that has a unique responsibility to provide accurate information about hysterectomy. That circle of power, however, often obscures information, omits facts, and reinforces harmful myths about hysterectomy.

This is the first of several posts that will highlight omissions of fact and misinformation about hysterectomy currently being provided to women on the websites of doctors, medical schools, and hospitals. As UPMC’s website (http://www.upmc.com/home.htm) demonstrates, the degree of accuracy of the information you will receive about hysterectomy depends in part on how you search their website, which is the reason why the following is broken into two sections.
_____________________________

Section A:

From the UPMC home page, if you click on “Health A-Z” a list pops up on the left side of your screen. Under “Personal Health,” if you click on “Women” it takes you to the “Health Library.” Next, click on “UPMC Patient Education Materials” then “Women’s Health.” Finally, from the bottom of that long list select “What is a hysterectomy?” Or, after you click on “Women” from the “Personal Health” section, you can find it by clicking on “Health Reference,” then “UPMC Patient Education Materials,” then “Women’s Health,” then “What is a hysterectomy?” The “What is a hysterectomy?” link takes you to http://patienteducation.upmc.com/Pdf/Hysterectomy.pdf . The following excerpts were taken from that web page on 1/1/08.

UPMC begins by defining three types. “Partial hysterectomy,” they tell us, “is the removal of the top part of the uterus (the fundus uteri), leaving the lower part of the uterus (the cervix) in place.”

HERS comment: If they said, “Partial hysterectomy involves severing the nerves, ligaments, and blood supply that attach to the body of the uterus, leaving the cervical stump,” then it would alert the reader immediately that this is a major surgery resulting in far-reaching anatomical and functional changes.

They also tell us, “A hysterectomy does not include the removal of the fallopian tubes and ovaries. Your doctor may recommend that these organs be removed at the same time,
depending on your age and the condition of the organs. Your doctor will talk with you about this.”

HERS comment: In order for UPMC to provide accurate information to women about female anatomy, they could say, “Your doctor may also recommend the removal of your ovaries. Just as the testicles are the male gonads, the ovaries are the female gonads. Removal of the gonads is castration.” If they said that, then women would understand that the removal of the ovaries is life-altering. UPMC implies that age is a disease. The gonads in both women and men continue to function throughout the human lifespan, and age is never a justification for removal of the ovaries. Women who understood this would be unlikely to consent to castration. It’s important for women to be informed of the correct medical terminology and consequences.

In the section titled “Removal of the ovaries,” the UPMC website tells women, “In general, ovaries are removed only if there is a problem with them. Two factors in this decision are a woman’s age and another is whether she has gone through menopause. In women who have not gone through menopause, the ovaries are important… The ovaries stop working after menopause, so they may be removed during hysterectomy in women who have completed or are close to menopause. Removing the ovaries reduces the risk of ovarian cancer, which is difficult to detect in its early stages. When a woman who has not completed menopause has both ovaries removed during hysterectomy, a condition called ‘surgical menopause’ occurs. Women who experience surgical menopause may have the same symptoms as those who have had natural menopause. These include hot flashes, night sweats, and shrinkage of vaginal tissue.”

HERS comment: This section begins with a contradiction. Whereas in the introduction to “What is a Hysterectomy?” we’re told, “Your doctor may recommend that these organs be removed at the same time, depending on your age…” this section says, “In general, ovaries are removed only if there is a problem with them.” So which is it? Do they mean to say that age is a disease or that the ovaries should only be removed if they are diseased? It can’t be both.

UPMC states that the ovaries “stop working after menopause,” although it’s well documented in medical literature that the ovaries continue to function in post-menopausal women. The ovaries are “important” to a woman’s health and wellbeing all of her life.

UPMC goes on to tell women that ovarian cancer is difficult to detect. But they fail to mention that the incidence of ovarian cancer is less than .01% of the population at risk and is listed by the National Institutes of Health as a “rare disease.”

Finally, UPMC also fails to use the word “castration,” which is the medically correct term for removal of the ovaries. Instead they use the euphemistic oxymoron “surgical menopause.” It is in fact impossible for a woman to become surgically menopausal. A menopausal woman has functioning, hormone-producing ovaries in her body. A woman whose ovaries have been removed doesn’t have the benefit of the natural hormones and other substances produced by her gonads. There is no comparison between castration and menopause, and the functions of the ovaries can’t be replaced.

Under the heading “Physical changes after hysterectomy,” UPMC states, “Unless extensive surgery is performed, the vagina remains the same after a hysterectomy. Once healing has occurred, the vagina will continue to function normally. Sexual inter-course [sic] is not affected by a hysterectomy.”

