hysterectomy - Page 5

Endometriosis and Hysterectomy: Reality and Recovery

Published on
6225 views
Angela Kawakami

Since my last post in March 2013, after my second surgery for endometriosis I have been through hell and back. My endometriosis continued to spread and cause pain and my doctors all but ignored my declining health.

December 24th 2013 I wrote my surgeon a letter to express my discontent. I did not feel that I received the care I needed, especially from one of the physicians he had trained. I felt betrayed and was still suffering immensely; I was left to fend for myself. According to them, if I wasn’t willing to take huge doses of endometriosis, nerve or antidepressant meds, then I wasn’t worth their time. I was a lost cause and they effectively ignored me.  I really felt lost in the Endo world once again.

When I wrote the letter to my physician, I was at a low point in my life. I hated my job; the stress was so high that I could barely cope. I was on and off medications prescribed by the pain clinic, in addition to those prescribed by my family physician. The side effects from all of these meds were so bad I could not function at work. I would cry at a drop of a dime. I was sick every day. I had to deal with stressful things that I should not have been put in the position to do. I felt like I was losing my mind.

Unexpected Compassion

I can’t remember the exact date, but sometime late January 2014 I got a phone call that changed my whole life. I wasn’t expecting anything, just to vent my frustrations. The nurse intern to one of my original surgeons called me. She said that she had spoken to the surgeon and was told to call me to say that “there seemed to be some misunderstanding” regarding my care. Umm no; there was no misunderstanding, as far as I could tell. The care was bad and they disregarded my continued pain.

She wanted me to come in for an appointment. I was hesitant. I had seen this physician so many times and left his office crying on many occasions over the last three years that I could not see willingly enduring any more appointments.  How could I withstand yet another appointment where I was pushed to take more drugs that did nothing to alleviate the pain, while making me suicidal and depressed?

I eventually decided to go to the appointment, because in Canada we have no endometriosis specialists. He is the only one.

I had an appointment with this physician the second week of February. I saw my GP a week before. I felt like I was losing my mind. I needed something to help. She suggested Prozac. I was reluctant, but desperate. I could barely get out of bed, I felt disassociated from my body and felt that I just wanted to end everything. I was suicidal and psychotic.

The following week, I saw my surgeon and he did indeed try to push me onto some fancy, new med that was used for fibroids but was started to be used for endometriosis as well. I pretty much tuned him out. None of these meds work and the side effects are often worse than the original disease. I felt that no matter what I said, he would not listen. I started to cry.  It was at this point, his nurse intern, my angel, spoke on my behalf.  I am not sure whether it was her job to advocate, but she did and I am forever grateful.  From our conversations on the phone and prior to this appointment, she knew what I wanted and expected to have happen. She wasn’t going to let me leave that office without having been heard. When I stuttered or began crying, she stepped in and said what I wanted to say. She held my hand, gave me tissue and had the empathy of someone you would expect to have when they too have experienced life with endo. It was a first for me, her compassion. In all of my 24 years of dealing with physicians and endometriosis, she was the first caregiver who expressed compassion.

Related posts:

endometriosisThe Reality of Endometriosis in the ER hysterectomy consequencesThe Long Term Repercussions of an Unneeded Total Hysterectomy
Pages: 1 2 3

You might be interested in

Confessions of a Castrated Woman

Published on
11716 views
onfessions of a castrated woman

I am a castrated woman. Therefore, I am sexually dead! On a scale of one to ten, my sexual desire and response went from a ten plus to zero. Thank goodness, I am a good actress, and to all appearances, I am still a sexually vibrant woman. In private, however, it’s a whole different reality.

I am a castrated woman. Therefore, I am exhausted. Continually exhausted. I have to push myself every minute of every day, and I have to be selective about how I “spend” what little energy I do have. Thank goodness, I am a good actress, and most people would never guess that I am functioning exhausted, every day of my life.

