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Hysterectomy’s Best Kept Secret: Figure Changes

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There are many misconceptions about the after effects of hysterectomy. There are a number of reasons for this. First and foremost, gynecologists are not honest with women. They present hysterectomy as merely the end of our ability to have children. A bonus is no more periods. Secondly, their professional society, ACOG, has a lot of influence on government and the media. Therefore, much of the information women find also misrepresents hysterectomy as benign. And last, but not least, most hysterectomized women fail to share the after effects. So it is no wonder secrecy abounds.

Over the years, I have written about many of the deleterious after effects of hysterectomy here, here, and here. Read the comments on any of these articles and see the thousands of women who have suffered. Among the least well recognized of these effects, however, are the figure changes that develop post-hysterectomy; changes that are related to both the anatomical effects of the surgery itself and the hormonal decline that ensues. Figure changes are hysterectomy’s best kept secret.

How Hysterectomy Changes a Woman’s Figure

How does hysterectomy change a woman’s figure? The “bands” (medically known as “ligaments”) that suspend the uterus are also the support structures for our midsection. They keep the spine, hips, and rib cage where they belong. The severing of these ligaments causes our entire torso to collapse. The hips widen, the spine collapses, and the rib cage drops onto the hip bones. This causes a shortened and thickened midsection, protruding belly, and a loss of the curve in our lower backs.

These unnatural changes lead to back and hip problems, loss of mobility, poor circulation in extremities, and chronic pain. Nerve injuries are another source of pain and loss of mobility. “Hysterectomy cripple” is a term from an old gynecology textbook that reverberates in my head. Two of my articles and readers’ comments on this best kept secret can be found here and here. Some women also talk about these changes here.

Other Harms of Hysterectomy

The uterus is essential for a woman’s whole life to keep her healthy. So are the ovaries. And the Fallopian tubes. We were not made to be disassembled. Studies prove it. Yet gynecologists continue to treat the female sex organs as disposable.

Although hysterectomy’s best kept secret is figure changes, there are a number of other harms. Hysterectomy’s effects on the bladder and bowel are explained here. Many women report sexual dysfunction including loss of desire. Feelings of emotional emptiness are common. So is chronic fatigue. Even the ovaries (vital endocrine glands) don’t escape unscathed. Their impaired function causes a whole other set of problems related to the diminished supply of vital hormones. For many, these life altering changes cause break-ups of romantic relationships and families. The effects can also end careers leading to financial hardship and shattered lives. The societal effects are far-reaching.

It is one thing to have cancer and have to live with these trade-offs. But over 90% of these surgeries are unnecessary since less than 8% are done for cancer.

Why Do We Not Know About the Figure Changes?

How can we not know that hysterectomy causes figure changes? Shouldn’t we have noticed this in women who had hysterectomies? Yes and no. Women gain an average of 25 lbs. in the first year after hysterectomy according to the HERS Foundation. That can certainly mask figure changes. Not only that, the torso collapses gradually so is not immediately discernible. And women tend to dress differently in an attempt to hide their altered figures. For women we didn’t know before their hysterectomies, we have no “before” view. Conversely, how much does any woman really critique other women’s bodies anyway? Not so much. Nor can we count on women to divulge these changes just as they fail to share other effects. Proof of this association does not require studies as it is evident from diagrams of the female anatomy. Hence, the reason hysterectomy’s best kept secret is figure changes.

So Much Despair

I had a hysterectomy 13 years ago at age 49. The effects were immediate and severe – physically, mentally, and emotionally. I never could have imagined that a person could age so quickly or feel that their very heart and soul were ripped out! You can read my story here. I quickly realized that my gynecologist of 20 years was dishonest about the consequences. And my medical records show that he also lied about my diagnosis and treatment options.

The changes to my figure amplify the despair that has plagued me since that fateful day. Like the author of the book Misinformed Consent, I cannot bear to look at myself in the mirror. And I shudder to think how much more height I will lose from my already small frame. Even more unsettling is the recent onset of hip and leg pain and midsection discomfort. I fear that reduced blood flow is causing my hip joint to deteriorate (known as “avascular necrosis” or “osteonecrosis”). I know some hysterectomized women who had hip replacements in their 40s or 50s for this reason. Great… more worries about my future health. The thought of any medical treatment, especially surgery, terrifies me!

The Harm of Female Organ Removal

There is long-standing evidence of the harms of female organ removal. Yet, nothing is being done to stop the abuse. It affects almost half of U.S. women. The states’ medical boards don’t care, and neither do legislators. Even women’s health organizations don’t care. Their platform is “reproductive choice.” I guess I was naive to think any of them would care. Then along came the #MeToo movement. I thought this was our opening to make our voices heard. But no. People don’t seem to view this as a form of sexual abuse or harassment. Evidently, perpetrators of surgical crimes against women get a free pass.

The ACOG works hard lobbying Congress and the media to keep it that way. One only need look at the Advocacy menu on their website. Hysterectomy is a big money maker. So maximizing these surgeries and denying the harm is in gynecologists’ best interest. The recent increase in resident minimum requirements from 70 hysterectomies to 85 is evidence of this. There is no training for myomectomy, or removal of fibroids, despite fibroids being a common reason for a hysterectomy. A gynecologist petitioned the ACOG to mandate myomectomy training, to make this uterine-sparing option more accessible. The ACOG rejected his petition. Clearly, the Ob/Gyn specialty puts profits before women’s health.