HERS comment: A majority of all hysterectomies are “total,” where the top of the vagina is cut into around the cervix in order to remove the uterus. After the surgeon removes the cervix, the vagina is then made into a closed pocket. The surgeon does this by pulling the walls of the vagina together to close the hole created in the top of the vagina and suturing it back together. Also, much in the same way that a seam created by sewing fabric together results in diminishing the pre-sewn size of the cloth, in addition to filling in the hole where the cervix had been the surgeon shortens the vagina when the seam at the top of the vagina is created by suturing it shut. Therefore, the vagina is altered in depth, shape, and elasticity.

And for those women who experienced uterine orgasm before the surgery, they won’t experience it ever again without their uterus. It would be informative for UPMC to explain how “sexual inter-course is not affected by” removing a sex organ. The possibility of uterine orgasm is eliminated, sensation in the vagina and external genitalia is diminished or lost entirely, the vagina is shortened, and the uterine ligaments, blood supply, and nerves that radiate throughout the pelvis are severed. Hysterectomy causes profound changes in sexual function.

In the section “Emotional effects” UPMC states, “A woman’s sexuality and femininity are not changed by a hysterectomy. During the recovery period from surgery, anxiety, fatigue, and fear of pain can cause a lack of sexual desire. Allowing time to heal and recover, sharing your feelings with your partner, and using a gentle approach can help you achieve sexual pleasure.”

HERS comment: A sex organ can’t be removed without altering sexuality and femininity. As we have said and is well-documented in medical literature, when the uterus is removed uterine orgasm can’t occur. The vagina is shortened, sutured shut at the top, and women develop adhesions that are often very painful. This scarring, shortening, and loss of elasticity in the vagina often makes sex extremely painful during intercourse. Furthermore, the nerves that attach to the uterus branch out to the vagina and external genitalia. Those nerves must be severed to remove the uterus. When they’re severed it causes not only a loss of physical sexual sensation, but it also often causes pain in the buttocks, groin, pelvis, and vagina. Severing of the ligaments affects skeletal structure, commonly causing pain in the lower back and hips. “Sharing your feelings with your partner” and “using a gentle approach” won’t replace the functions of the nerves, ligaments, blood supply, or sex organs. Nor will they stop the painful aftermath of hysterectomy. Lack of sexual desire is to be expected when a sex organ is removed.

In the section titled “Myths associated with hysterectomy,” UPMC refers to “Sex will be less enjoyable” as a myth. They elaborate by stating as fact that, “The ability to enjoy sexual intercourse should not be affected by a hysterectomy… Once healing has occurred, the ability to enjoy sex and achieve orgasm will return to normal and may even improve. Some women have a temporary loss of vaginal sensation and less lubrication during sexual activity. These are common side effects of the surgery. Vaginal sensation and lubrication will return to normal when healing is complete.”

HERS comment: No—sex can never return to “normal” after hysterectomy. That’s impossible because a sex organ has been removed. Even if you never experienced sex before the surgery, the potential to experience sexual satisfaction and uterine orgasm will no longer be possible. Sex isn’t improved by the removal of sex organs or by shortening the vagina. The loss of sensation to the vaginal and external genitalia isn’t temporary, it’s permanent. The nerves that made physical sensation possible are severed during hysterectomy and they can’t be reattached. The permanent loss of physical sensation and uterine function is universal. But sexuality and sensuousness aren’t limited to sexual acts. All of human interaction, sexual energy, and vitality are diminished by the removal of the female organs.

There are two “UPMC Patient Education Materials” about hysterectomy. The misinformation in “What is a Hysterectomy?” is reinforced and expanded in the “educational” document from the same list called “Preparing for a Hysterectomy.” On the third page, under the heading “Will a hysterectomy affect my sex life?” it says at the end of the first paragraph and into the second paragraph, “At this point in recovery your ability to enjoy sex and achieve orgasm will return to normal and may even improve. Because of the temporary shrinkage of tissues that occurs after surgery, your vagina may feel shorter or narrower even though no tissue has been removed.”

HERS comment: No woman can experience uterine orgasm without a uterus. A woman whose pain was relieved by removal of her uterus may be glad to be rid of that particular pain, but that doesn’t mean that she would have consented to the surgery if she had known that she would experience a total loss of uterine orgasm and diminished or lost sensation to the vagina and external genitalia.

The shortening of the vagina in a total hysterectomy is not temporary. It is an irreversible consequence of cutting a hole into the top of the vagina that is then sutured shut. The vagina is permanently shortened.