I am a castrated woman. Therefore, I am crazy. Loveable but crazy. Psychologically, I have been shattered into a million pieces, and I spend my life trying to hold myself together, mentally and emotionally. Most of the time, it feels as though I’m not “me” anymore. Thank goodness I am a good actress, and most people would probably describe me as an interesting fireball and a little bit crazy, but charmingly so.

I am a castrated woman. Therefore, I am living with so many additional resulting health issues, the list is way too long to mention each one. Dealing with all these problems has put tremendous strain on my acting ability, but I do the best I can.

As the years have passed, it has been more and more difficult to deal with all of the unfixable consequences that were caused by the destructive surgery of hysterectomy and castration. I have survived for nearly 40 years, through stubbornness and determination, but at some point, my acting ability will be all used up. How I wish I had known that, unless there is invasive cancer or uncontrollable bleeding, this disabling surgery is totally unnecessary.

Every year in this country, approximately half a million unsuspecting women subject themselves to this surgery, because they are not informed about the numerous, life-changing problems they could face afterward.

I have never been courageous enough to “go public” with warnings. I prefer to do so in private ways, such as this anonymous article. If you have never heard this warning before, please trust me. I am telling you the truth.

Maybe, I should have shouted from the rooftops years ago. To any woman I might have warned, who is suffering now, I do apologize. One of the problems, in trying to “sound the alarm” is the fact that there are women who would tell you that what I have said is ridiculous. Maybe these women are the lucky ones, who have experienced only a few adverse after effects, and have no idea what it’s like for those of us who have had to deal with numerous, life-long problems we never could have imagined.

To those women who may have sailed through hysterectomy and castration with very few problems afterward, I am delighted for your good fortune. However, please be sensitive to the fact that many of us have been left with a half-alive, nightmare existence that never ends. When we try to warn other women, it’s because we care about them. How I wish somebody would have warned me, nearly 40 years ago.

If you are considering hysterectomy and/or castration, you may have to decide whom to trust: the woman who cares enough to warn you or the one who says I am ridiculous.

Author Anonymous

Related posts:

hysterectomy consequencesThe Long Term Repercussions of an Unneeded Total Hysterectomy hysterectomy secret - figure changesHysterectomy’s Best Kept Secret: Figure Changes

You might be interested in

Morcellation: Could There Be a More Foolhardy Technique?

Published on
3792 views
morcellation and hysterectomy

Uterine morcellation, the surgical technique that involves using a morcellator device to mechanically chew up larger pieces of uterine tissue, tumors and fibroids into much smaller, more easily removable pieces of tissue, has been a mainstay of laparoscopic gynecological surgeries, especially hysterectomy, since the mid nineties. It was only recently, when a high profile physician was herself injured by morcellation, did the dangers of morcellation come to the attention of the media and the broader medical community. One has to wonder, who the heck thought grinding up potentially diseased tissue and spreading those diseased cells, however inadvertently, within peritoneal cavity was a good idea in the first place?  Really, how in the world did these devices get approved and so readily adopted into medical practice?

FDA Clearance of Morcellators: No Safety Data

The first electromechanical tissue morcellators were cleared for sale in 1995 FDA’s 510k process. The 510k process is used for devices that are considered substantially equivalent to medical devices or tests already on the market. The 510k clearance is not approval per se, but a quick step around the approval process. It allows the manufacturer to go straight to market with the product, after a 90 day waiting period. No clinical trials are required, no safety data are required. According to the Project on Government Oversight blog:

“…the 510(k) process doesn’t evaluate anything about a device except whether it is substantially equivalent to previous devices. Thus it can’t really ensure the safety and effectiveness of these devices.”

Morcellators were cleared for sale via this process of suggesting that they were no more dangerous than the laparoscope itself. Since 1995 the FDA has cleared about two dozen electro-mechanical morcellators, all via the 510k process. In essence, these devices came to market without safety data. Indeed, there were no published studies evaluating the safety or efficacy of these devices for almost the first 10 years of their use, although case studies began emerging in 2002. How was that possible?