One has to question why insurance companies continue to authorize and pay for so many unwarranted hysterectomies. What documentation are gynecologists submitting to get these authorizations? My insurance company refused to divulge what my gynecologist submitted to get authorization. I had an ovarian cyst yet my medical records show authorization for a “hysterectomy.” There was absolutely nothing wrong with my uterus or other ovary as proven by pre-op imaging and post-op pathology. He should have removed only the cyst.

Protect Yourself

Don’t allow yourself to be deceived or bullied by a gynecologist. If you do go into an operating room, protect yourself. Modify the consent form to explicitly state what can and cannot be done and removed. Have the surgeon(s) sign off on all revisions.

You certainly don’t want to endure a hysterectomy’s figure changes or any of the other negative effects. The HERS Foundation and Ovaries for Life are good resources for understanding the lifelong importance of the female organs.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, and like it, please help support it. Contribute now.

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This article was published originally on June 13, 2019. 

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Hysterectomy: Bad for the Heart and Much More

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A Mayo Clinic study has shown that hysterectomy without removal of ovaries increases the risk of heart disease. Women who had a hysterectomy before age 35 are at a particularly high risk. Specifically, their risk was 4.6-fold for congestive heart failure and 2.5-fold for coronary artery disease. But this association is not new. This 1981 study showed a 3-fold increased risk of heart disease after a premenopausal hysterectomy. This would include most women who undergo hysterectomy. This 1982 study and this one from 1985 cite the uterine substance prostacyclin as the likely factor in women’s heart health. Since about 45% of women have a hysterectomy, it is no wonder heart disease is the #1 killer of women!

Heart Disease: Just the Tip of the Iceberg

Hysterectomy is bad for much more than the heart.

  • Hormone changes. Hysterectomy impairs the function of the ovaries which are part of the endocrine system. Multiple studies have shown this including this one and this one. This would logically predispose hysterectomized women to the same increased health risks and accelerated aging of ovary removal (castration). According to numerous studies such as this one and this Mayo Clinic one, the risks of ovary removal include heart disease, stroke, metabolic syndrome, osteoporosis, hip fracture, lung cancer, colorectal cancer, dementia, Parkinsonism, impaired cognition and memory, mood disorders, sleep disorders, adverse skin and body composition changes, adverse ocular changes including glaucoma, impaired sexual function, more severe hot flushes, and urogenital atrophy. Wow, what a list for such a common and rarely necessary surgery!
  • Figure changes. The uterus and its ligaments are key to the integrity of the pelvis. The cutting of those ligaments, the pelvis’ support structures, destroys pelvic integrity. As a result, a woman’s figure changes. The hips widen and the torso collapses until the rib cage sits directly on the hip bones. This causes a shortened and thickened midsection, protruding belly, and loss of the curve in the lower back making the derrière appear flat. These changes lead to back, hip, and leg problems, chronic pain, and impaired mobility. These effects are discussed here. Back pain after hysterectomy is one of the (many) “dirty little secrets” of Gynecology.
  • Organ dysfunction. The uterus sits between the bladder and bowel and keeps them where they belong. Hence, these organs drop and are adjacent to each other after hysterectomy. These changes can cause dysfunction as discussed here and here.
  • Sexual dysfunction. The uterus is a sex organ. Many hysterectomized women report a loss of sexual function – libido, arousal, and ability to orgasm – with or without ovary removal. Many also report feeling asexual and emotionally empty. This may explain why a renowned gynecologist referred to the uterus as a woman’s “heart center.” How ironic that the uterus is also essential to heart health!
  • Cancer risks. Last but not least, removal of the uterus increases the risk of some cancers. These include thyroid, renal cell (kidney), bladder, rectal and brain cancers.

The Devastating Toll of Hysterectomy

Women’s experiences are also compelling evidence of the devastating effects of hysterectomy. It can affect every relationship and aspect of life having far-reaching societal repercussions. Here, here and here are some heartbreaking stories of shattered lives. The Bleeding Edge documentary chronicles the stories of a few women who were harmed by Essure (tubal sterilization coils) and subsequently had hysterectomies. The HERS Foundation’s recently launched “In My Own Voice” project includes some women’s stories. Hopefully, more will come forward and share their experiences.

The uterus and ovaries are essential to a woman’s whole life. Female organ removal has been proven over and over again to be incredibly harmful as far back as 1912. Yet 45% of women end up having a hysterectomy. And over half are castrated at the same time which further increases the risk of heart disease. Additionally, more women have ovaries removed during separate surgeries. It is no wonder heart disease is the #1 killer of women.

Female organ removal is the biggest healthcare con as discussed here. Lack of informed consent is standard. And even worse, gynecologists commonly use unethical tactics such as instilling fear of cancer and intentionally misinforming women about the consequences. If women knew the facts, very few would consent to hysterectomy or oophorectomy.

In conclusion, the medical industry can no longer put its head in the sand or deny the horrific harm of these surgeries. Only 10% are done for a cancer diagnosis. Yet, it appears that they are gearing up to do even more. The Graduate Medical Education (GME) hysterectomy minimum was recently increased from 70 to 85. When will the ethical medical professionals or authorities address this intentional harm and sexual assault of almost half of U.S. women?

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, and like it, please help support it. Contribute now.

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Image from PxHere; CCO public domain.

This article was published originally on February 12, 2019.

