Indications for a Hysterectomy

Comments: 1 | August 1st, 2011

Three years ago, I was giving a lecture to a large group of women.  One of the topics which I discussed was about hysterectomies. Out of curiosity I asked the audience through a show of hands to let me know how many had hysterectomies. The response shocked me. More than ½ raised their hands. They were women between 35- 60 years of age and there were more than 100 in attendance.

I decided to investigate the reason why this was the case. We were in a small town in the Midwest and I quickly discovered that there were only two local practicing gynecologists. The indications for a hysterectomy made by the physicians were apparently simple and quite broad:

1.The patient had a uterus
2.The patient was finished having children
3.The patient had complained of irregular or heavy bleeding, fibroids or any other possible problem linked to the uterus

As a patient advocate and practicing physician for more than 20 years, I was mortified.

I stopped my planned lecture and focused on the issue of preventing unnecessary hysterectomies and helped the audience develop the confidence and knowledge to protect themselves from potentially unnecessary hysterectomies.

Since that experience, I no longer take for granted the fact that all doctors are protective of women’s uteruses. I now make sure every woman I speak with knows the true indications for a hysterectomy. Once every woman knows that, she can no longer be pushed into this often unnecessary surgery that robs more than 600,000 women of their uteruses each year in the US.

Here are the indications for hysterectomy:
1.Uncontrollable Bleeding
2.Cancer of the uterus or cervix
3.Severe uncontrollable endometriosis

Anything else, including fibroids, most cases of endometriosis, irregular bleeding, thickening of the uterine lining, hormonal imbalances causing abnormal bleeding, are not absolute indications for a hysterectomy.

Hysterectomies should be a last resort as a treatment option even if the woman is finished having children regardless of age.

Before considering a hysterectomy, natural, bioidentical hormone therapies should be undertaken for at least 6- 12 months and evaluation of the response should be of utmost importance. Thickening of the uterine lining often occurs with the aging process and treatments with only estrogen will increase the thickness of the uterus. That situation is not an indication for a hysterectomy. Adding progesterone and providing better balance of the bioidentical hormone regimen will prove a safer and less damaging treatment in the long run.

You can always have a hysterectomy, but once it’s done you can never get your uterus back. No matter what the surgeon will tell you about how easy and simple the surgery is and how your recovery will be a walk in the park. Keep in mind that the doctor is not undergoing the surgery.

Finally, a year after the initial seminar, I was asked to return to the same venue to give another talk. I was pleased to see that my audience had doubled in attendance. When I asked to see how many women had had hysterectomies by a show of hands, fewer than 10 women raised their hands.

From my perspective, I had accomplished my goal. Women need to protect their health. Do not allow glib, uncaring and hasty decisions made by a physician to remove your uterus cause your health to suffer!