“This educational material,” UPMC tells us, “was developed by a team of women’s health care experts throughout UPMC, including Magee-Womens Hospital, a National Center of Excellence in Women’s Health as designated by the U.S. Department of Health and Human Services.” Visitors to Magee-Women’s Hospital of UPMC are provided with a prominent link back to this hysterectomy information on UPMC’s main website. In the “About Us” page on Magee’s website they say that part of their “WOMANCARE PHILOSOPHY” is being “committed to…empowering [each woman] through education.”
_____________________________

Section B:

UPMC’s contradictory information about hysterectomy becomes clear by clicking on a different link on the same website. It was “last reviewed January 2007.”

From the UPMC home page, click on “Health A-Z” and then “Women.” But this time, instead of clicking on the link to “UPMC Patient Education Materials,” click on “Procedures.” Once there, you’ll see a long list of “Procedure & Surgery Fact Sheets.” Next, scroll down the long list of “fact” sheets to the link for “Hysterectomy” where, in addition to reading about the surgery, you can view an animated hysterectomy, although this animated version does little to convey the extreme physical assault to a woman’s body.

The first paragraph narrowly defines hysterectomy as “the surgical removal of the uterus, resulting in sterility, or the inability to become pregnant. It may be done through the abdomen or the vagina.”

HERS comment: In addition to the comments above that demonstrate that this definition is incomplete, by omission it informs women only about the loss of childbearing, not the many other important functions of the uterus.

In the section titled “Parts of the Body Involved,” UPMC lists the following:
• Partial or Subtotal Hysterctomy [sic] – Removal of the uterus
• Total, Complete, or Simple Hysterectomy – Removal of the uterus and cervix (the opening of the uterus leading to the vagina)
• Radical Hysterectomy – Removal of the uterus, ovaries, fallopian tubes, upper part of the vagina, and the pelvic lymph nodes
• Salpingo-oophorectomy – Removal of the ovaries and fallopian tubes (may be combined with any of the above procedures)

HERS comment: In the first definition, although the cervix is not wholly removed during a “subtotal” hysterectomy, it is “involved.” The uterus is amputated from the cervix, which leaves a cervical stump. The description of “radical” hysterectomy fails to mention that the paraaortic lymph nodes and the omentum are often removed. And in defining salpingo-oophorectomy they fail to define removal of the ovaries as female castration. Rarely would a woman consent to being castrated.

It would be much more informative for people who hold themselves out as women’s health experts to say, “No matter how or what type of hysterectomy is performed, every cell in a woman’s body is involved. The endocrine system (of which the uterus and ovaries are major components) helps regulate every part of a woman’s body to maintain health and wellbeing in far-reaching ways, such as hair follicle stimulation, sexual function, bone structure, metabolism, sleep, insulin production, cardiovascular health, and all of the known (and unknown) functions of the female organs throughout every woman’s anatomy. For example,” they might add, “hysterectomized women have a three times greater risk of heart disease, and women whose ovaries are also removed have a seven times greater risk of myocardial infarction.” But UPMC fails to mention those facts.

Under the subheading “Description of the Procedure,” in the section titled “What to Expect,” we're told that during an abdominal hysterectomy, “A cut is made in the lower abdomen to expose the tissues and blood vessels that surround the uterus and cervix. These tissues are cut and the blood vessels are tied off to remove the uterus. Stitches are placed in these deep structures, which will eventually dissolve and do not need to be removed. The uterus is removed from the top of the vagina, and the vagina is closed to prevent infection and to keep the intestines from dropping downward.”

HERS comment: UPMC fails to inform women that the tissue and blood vessels not only surround the uterus and cervix but are attached to it. They fail to mention a fact of significant importance—a large bundle of nerves and broad bands of ligaments that are attached to the uterus must be severed to remove it. By stating that blood vessels are tied off it doesn’t convey that the rich blood supply that provides blood flow to the uterus and throughout the pelvis and lower extremities is severed. It also doesn’t mention that one of the ligaments that must be severed is the utero-sacral ligament that attaches to the uterus and to the sacrum in the lower back, which may be one of the reasons why hysterectomized women experience chronic back problems.

And once again UPMC fails to inform women that during a total hysterectomy the top of the vagina is cut around the cervix and the body of the uterus and the cervix are removed. It states that the vagina is closed to “keep the intestines from dropping downward.” In fact the intestines do move down to take up the space where the uterus had been, but because they’re no longer in their natural location behind the uterus they now sit directly on top of the surgical scar at the top of the vagina where adhesions develop. So suturing the top of the vagina shut doesn’t prevent the intestines from dropping downward, it only prevents them from falling through the hole that the surgeon has made into the top of the vagina.