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Hysterectomy: Greed and Ignorance Reign

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Hysterectomies and C-sections are two of the most overused surgeries. One in three women has a hysterectomy by age 60 and about half eventually have one. Approximately 600,000 women undergo hysterectomy annually, 50,000 to 60,000 of which are for a cancer diagnosis. This graph (figure B) depicts the number done for cancer (which are typically done as inpatient). However, the graph misrepresents total hysterectomies as it depicts only inpatient figures. In 2014, 70% of hysterectomies were done as outpatient – in ambulatory surgery centers or in hospitals with discharge in less than 24 hours. So one could say that ~90% of the ~600,000 are unnecessary. ACOG says that 76% do not meet ACOG criteria.

The Greed Factor

What is driving the high rate of hysterectomies? The more cynical among us would argue that money or greed is a large contributing factor and there are certainly data to back this up. In this article, a gynecologist talks about attending a seminar where gynecologists were coached on how to cultivate patients for hysterectomy to maximize fees. The healthcare dollars wasted on unnecessary medical procedures, especially hysterectomy at $17B, is discussed here. Another factor contributing to this gross overuse is the failure to properly diagnose and inform patients of treatment options and their risks and benefits. This failure may also be due, at least in part, to greed.

Ignorance at Play?

Still yet another variable may be at play: ignorance. For whatever reason, there is a huge disconnect between the perceived benign nature of the procedure and its reality. The research here, here and here are just a few examples of the compelling evidence of the damaging effects. These effects are affirmed by the thousands of comments on the various hysterectomy articles on this blog and others.

A Gynecologist’s Defense of Hysterectomy

A comment by a gynecologist on one of my articles reflects the ignorance and arrogance regarding the many aftereffects of hysterectomy (with or without ovary removal / castration).

Here is the May 3, 2018 comment by gynecologist Yvonne Treece, MD, FACOG:

There is no or minimal evidence to support many of these claims particularly in regards to pelvic ligaments providing support to the entire torso, loss of sensation, loss of sexual pleasure, fatigue, joint and ligament pain. There is some risk of nerve damage, but it is very small and does not result in loss of sensation over the whole vulva and vagina. There is a small risk of damage to bowel or bladder, with the ureters at highest risk. The percentages given in the YouTube video are grossly exaggerated, and most have no proven correlation with hysterectomy. The uterosacral ligaments are preserved in supracervical and most laparoscopic hysterectomies. The vast, vast majority of hysterectomies are uncomplicated. Most of the YouTube video is false. The false and misleading information is a disservice to patients. Where is the evidence for these claims?

I disagree that 70-90% of hysterectomies are unnecessary. Source? As alternative treatments become available, hysterectomy rates are falling. I am an OB/Gyn, and certainly do not do unnecessary hysterectomies, especially not for profit! That is a very hurtful, and malicious thing to say. It is not true of any one I know. Certainly someone may be performing unnecessary surgery for profit, but that is highly unethical, and illegal. Not mainstream.

Please look at an anatomy book (like the slides on the YouTube videos). A lot of your claims are physiologically nonsensical. It makes me sad that people have bad outcomes sometimes, but it saddens and frustrates me when patients are given misinformation attributing physical symptoms to a hysterectomy when they are unrelated.

I would be happy to have a dialogue with you about hysterectomy. I’m sure we could both learn from each other.

Here is my rebuttal comment: 

Yvonne – As a doctor in a specialty (gynecology) whose training and livelihood is entrenched in doing hysterectomies (as well as oophorectomies), it’s natural to deny and defend. I don’t know how much of your misinformation is due to lack of proper medical training (including intentional omission by medical schools) and how much is in defense of your profession and livelihood. But regardless, I will address your points:

1) The severing of the ligaments that run from the uterus to the pelvic wall cause a collapse of the torso. It’s an anatomical fact. To use an analogy – If you cut through bridge supports, the bridge will collapse. A woman can still be “fit” after a hysterectomy but her figure / skeletal structure will be altered. Her midsection will gradually shorten and thicken (even absent weight gain). Women’s comments corroborate this. Further evidence of this can be seen as an indentation at each side of her back (one woman referred to it as a “plane” across her back) where her rib cage is now sitting on her hip bones. Another telltale sign is a crease / line that starts a couple inches above the navel and then gradually lengthens across her midsection as her rib cage drops. I doubt you typically observe patients before their surgeries and a few years after in their underwear to be able to observe these changes. And it seems many women end their relationships with their surgeons. They certainly don’t need birth control or any other reproductive services.

2) Another anatomical fact – The uterus separates and anchors the bladder and bowel. Its removal displaces them increasing risk for dysfunction in the short and long-term including incontinence and prolapse. With so many women having had hysterectomies, it’s no wonder incontinence is so prevalent.

3) Another anatomical fact – A shortened and sutured shut vagina lacks the bundle of nerves at the bottom of the cervix as well as the tip of the cervix that heightens sexual pleasure for both the woman and man.

4) How can you truly believe that severing of nerves and blood vessels, including those running through ligaments that are severed, does not cause loss of sensation and sexual pleasure? It is basic physiology that innervation and blood flow are vital to sensation. Many women even report loss of nipple sensation. And furthermore, uterine orgasms cannot physically happen without a uterus. This is a HUGE loss for many women. And many women who still have ovaries (the lucky ones whose ovaries haven’t “died” due to loss of blood flow and feedback with the uterus) report loss of libido and sexual function. There are PLENTY of women’s stories of shattered lives on the web if you really care to know.