The same facts apply to their definition of “Vaginal Hysterectomy.” In the second sentence of the paragraph describing what is done to women during vaginal hysterectomy, UPMC tell us, “The doctor does, however, make an internal incision at the top of the vagina around the cervix.”

HERS comment: If the precise language was used in all of the descriptions of “total” hysterectomy, then women would understand that their vagina will be cut into and sutured shut at the top, whether the surgery is performed abdominally, vaginally, with the use of a laparoscope, by a robot, or any other method.

This section is also inaccurate when discussing the dislocation of the intestines, as mentioned above. They don’t mention that there’s also a loss of the natural barrier of the uterus between the intestines, the vagina, the bladder, and the bowel, which is one reason why hysterectomized women usually experience bowel and bladder problems.

In the subsection titled “Possible Complications,” UPMC provides the following list:
• Reactions to anesthetics
• Pain
• Infection
• Bleeding
• Fatigue
• Injured pelvic organs (bowel and/or bladder)
• Urinary incontinence (problems holding your urine)
• Loss of ovarian function and early menopause
• Depression
• Sexual dysfunction

HERS comment: When the blood supply to the ovaries is damaged during the surgery causing the ovaries to cease to function (which occurs as often as 35-40% of the time), the doctor’s actions result in a de facto castration (a total loss of ovarian function) even if the ovaries aren’t removed at the time of hysterectomy. Loss of ovarian function is not comparable to menopause. A menopausal woman has ovaries that produce hormones her entire lifetime. She also has a functioning uterus. Menopausal women have not had their female organs removed.

In the section titled “Outcome” there are several subheadings. The first is “Physical,” in which the last paragraph begins, “If the ovaries are removed (oophorectomy), your body's main source of estrogen and other sex hormones is gone. If you were not already postmenopausal, this sends your body into an instant menopause…”

HERS comment: Again it incorrectly defines the removal of the ovaries as being the same as menopause and not castration.

Next is the subheading “Emotional.” Here UPMC tells us, “Some women have strong emotional reactions, including depression, in response to the loss of their uterus.”
HERS comment: This statement would be correct if it said that women experience depression because of the loss of the functions of the uterus and ovaries.

Finally, the last subheading is “Sexual.” In this subsection UPMC tells us, “Some women notice a change in their sexual response after a hysterectomy. Because the uterus has been removed, uterine contractions you may have felt during orgasm will no longer occur. If the ovaries have been removed, vaginal dryness may be a problem, but this is usually relieved with the use of estrogen. Some women report an increase in their sexual enjoyment, possibly because they are relieved of the pain from the condition that prompted this procedure, or no longer need to worry about an unintended pregnancy.”
HERS comment: Women who happen to find this link on UPMC’s website will at least be informed that the uterus is a sex organ and that uterine contractions that occur during orgasm can no longer occur without a uterus. But if they click on the Patient Education Materials link they’ll be told the opposite…that the “ability to enjoy sex and achieve orgasm will return to normal and may even improve.” This contradictory information is potentially dangerous and damaging. UPMC is one of the rare hospital websites that educates and informs the public about uterine contractions that occur during orgasm and that they will no longer occur without a uterus. It is unfortunately the last statement in this long description of hysterectomy and contradicts earlier statements. It should be one of the first, most prominent statements and mentioned throughout, not buried at the end. The loss of uterine orgasm is of vital importance to women.

Visitors to the UPMC website must wonder why it is that the question “Will a hysterectomy affect my sex life?” is answered in the Patient Education Materials page titled “Preparing for a hysterectomy.” This is information women need to be told prior to deciding whether or not they’ll proceed with the doctor’s recommendation for a hysterectomy and not while preparing for the surgery itself. As we have discovered, UPMC admits that in a total hysterectomy the cervix is removed, the vagina is incised and closed at the top, and uterine contractions that occur during orgasm can’t occur without a uterus. Why is it, then, that UPMC fails to provide the correct information when they themselves ask the question “Will a hysterectomy affect my sex life?” It’s baffling that they then answer that question by stating that sex “will return to normal and may even improve.”

“References” for these “facts,” UPMC tells us, were obtained by accessing the websites of the American College of Obstetrics and Gynecologists, the American Medical Association, and the National Women’s Health Information Center on October 14, 2005.

There are many contradictions throughout UPMC’s website, but for the purposes of this discussion we will point out just a few more. “UPMC Patient Education Materials” don’t provide a separate information page for oophorectomy—female castration, the surgical removal of the ovaries. But in their “Procedure & Surgery Fact Sheets” UPMC has a page titled “Oophorectomy.”