5) Most hysterectomies may be (in your words) uncomplicated (absent the “surgical” errors of ureter, bladder, bowel damage, nerve damage, blood clots, hemorrhage, infection, morcellated / upstaged tumors, anesthesia harms, death). But the after effects are forever (as are the after effects of some complications when they occur). And shockingly, 55% of hysterectomies include removal of ovary(ies) (equivalent of a man’s testicles) despite the average woman’s lifetime risk of ovarian cancer being a measly 1.3%. More ovaries are removed as separate surgeries.

6) According to Obstetrics & Gynecology August 2013, ~50,000 hysterectomies are done for cancer. That is less than 10% of all hysterectomies making over 90% unnecessary. Media reports of declining hysterectomy rates are misleading in that they typically report only inpatient hysterectomies and the large majority are now done outpatient / ambulatory as I’m sure you’re aware. In 2014, 70% of commercially insured hysterectomies were outpatient.

7) I’m concerned that you also fail to inform your patients of the many increased health risks associated with hysterectomy (with ovarian “conservation”) – cardiovascular disease (3-fold), metabolic syndrome, increased Body Mass Index, increased BP, renal cell cancer, colorectal cancer, thyroid cancer. Ovary removal (castration) or post-hysterectomy ovarian failure is also common and is associated with another whole list of health risks such as cardiovascular disease (7-fold), stroke, lung cancer, osteoporosis, hip fracture, dementia, parkinsonism, impaired cognition and memory, mood disorders, adverse ocular and skin changes, sleep disorders, more severe hot flushes. Even unilateral oophorectomy (with or without hysterectomy) is associated with increased risk of cognitive impairment, dementia and parkinsonism.

Needing CME credits? You may have just earned some although you should have already known all of the above since this is your specialty.

Let the women who have had unnecessary hysterectomies (and those who love them) decide who is doing a “disservice to patients.”

Alternatives to hysterectomy are great but some of those also cause permanent harm. Ablation has been shown to increase risk of hysterectomy due to Post Ablation Syndrome. The blood can get trapped in the uterus (behind the scarred lining or due to a stenotic cervix) and/or back up into the tubes causing chronic and debilitating pelvic pain. Although procedures are the money makers, they should only be used as a last resort especially when they can do more harm than good. That applies to any specialty.

You said you “certainly do not do unnecessary hysterectomies, especially not for profit!” You mentioned you’re an ob/gyn so I assume not a gynecologic oncologist. In that case, all hysterectomies you do should be for benign conditions which makes them unnecessary.

If “performing unnecessary surgery for profit” is not “mainstream” then how do you explain the high rate of hysterectomies when less than 10% are done for cancer? And why do residents have to do so many hysterectomies yet ZERO myomectomies when many hysterectomies are done for fibroids? Yes, it’s very unethical but it’s the “standard of care” so it continues.

It’s no surprise that she did not respond to my rebuttal even though she stated “I would be happy to have a dialogue with you about hysterectomy.”

It Comes Down to Money

Gynecologists are supposed to be the experts on female anatomy and physiology. There is an abundance of medical literature on the harms of female organ removal. So how can they not know the consequences of removing the uterus and/or ovaries? As Upton Sinclair said:

“It is difficult to get a man to understand something when his salary depends on his not understanding it.”

You can read all my articles about three of gynecology’s destructive procedures – hysterectomy, oophorectomy, endometrial ablation – here. They include citations to medical literature.

For the truth about female anatomy and the lifelong functions of the female organs, check out this video:

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

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Sexual Function after Hysterectomy

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Whether a hysterectomy will affect sexual function is a common concern amongst women considering the surgery, as well it should be. Sex is a vital part of life and the loss of sexual function can be devastating. Whether and how hysterectomy affects sexual function is not very clear, however, and depends upon a number of variables, not the least of which is sexual function pre-hysterectomy, and particularly, pre-gynecologic problems. In many cases, women have a hysterectomy to rectify conditions associated with heavy bleeding and/or excessive pain like fibroids, endometriosis, adenomyosis and cysts. Reducing pain and bleeding should positively affect sexual frequency; however, effects on function may vary. Hysterectomy can diminish sexual function either directly because of the disconnection of the nerves and blood vessels that supply sexual energy or indirectly via the loss of critical hormones when or if the ovaries are removed or cease to function. And for many women, those with endometriosis, the hysterectomy itself provides only temporary relief from the disease process.

When evaluating the possibility of having a hysterectomy relative to sexual function outcomes, there are a few things women must consider.

Understanding the “Anatomy” of Sexual Function

According to Masters and Johnson, there are four phases of sexual response – Excitement, Plateau, Orgasm, and Resolution.

Sensation to any body part requires proper nerve conduction and adequate blood flow. Many nerves, blood vessels, and ligaments are severed to remove the uterus. The uterus and its ligaments themselves are rich sources of blood supply. As a result, sensation to the vagina, clitoris, labia, and nipples can be diminished by hysterectomy. This loss of sensation can hamper sexual function.

The Excitement phase is triggered by sexual stimuli, either physical or psychological. The stimuli triggers increased blood flow (vasocongestion) to the genitalia. With a blood vessel and nerve network altered by hysterectomy, this process may be hampered.

Contractions of the uterus are listed as a part of the Orgasm phase. So without a uterus, orgasm is not complete. Hence, it would make sense that orgasm is negatively impacted by hysterectomy, ovary removal or not. I have read, however, that some women do not experience uterine orgasm. So for them, a hysterectomy may not affect their orgasms.

My Personal Experience Post Hysterectomy

I realized very quickly after my hysterectomy that my libido, arousal, and ability to orgasm were broken. A steamy sex scene in a novel or movie or a hot looking guy no longer elicited sexual feelings. And the thought of sex was repulsive. That was a very sad day for me and I still mourn the loss of my intact sexuality. Some may question whether these changes are really due to the loss of my uterus or more so from the loss of my ovaries. When my hormone replacement was inadequate, the thought of sex was repulsive. However, I did have occasional orgasms but they were difficult to achieve and very infrequent as well as disappointing compared to before hysterectomy. Before my surgery, I had a good libido and an intense uterine orgasm every time I had intercourse. I have been on a good hormone regimen for over 6 years now. Sex is no longer repulsive but I do not have a libido or feel sexual in any way. Arousal takes much longer and orgasms are still weaker than before hysterectomy, do not always happen, and rarely occur during intercourse. Testosterone did not improve libido or arousal nor improve orgasm frequency or quality. Nipple sensation has been absent since surgery. These losses to my sexuality have affected my marriage relationship as well as social and professional relationships as I lack what I would call “sexual energy” and confidence.  

Other Possible Sexual Sequelae Post Hysterectomy

Removing the Cervix. The changes to the vagina after hysterectomy can further hamper sexual function. The removal of the cervix (the lower part of the uterus) requires that the vagina be shortened and sutured shut. This is called the vaginal cuff. The shortened vagina can present problems with deep penetration. Also, the vaginal cuff sutures can tear (dehiscence) which is a serious medical problem, although this is rare. Retaining the cervix eliminates these concerns and may preserve some of the nerves and sensation. During sex, the tip of the penis is “grabbed” by the cervix enhancing the man’s pleasure. However, even if the cervix is retained, this “grabbing” sensation may not occur without the uterine contractions.

emale sexual function after hysterectomy

Reduced Lubrication. Many women report diminished vaginal lubrication post-hysterectomy even when ovaries are not removed. Lubrication is critical for sexual activity as well as sensation. When the ovaries are removed or fail from the loss of blood flow, lubrication is lost and the vagina atrophies making sex painful. Over time, the vagina may prolapse as it no longer has the uterine ligaments to anchor it. Changes to bladder, bowel, and vagina position and function post-hysterectomy can likewise affect sexual function and satisfaction. A falling vagina and urgency and incontinence are certainly not sexy!

Body Changes. The hysterectomy induced changes to a woman’s figure which include a thick, shortened midsection and protruding belly are another source of sexual dysfunction and anxiety. Appearance changes from hormonal effects such as hair thinning, graying, and texture changes, skin dryness and aging (including loss of plumpness and pinkness in the genitalia), and loss of muscle mass and tone can also negatively impact sexuality. I have written about the anatomical and skeletal effects of hysterectomy here and here.

Emotional Changes. Many hysterectomized women with whom I have communicated report a loss of feeling connected to others including their loved ones. At first I thought the loss of my romantic and maternal feelings was solely attributed to the loss of my ovaries (despite taking estrogen). But after hearing from other women who still had functioning ovaries and reported the same feelings, I realized that maybe our uterus is what makes us loving and social beings. A renowned gynecologist on a talk show a few years after my hysterectomy referred to the uterus as “a woman’s heart center.” And for women love and sex are very much intertwined.

Hysterectomy and Sexual Function

Why is it that so many dismiss sexual problems post-hysterectomy as psychological? If a man has his prostate and/or testicles removed or penis shortened (heaven forbid!), sexual problems are attributed to the loss or surgical alteration of his SEX organ(s). So why would it be any different for women?

Although there have been some studies on sexual function after hysterectomy, I have not been able to make much sense out of them. It seems that most use a benchmark of (impaired) sexual function shortly before hysterectomy when gynecologic problems impede sexual activity and function versus prior to the gynecologic problems that are the reason for the hysterectomy. This observational study compared sexual pleasure, activity, and problems by type of hysterectomy at 6 months post-operative. It concluded that “sexual pleasure significantly improved in all patients, independent of the type of hysterectomy.” However, it also concluded that “the prevalence of one or more bothersome sexual problems six months after vaginal hysterectomy, subtotal abdominal hysterectomy, and total abdominal hysterectomy was 43% (38/89), 41% (31/76), and 39% (57/145), respectively.” With these high rates of “bothersome sexual problems” I cannot imagine how this could have been an improvement. However, if the benchmark was based on the time frame when pre-operative heavy bleeding, discomfort, or pain impaired sexual activity and function, then it would certainly be possible for sexual function to improve post-operatively. That does not mean it was an improvement over NORMAL sexual function (pre-gynecologic problems).

This Boston University School of Medicine article discusses post-hysterectomy sexual dysfunction. It says,

“Desire, arousal, orgasm and pain disorders may all be seen post-hysterectomy…..Internal orgasms are often changed significantly after hysterectomy. This is observed in part due to the inability to have rhythmic contractions of uterine muscles without the uterus present. Also, internal orgasms are changed after hysterectomy due to injury to the nerves which pass near the cervix. Surgeons should try to spare these nerves, but efforts to spare them are limited at the present. The result is that after hysterectomy, many women lose the ability to have an internal orgasm.”