They define oophorectomy as follows: “The surgical removal of one or both ovaries, called bilateral oophorectomy. This procedure may be combined with the removal of the fallopian tubes, in which case it is called a salpingo-oophorectomy. Removal of the ovaries and/or fallopian tubes is often done as part of a complete or total hysterectomy.”

HERS comment: Again, because these are presented as “fact” sheets from those who hold themselves out as medical experts, if they used the medically correct definition for the ovaries it would convey an immediate understanding that the consequences of removal of the ovaries is serious and damaging. The ovaries are the female gonads. Removal of the gonads is castration. By omission UPMC fails to provide the critical information needed for women to decide whether they will consent to being castrated.

Under “Parts of the Body Involved,” UPMC provides a drawing of the “Female Reproductive System.” It would be accurate to say that the brain (chiefly the hypothalamus and the pituitary), the breasts, and other “parts” of the female anatomy (such as the adrenal glands and all of the connecting tissues, vessels, and nerves) complete the female reproductive system, along with the uterus, ovaries, fallopian tubes, and vagina. But not only are the brain, breasts, adrenals etc not included in UPMC’s artist rendition of the female reproductive system, the uterus itself isn’t labeled. The drawing only labels the ovaries, fallopian tubes, bladder, and vagina.

HERS comment: Their failure to label the uterus while labeling the bladder in a anatomical drawing of “The Female Reproductive System” is shocking. The uterus is a hormone-responsive reproductive sex organ, without which (UMPC makes clear elsewhere) reproduction isn’t possible. Under the anatomical drawing used on UPMC’s website it says, “Copyright © 2005 Nucleus Communications, Inc.” We visited the Nucleus Communications website and found many drawings of the female reproductive system, but we couldn’t find one where the uterus wasn’t labeled. In fact, the only Nucleus Communications drawing that we could find that resembles the drawing that UPMC uses on their website is called “Nerve Distribution of the Bladder and Uterus - Medical Illustration.” Not only is the uterus labeled on this drawing, but the “Pelvic Nerve Plexus” is labeled along with the “Left Inferior Hypogastric Nerve Plexus.” As evidenced by yellow-colored neural pathways that literally engulf the reproductive organs, it’s clear to see that these are some of the very nerves that radiate throughout the pelvis and enervate the sex organs. Why would UPMC choose to use an anatomical drawing that doesn’t label those too?

At the end of the “Procedure & Surgery Fact” sheet on oophorectomy, UPMC credits EBSCO Publishing. EBSCO is a privately held corporation out of Ipswich, Massachusetts. On their website, under “Consumer Health Complete Database Coverage List,” among many other publications they offer an “Evidence-Based Fact Sheet” called “Hysterectomy: Surgical Removal of the Uterus [or Womb], Vaginal Hysterectomy, Abdominal Hysterectomy” from “Great Neck Health Publishing.” They also offer “Health Animation” from “Blausen Human Atlas.” Blausen offers many short videos. In the one called “Ovariectomy” it says, “A woman’s reproductive system includes the uterus, the ovaries, the fallopian tubes, and the vagina.”

In the section titled “Possible Complications,” UPMC lists “changes in sex drive.” This fact, however, isn’t listed in the “Outcome” section.

HERS comment: Changes in sex drive are to be expected after removal of sex organs. It’s an outcome, not a complication. UPMC repeatedly makes the point that removal of the ovaries often accompanies removal of the uterus. In fact, the NIH reports that about 75% of all hysterectomized women are castrated at the time of hysterectomy. It’s baffling then, that elsewhere UPMC makes the blanket statement that sex will return to normal and may even improve after hysterectomy.

Under the heading “Postoperative Care,” UPMC states that, “If both ovaries are removed, your body goes immediately into menopause. If you are not being treated for breast cancer, your doctor will prescribe hormone replacement therapy (HRT), either estrogen alone or with progesterone, to help manage the symptoms of menopause.”

HERS comment: Castration—removal of the ovaries—results in the loss of the production of the many hormones and other substances produced by the ovaries. “Hormone replacement” is a misnomer, because it isn’t possible to replace the natural, complex, lifelong functions of the ovaries with any other substance produced outside of the body. This would be an ideal place for UMPC to mention the largest randomized HRT study ever conducted on healthy post-menopausal women. The NIH’s Women’s Health Initiative study was abandoned when researchers determined that the risks of HRT outweighs the benefits. A significant number of the study’s participants experienced serious complications, including breast cancer, strokes, heart disease, ,endometrial cancer, and other adverse effects.