Changing the Mindset: Removing a Woman’s Sex Organs Impairs Sexual Function

First and foremost, we need to stop referring to women’s sex organs as reproductive organs since they have vital, lifelong functions far beyond reproduction. In addition to the sexual functions, these include endocrine/hormonal, bladder and pelvic floor and anatomical and skeletal as detailed in my articles and the HERS Foundation’s video.

Secondly, women need to be more open about the effects hysterectomy has had on their health and quality of life, sexual and otherwise. It seems that some do not connect their problems with the surgery and many others choose not to talk about it. Before surgery, we are likely to believe that hysterectomy is fairly harmless since it is such a common surgery (second to c-section). No surgery is harmless. One that removes a woman’s sexual organs cannot help but cause problems with sexual function.

Some other factors that may be in play are that women seem to value their sex lives less than men. We tend to shortchange ourselves in other areas as well, putting others’ needs ahead of our own. Women of older generations were taught to trust and obey authority figures. So we typically trust our doctors and follow their recommendations. We are particularly vulnerable with gynecologists as we tend to have a long history with them through annual well woman checkups and pregnancies and deliveries. We are easy prey for hysterectomy marketing.

Clearly, there are far too many women being harmed by unwarranted hysterectomies and castrations. According to this 2000 study, 76% of hysterectomies do not meet ACOG criteria. Yet the rates have not declined and the use of robotics seems to be fueling even more hysterectomies with promises of quicker recoveries. Hysterectomies are big business with revenues rolling in to the tune of over $16 billion annually. With so much money at stake, we cannot count on the medical establishment to restrain themselves. It is up to us to spread the word.

Does Hysterectomy Affect Sexual Function?

Yes, it does. How can it not, given the nature of the surgical procedure? Whether the effects are generally more negative or positive is not clear. It largely depends on the reason for the hysterectomy including the severity and prolonged nature of those gynecologic problems. There is very little research and even less consideration or conversation regarding women’s pre- and post- hysterectomy sexual functioning. That is something we can change together by sharing our stories and communicating our needs.

Additional Resources

I highly recommend the non-profit HERS Foundation’s video “Female Anatomy: the Functions of the Female Organs.” It taught me most of what I know about the consequences of hysterectomy and/or ovary removal (castration). When I first discovered the video, some of it did not make sense. But as more time elapsed, the changes became clearer. My body and life have changed in ways I never could have imagined. I only wish I had found the video prior to my unwarranted hysterectomy.

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This article was published originally on April 10, 2014. 

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Tangled Ribbons, Tangled Lives

Awareness ribbons looped on lapels. Around trees. Through chain-link fences. Yellow for missing children and bone cancer. Red for heart

Medical Rape: Coerced Hysterectomy, Oophorectomy, and Lymphadenectomy

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medical rape unneeded hysterectomy

I was one of those lucky women who never suffered any gynecological problems in the 58 years I had my precious female organs fully intact. I trusted the female GP who did my yearly Pap smear (which she insisted I have every year, despite never, ever having abnormal cells). I did not know she was in cahoots with corrupt gynecologists looking for easy prey to perform hysterectomies. She forced me into seeing a gynecologist, writing that I had post-menopausal bleeding. This was a blatant lie, as I NEVER had a single drop of blood since my menopause finished 5 1/2 years before. She would not take “NO” for an answer. She did everything to gain my trust, so I didn’t understand what was going on. She wore me down until I gave in. I went to the gynecologist she referred me to so he could examine me, say I’m fine and send me home. I’d never seen him before in my life.

As soon as I sat down, he opened the referral, and the first words out of his mouth was: “You have bleeding. I’m giving you a curettage.” I was shocked. He didn’t ask me one single question, and he didn’t examine me. I said I had no bleeding and I’m not having a curettage, but he would not take “NO” for an answer. He already had me booked in for the pre-admission and the curettage at a hospital I’d never been to before. I was not told that it is my choice. He manipulated and coerced me until I gave in.

At the post-op appointment two weeks later, he said that I had cancer and had to have a hysterectomy. He’d already sent the referral to a public hospital I had never been to before, and was not told was a teaching hospital. I only went there to be examined, told I’m fine, and sent home. The Clinical Fellow in Gynecology/Oncology called me in after the waiting room was empty. He then mentioned the bleeding. I was so angry, I said:

“Why do you people keep saying I had bleeding, when I hadn’t had a single drop since my menopause finished over five years ago, until I was given the curettage and bled for 3 days.”

He ignored me and told me he was going to take out my cervix, my uterus, my Fallopian tubes, and my ovaries. And he was going to do it by laparoscopy, but still may have to cut me open. Again, I was shocked. I said:

“I have no bleeding, no pain, no symptoms whatsoever, and begged for another option.”

His face was full of anger and contempt as he yelled at me:

“YOU HAVE NO OTHER OPTION. YOU SHOULD CONSIDER YOURSELF LUCKY YOU DON’T HAVE TO HAVE CHEMOTHERAPY. NOT LIKE ALL THOSE WOMEN IN THE WAITING ROOM”, and he flicked his hand toward the empty waiting room and said: “THEY WEREN’T SO LUCKY”.

I was shocked.

He then answered every question I asked with:

“You’ll be fine,” and insisted I go in, in two days.

Next, he shoved a piece of paper in front of me and pointed where to sign. He did not go through one thing written on that consent form. I asked him if he’d done laparoscopy surgery before, and he looked me in the eye and told me he’d done hundreds, that he could do them with his eyes closed. A blatant lie. I did not know that after I left, he added on the form he bullied me into signing that he may take out some pelvic lymph nodes as well. He sprung that on me just before the surgery.

To make a long story short. He mutilated six organs from my body, and God knows how many lymph nodes, as that was covered-up. He botched it beyond repair leaving me wailing in agony every day and bleeding out since he butchered me in June 2005.

The morning after he slaughtered my organs, he smugly told me that I was as clean as a whistle; that all my removed organs had been healthy.

He removed healthy organs.

I was coerced into having an unneeded hysterectomy; a hysterectomy that has left me in agonizing pain ever since. For what? Profit? Medical training? I don’t know, but I am devastated.

When I tried to bring a complaint against him and the hospital, the whole system took his side and did everything to discredit me and spread the word I was paranoid. They denied that I was in any pain, and kept sending me to psychiatrists who just kept pushing drugs on me and telling me they found nothing wrong in the tests when I kept telling them how much pain I’m in.

I’ve never in my life been touched by such evil. I was a victim of fraud and criminal medical malpractice, and my health and my life has been destroyed by those evil doctors. Why aren’t women warned about these corrupt doctors who trick healthy women into unnecessary hysterectomies. This surgical racket has been going on for decades and will never stop because the system is geared to protect doctors, and not patients, from unnecessary harm. As Dr. Phil Hammond said: “The system is still geared to protecting doctors’ reputations rather than protecting patients from unnecessary harm.”

Share your Story

If you have a hysterectomy story, please consider sharing it on Hormones Matter.

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Please! No More Hysterectomy and Castration

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hysterectomy and castration

My experience with hysterectomy and castration (oophorectomy – removal of the ovaries) began in October of 1975, long before information was easily available on the Internet, and in a time when any kind of warning about this surgery was virtually non-existent, and when a doctor’s recommendation was rarely questioned. With that said…

The trauma done to a woman’s life, from hysterectomy and castration, is not something any woman truly wants her friends and acquaintances to know about her. Many women solve this problem by insisting they don’t have any resulting problems. This, in turn, makes those of us who tell the ugly truth appear to be nothing but neurotic kooks.

In all fairness, some of these women may not be intentionally denying the truth.  They may simply be uninformed about the numerous potential consequences of this surgery, even though they might be suffering from many of them. During the first 11 years, this was my experience. In spite of the fact that I was going from doctor to doctor, trying to find out “what’s wrong,” it never occurred to me that all of the seemingly unrelated problems I was living with had been caused by this destructive surgery.

Finally, I started learning the truth: I was stuck with this “disabled” existence for the rest of my life.  At first, I was overwhelmed with anger at the gynecologist who had told me this surgery was absolutely necessary, without telling me I would be left with numerous, unfixable problems. Eventually, I put the anger on a shelf in my mind, and became determined to warn other women and the men who love them.

Hysterectomy and Castration Consequences: Sounding the Alarm

Fairly quickly, I discovered that my truthful warning was almost always met with indifference, disbelief and sometimes ridicule, even with family and friends.  I also learned that this was a common reaction, experienced by many others, who also tried to share truthful warnings. I finally decided that, with rare exceptions, I would share the warning in a written pamphlet, and I would do so anonymously.  Maybe this was cowardly of me, but it was the decision I made, partly because I needed to get on with my life, as best I could. I had a business to run, so I didn’t have the time or energy to “go public” or become a crusader.

And then, there was the medical establishment to contend with. They make billions from this surgery and its aftermath. Consequently, they work very hard to keep the general public uninformed, and they’ve done a very good job of it for decades.  To make matters worse, any woman who seeks help for problems, following hysterectomy and castration, is told that the problems are all in her head, and she should see a psychiatrist. I know this from my own 11-year experience, as well as hearing it from many other victimized women.

If it were men having problems, after their sex organs had been amputated, they would be taken seriously. Unfortunately, the same respect is not extended to women. When it comes to women, in spite of the fact that we have been anatomically altered and psychologically shattered and sexually neutered, doctors tell us the resulting problems are all in our head. Sadly, this same destructive surgery and the same belittling attitude from doctors afterward still happens to hundreds of thousands of women each and every year. When will it end?

Hopefully, the next Generation Can Step Up

Quite often, I remind myself that it took women over 70 years of pleading and reasoning and persecution and suffering jail time before we were finally granted the right to vote. Some fights for justice and equal treatment take a long time.  That’s reality.

Even though this fight must go on, there’s not too much I can do anymore. After 40 years of enduring the damaging consequences of hysterectomy and castration, my physical strength is almost completely gone, to the point that I can barely function. These days, I jokingly describe myself as a physically broken-down old mule with a sparkling personality and a sharp-as-ever mind. It helps if I can laugh about it.

I will never stop caring about the millions of uninformed, unsuspecting women who represent the next potential “crop” of victims, but I don’t have the strength to fight anymore. It’s time for me to leave this struggle in the hands of younger women, and hope they can finally succeed in putting a stop to this legal assault on women.