“References” for the “facts” mentioned on UPMC’s website regarding the surgical removal of the ovaries, they tell us, were obtained by accessing the websites of the American College of Obstetrics and Gynecologists and the National Cancer Institute. It goes on to say that this information was last reviewed by them as recently as January 2007. “Copyright © 2007 EBSCO Publishing. All rights reserved.” Visitors to UPMC’s website must wonder what the organizations referenced throughout this website have to say about having their organizations’ reputations attached to these confusing contradictions and omissions that are published by a major medical teaching hospital.

Let the reader beware. Before you make any decision about female surgery watch the
12-minute video “Female Anatomy: the Functions of the Female Organs” at www.hersfoundation.org/anatomy.

Email HERS at hersfdn@earthlink.net if you know of a doctor, medical school, or hospital website that you think should be highlighted on this blog.

If you would like to talk with women about the consequences of hysterectomy, HERS provides a network of women who will talk with you about their experiences. If you have undergone a hysterectomy at UPMC or their affiliated hospitals since 2003, contact HERS at hersfdn@earthlink.net.

Hysterectomy - the Experts Speak Out

hersfdn@earthlink.net (HERS Foundation) — Wed, 05 Dec 2007 22:56:00 +0000

Hysterectomy - the Experts Speak Out

It's hard to believe that hysterectomy was popularized in the United States over a century ago. The surgical removal of the female hormone responsive reproductive sex organs is a primitive practice, yet there were an average of 622,000 hysterectomies((removal of the uterus) performed a year for the last decade. In 2005 76% of the women hysterectomized had their ovaries removed. The ovaries are the female gonads, and removal of the ovaries is castration. Doctors tell women sex will be the same, or better than ever. Women say their sex lives are over, they're "dead in bed".

As women who have had their sex organs discover after the surgery, this is about much more than sex. Among the most commonly report effects of hysterectomy are a loss of vitality, loss of sexuality, loss of sensuality, loss of short term memory, loss of creativity and change in personality.

This is a place for all hysterectomized and castrated women to tell the truth about their experiences and observations.

Family and friends are welcome to post, too.
Labels: castration, experts, Female Anatomy, hysterectomy, oophorectomy, ovaries, sex, sex after hysterectomy, support

Protest Play Empowers Women

hersfdn@earthlink.net (HERS Foundation) — Wed, 10 Oct 2007 19:28:00 +0000

Protest Play Empowers Women’s

Women who understand female anatomy and the functions of the female organs are empowered to make informed health decisions. “UN BECOMING” is the story of a sensuous artist named Emma Douglas. Emma is empowered to take control of her own body when an unlikely hero rises up to help her avoid an unwarranted surgery to remove her healthy sex organs.

Pasadena is the 40th city to host “UN BECOMING” since it’s New York premiere in 2004. Written in the tradition of the Federal Theater Project’s “living newspaper” theater, “UN BECOMING” explores how any woman can lose control when the voice of intuition is silenced.

UN BECOMING, by Rick Schweikert
DVD screening of the Off Broadway premiere
Friday, November 2, 2007, 7:30pm
The Westin Pasadena, Plaza Room
191 North Los Robles
Pasadena, CA 91101
Open to the public
Followed by a talk-back with the playwright & the HERS Foundation’s Nora W. Coffey

“If you have a mother or wife or sister or daughter or female friend, un becoming is vitally important."
–Robert’s Reviews

“Every woman, man and child should see this play!
–Barbara Seaman, author of The Greatest Experiment Ever Performed On Women

Contacts:
Nora W. Coffey, 610-662-9114
Rick Schweikert, 484-432-8356

Removal of one or both ovaries increases incidence of cognitive loss

hersfdn@earthlink.net (HERS Foundation) — Sat, 29 Sep 2007 03:46:00 +0000

HERS Foundation said...
This article is soon to be published in the Journal 'Neurology'. Many hysterectomized and castrated women experience memory problems that began after the surgery. Because they are often ridiculed by doctors for connecting their memory problems to their surgery their concerns and experiences are often trivialized by family and friends.

The Real Experts have been telling the so-called medical experts for a century that castration causes memory loss and impaired cognitive function. Doctors tell them their memory loss is because they have a relationship problem with a partner, family or friends. They tell them taking hormones is the remedy. And they tell them they have memory loss because the are depressed.