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The Ethics of Female Castration: Hysterectomy Plus Ovariectomy

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Over half a million hysterectomies are performed each year in the United States. Approximately 60% – 74% of those hysterectomies include removal of the ovaries or ‘castration’. Castration (also referred to as gelding, neutering, fixing, orchiectomy and oophorectomy) is any action, surgical, chemical, or otherwise, by which a male loses the functions of the testicles or a female loses the functions of the ovaries.So there you have it – ugly as it may be. The correct medical term for removal of women’s ovaries is ‘castration’.

Most women do not know that when they agree to removal of their ovaries that they are agreeing to castration. They don’t know because the term castration is never used. They are told they will be undergoing some far-and-away sounding thing called ‘oophorectomy’. Women falsely believe they don’t need their ovaries because their doctors tell them they don’t. Women are purposely led to believe that their ovaries stop producing hormones once they’ve entered menopause anyway. They’re also assured that hormone replacement therapy can replace their own natural hormones. The truth is that there is no artificial hormone of any kind that can replace a woman’s own natural hormones. A woman’s ovaries continue to produce hormones all of her life. There is never a time when a woman doesn’t need her ovaries or the life-sustaining hormones they produce. No woman can give informed consent to ovary removal when she doesn’t understand that she is agreeing to castration. Far too many women are misinformed, uninformed or not informed.

And, it’s not just that women aren’t informed that oophorectomy is castration or that women agree to ovary removal in the first place. I hear from women all the time who tell me that they did not consent to removal of their ovaries, only to wake up from surgery with them missing. It seems doctors routinely take it upon themselves to remove healthy ovaries when they perform hysterectomies for benign diseases. They say it prevents the possibility of ovarian cancer. It should be noted however that the risk of ovarian cancer in women who have no family history of the disease is less than 1%. Meanwhile, removing the ovaries greatly increases the risk of cardiovascular disease (the #1 killer of American women) and accelerates osteoporosis. Removal of ovaries is linked to a variety of diseases and cancers, not to mention mental impairment and sexual dysfunction.

My healthy ovaries were removed without my consent during a routine hysterectomy in 2007 which I’ve previously discussed via my post “Wide Awake: A Hysterectomy Story.” My life has been altered in ways I never knew or understood was even possible. I suppose it’s true that we don’t know what we’ve got until it’s gone. Our ovaries are such a vital part of who we are as women. Yet, it’s not always possible to know this until we are forced to live without them. Ovary removal is not reversible. The devastating consequences last forever. It’s unnecessary trauma at best and forced castration at worst.

Forced castration is considered to be immoral and barbaric according to every country in the world other than Germany and the Czech Republic. More specifically, it’s considered to be immoral and barbaric to surgically castrate convicted sex offenders. Nearly one hundred men have been surgically castrated in the Czech Republic over the past decade. All 94 men had one thing in common: they were sex offenders being punished for heinous crimes. This practice garnered some unwanted attention when the Council of Europe, a leading human rights organization, published a report calling the practice “degrading, invasive, irreversible and mutilating.” Interestingly, the Council of Europe also stated that “even a minor interference with the physical integrity of an individual must be regarded as an interference with the right to respect for private life.”

Indeed, the South Carolina Supreme Court held in State v Brown (1985) that surgical castration is a form of mutilation and therefore considered to be cruel and unusual punishment and illegal under the 8th amendment of the U.S. Constitution. David Fathi, Director of Human Rights Watch’s U.S. program in Washington D.C., contends that surgical castration is “an irreversible punishment and is a fundamental violation of human rights.” Further, he says “Any kind of mutilation is barbaric.” American Bioethicist Arthur Caplan declares “While prisoners are excluded from moral life losing the right to vote, Americans have not reduced them to non-human status.”

If castration of less than a hundred sex offenders is an alarming violation of human rights, what conclusion should we draw from the fact that nearly half a million women are castrated every year in the United States alone. Is it somehow acceptable to reduce women to a non-human status? If it’s considered morally wrong to surgically castrate rapists and child molesters, then why is there no outcry about the castration of millions of innocent women? We simply must begin asking these profoundly important questions.

Quite literally, thousands of women are surgically castrated every single day in hospitals across this country. That works out to be approximately 9 women every 10 minutes. Keep in mind that these women have committed no crime. Innocent and unsuspecting women agree to hysterectomy and wake up castrated. Where exactly is the outrage? What about cruel and unusual punishment being illegal? Does it somehow not apply to women? What about a woman’s right not to be mutilated? Let’s be honest here. If this were happening to men, there would be mutiny in the streets.

It is past time for us to begin talking about the issue of female castration. The ovaries are ‘essential’ parts of a woman’s body. They are part of the fabric of life and so they are integral to the reproductive powers of the body itself. Female castration is simply not ethical in most instances.

I support Hormones MatterTM and their research on hysterectomy. If you have had a hysterectomy, take The Hysterectomy Survey. Your data could save the life of another woman.

My Websites and Social Media

Website: Hysterectomy Consequences

Blog: Hysterectomylies

Twitter: @jiggaz31

Facebook: www.facebook.com/hysterectomyconsequences

A petition to stop unnecessary hysterectomy can be found on the Hormones MatterTM Sign a Petition page: Help Stop Unnecessary Hysterectomy and Castration

Post Script: This article was previously published with the incorrect title: The Ethics of Total Hysterectomy – Female Castration. It is the removal of the ovaries, often with hysterectomy that we contend should be considered female castration. Total hysterectomy does not include the removal of the ovaries. We apologize for the confusion.

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