The loss of memory results in a profound loss of self and identity. Competent, intelligent, dynamic women suddenly have difficulty finding the common ordinary words they know as well as their own names. Thoughts run around the edge of their brains, unable to be retrieved. Most women characterize this tremendous loss as irritating, frustrating, and terrifying. The thing that I always find incredible is the way so many women have learned to cope with this loss by compensating. Sometimes it's a facile changing subject, or with a laugh, "oh, you know what I mean". Sometimes it's like charades. "It's green, it's wood, it has a back, and you sit on it." All the while she's trying to be pleasant and not show how foolish it feels to play a game to get others to guess what is in her head.

Women who experience these problems can use this article to help family and friends understand what is so difficult to comprehend and accept, particularly because it is denied by gynecologists who perform the surgery. Acknowledging the problems caused by hysterectomy is not good for business. Kudos to the authors.

Increased risk of cognitive impairment
or dementia in women who underwent
oophorectomy before menopause

W.A. Rocca, MD, MPH
J.H. Bower, MD
D.M. Maraganore, MD
J.E. Ahlskog, PhD, MD
B.R. Grossardt, MS
M. de Andrade, PhD
L.J. Melton III, MD, MPH
ABSTRACT
Objective: There is increasing laboratory evidence for a neuroprotective effect of estrogen; however,
the clinical and epidemiologic evidence remains limited and conflicting. We studied the association
of oophorectomy performed before the onset of menopause with the risk of subsequent cognitive impairment or dementia.

Methods: We included all women who underwent unilateral or bilateral oophorectomy before the
onset of menopause for a non-cancer indication while residing in Olmsted County, MN, from 1950
through 1987. Each member of the oophorectomy cohort was matched by age to a referent woman from the same population who had not undergone oophorectomy. In total, we studied 813 women with unilateral oophorectomy, 676 women with bilateral oophorectomy, and 1,472 referent
women. Women were followed through death or end of study using either direct or proxy
interviews.

Results: Women who underwent either unilateral or bilateral oophorectomy before the onset of
menopause had an increased risk of cognitive impairment or dementia compared to referent
women (hazard ratio [HR] 1.46;95%CI 1.13 to 1.90; adjusted for education, type of interview, and history of depression). The risk increased with younger age at oophorectomy (test for linear
trend; adjusted p 0.0001). These associations were similar regardless of the indication for the
oophorectomy, and for women who underwent unilateral or bilateral oophorectomy considered
separately.

Conclusions: Both unilateral and bilateral oophorectomy preceding the onset of menopause are associated with an increased risk of cognitive impairment or dementia. The effect is age-dependent and suggests a critical age window for neuroprotection. Neurology® 2007;69:1074–1083

Fibroids: you never need a hysterectomy for fibroids

hersfdn@earthlink.net (HERS Foundation) — Thu, 02 Aug 2007 02:57:00 +0000

The most common reason hysterectomy is performed is for fibroids. Most fibroids don't cause any symptoms and rarely cause a true medical problem. But if you had symptoms that were more than annoying, if they really impacted your ability to function, there would be no reason to undergo a hysterectomy. If you are told that a hysterectomy is your only choice to treat symptomatic fibroids, find another doctor who has the skill to perform a myomectomy, and who will respect your decision to choose the treatment that you think will be best for you. It's your body, you always have the right to refuse treatment.

Here is basic fibroid information that can help you decide if what you have is a true medical problem or if it's really a nuisance.

Fibroids are benign growths of muscle and connective tissue that grow until you reach menopause. Then they slowly and gradually shrink to a negligible size, at which time they will become small and calcified. Less than 1% of fibroids are cancer, a leiomyosarcoma.

The average size of the uterus including fibroids in the late thirties to early forties is a ten to twelve week pregnancy size (about 13cm in the largest dimension), in the middle forties fourteen to sixteen weeks is average (about 17cm in the largest dimension), and in the late forties to early fifties eighteen to twenty weeks is average (about 21cm in the largest dimension).
Fibroids have two rapid growth spurts that are natural, predictable, and not a cause for alarm. The first rapid growth spurt is in the late thirties to early forties. Then you have a few years of slower growth. Right before you go through menopause, when you have the hormone changes associated with the beginning of menopause, you have the second and last rapid growth spurt. Then the fibroids slowly and gradually shrink to a negligible size.

You develop all of the new fibroids you are going to have in your 30's you do not develop new fibroids in your 40's. Both estrogens and progesterone stimulate fibroid growth. Many women use the so called "natural" progesterone yam cream that promoters claim shrinks fibroids, but in fact it makes them grow.

Fibroids are not a disease, they are your genetic blueprint. If you can live with the symptoms it would probably be better than unnecessary intervention of any kind. If you cannot live with the symptoms a myomectomy, the surgical removal of fibroids leaving the uterus intact, is a reasonable option. Even in the case of leiomyosarcoma, some women choose myomectomy, if the leiomyosarcoma is in the wall of the uterus, and not attached to a ligament.

If a doctor tells you that it can't be done because you have too many fibroids or that your uterus is too large it just means they don't have the skill, and that you need a doctor that does have the skill. Fibroids that cause heavy bleeding with large blood clots are submucosal, they are in the endometrium, the inside layer of the uterus. A submucosal fibroid that is 4cm or cm or smaller can be removed hysteroscopically. A hysteroscope, a long tube, is inserted into the vagina, into the cervix, and into the uterus. A tool is attached to it, and the surgeon chips away at the fibroid until nothing remains but the shell. If the submucosal fibroid is larger than 4cm you would need a myomectomy. A horizontal incision would be made above the pubic bone, and the fibroid would be dissected out of the uterus. Fibroids in other locations do not cause heavy menstrual bleeding or large blood clots.

Although there are many other treatments for fibroids, such as uterine artery embolizaiton (UAE, also called UFE), endometrial ablation, focused ultrasound, myolisis, and Lupron to shrink them, they are all destructive. The only constructive treatment for fibroids is myomectomy, but only if you're in the hands of a skilled gynecologist who has consistently good outcomes. A good outcome from myomectomy means you came out of the operating room with an intact uterus, you were not given a blood transfusion, and you did not have a new medical problem that you did not have before the myomectomy.

Hysterectomy Myths vs Facts

hersfdn@earthlink.net (HERS Foundation) — Thu, 26 Jul 2007 03:11:00 +0000

Female Anatomy Exposed:

If the female sex organs were visible like the male sex organs,
would they still be removed from 622,000 women each year?

Myth: “Only men have gonads.”

FACT: A woman’s gonads are her ovaries. Removal of the ovaries is castration, and the aftereffects are to women what the aftereffects of removal of the testicles are to men.

Myth: “Sex will be better than ever after hysterectomy.”

FACT: Removal of the uterus causes the loss of uterine orgasm, one of the many irreversible consequences of hysterectomy.

Myth: “After the surgery you’ll feel like a million bucks!”

FACT: The most common problems women report after hysterectomy include loss of sexual feeling, loss of vitality, bone/joint/muscle pain, fatigue, and personality change.

Myth: “Doctors don’t perform as many hysterectomies as they used to.”

FACT: Less than 2% of all hysterectomies are life-saving. Most hysterectomies are performed for benign conditions, not medical problems. The rate of cancer in the female sex organs and the male sex organs is almost identical. The rate of male sex organ removal is statistically insignificant, and yet in the last decade an average of 622,000 hysterectomies and 454,000 female castrations were performed each year in the U.S. That’s more than one every minute of every hour of every day. There are 22 million women alive today in America whose sex organs have been removed.

Myth: Doctors don’t have enough time to provide information about female anatomy and the functions of the female organs before they tell women to sign hysterectomy consent forms.

FACT: It takes just a few seconds for doctors to hand women HERS’ 12-minute “Female Anatomy: the Functions of the Female Organs” DVD, available at www.hersfoundation.org/anatomy.

HERS’ 12-minute female anatomy video makes the female organs visible. It fills the information gap and can prevent about 610,000 unnecessary hysterectomies each year and save more than $17B+/year in rising healthcare costs.

Then sign the Petition to compel doctors to provide the information in this video to every woman before she is told to sign a Hysterectomy Consent Form.

What you can do!

hersfdn@earthlink.net (HERS Foundation) — Mon, 23 Jul 2007 05:46:00 +0000

ALERT!

So many have asked, “What can I do to help?”

The answer to this question has never been so simple, and the need for help has never been so urgent.

Visit www.hersfoundation.org today to SIGN THE PETITION mandating that HERS’ DVD “Female Anatomy: The Functions of the Female Organs” be shown to every woman who is told she needs pelvic surgery. Please do it now, and dedicate one full day to make sure everyone you know signs it.

Contact HERS for a sample email to send to everyone on your email list or any email list you can get your hands on. Make follow-up calls to make sure your friends and family sign the petition. Post the petition on listservs, online chat rooms, and blogs. Ask HERS about sponsoring an ad in your local newspaper. Make your voice heard, and help HERS end unconsented hysterectomy for all time!

Send everyone you know to www.hersfoundation.org. Urge them to watch HERS’ DVD “Female Anatomy: the Functions of the Female Organs” and to sign the petition. Do all that you can to make your state the first one to pass laws to compel doctors to provide accurate information that is every woman’s right to know.