Adoption of Morcellation in Gynecological Surgery: The Business Case

Over half a million women in the US have hysterectomies annually. In fact, every 10 minutes, 12 American women lose their reproductive organs, every day of every year. Worldwide, the numbers are equally staggering. By the age of 60, one third of all women will have had a hysterectomy. Between 70-90% of hysterectomies are deemed medically unnecessary. Worse yet, an estimated 73% of hysterectomies include the removal of the ovaries, a procedure akin to male castration with all of the concomitant side-effects one might expect when critical, hormone-producing, organs are removed. Unnecessary hysterectomies are big business for hospitals and surgeons. It is within this landscape that morcellators found their market.

Morcellation is a no-brainer within the ever-expanding business landscape of hysterectomy. Considering up to 90% of hysterectomies are medically unnecessary in the first place, it is not difficult to see how decisions about surgical techniques and instruments might be more skewed toward efficiency than safety. And of course, from a purely mechanical perspective, grinding large matter into smaller pieces makes quick work of tissue removal from the ever decreasing size of excisions. Morcellation with laparoscopic or robotic hysterectomy is more efficient. No doubt, that is how these devices were marketed.

From a biological perspective however, morcellation makes absolutely no sense whatsoever. How did so many physicians, so easily disregard core concepts of human biology – that spreading cells means spreading disease – in favor of the latest gadgetry?  The potential risks of mechanical tissue morcellation could not be clearer. According to one of the first studies (2012) to address uterine morecellation:

“In order to remove these bulky lesions from the abdominal cavity through laparoscopic ports the tumors must be morcellated. This technique involves fragmenting the lesion such that it can pass through a small incision (i.e. the laparoscope port itself). Originally performed by hand with the assistance of a laparoscopic scalpel, newer methods involve the use of power morcellators, devices designed to draw the lesions into a whirling blade, which then generates small (approximately 1 cm diameter) cores of the lesion, capable of being removed through the port incision. The velocity with which these blades spin has been associated with dispersal of microscopic tumor fragments, thus potentially seeding the peritoneum with small pieces of both neoplastic and non-neoplastic material. This phenomenon is compounded with the fact that some morcellated tumors are not benign.”  

Indeed, the research shows the risk of metastatic cancer post morcellation is up to 9 times higher than when non-mechanical surgical techniques are used. Case reports show the possibility of spreading endometrial implants and parasitic myomas post morecellation.

Rate of Morcellation and Risks

Data are scant on the percentage of hysterectomies using morcellation and even more sparse on the adverse events associated with these devices. Some estimates suggest 11% of ~600,000 hysterectomies annually use morecellators – about 66,000 women per year. The risk of morcellation of an occult tumor is believed to between one in 400 and one in 1000 women. The risk for dispersal non-cancerous, but diseased tissue such as endometriosis or parasitic myomas is unknown. However, with such spotty reporting on these devices and this technique, it is difficult to calculate the real risk or even the real use patterns. The number of women potentially harmed by morcellation could be much larger.

The Morcellation Debacle

In essence, mechanical morcellation seeds cells in the abdominal cavity. If those cells are diseased or cancerous, the results can be deadly. And yet, this device was cleared by the FDA and adopted by surgeons with nary a question of its obvious risks – risks that could be presupposed based upon basic principles of biology. Of course, mechanical, high speed tissue morcellation would spread microscope cells. Of course it would. How could this not be recognized up front? How did it take until 2014, 19 years on the market, before the medical societies and the FDA recognized the dangers? More so, even though there were case reports beginning in 2002, evidence that the manufacturer was warned of its dangers in 2006, a large study in 2012, it wasn’t until a prominent physician was injured herself, and her husband, also a prominent physician, exposed the dangers publicly that the respective medical societies and the FDA recognized these dangers and felt compelled to issue statements of risk. To say this is an egregious lack of oversight does not begin to capture the across-the-board levels of ignorance and incompetence associated with the adoption of this procedure.

Sign a Petition to Stop Morcellation

Hormones MatterTM is conducting research about hysterectomy. If you have had hysterectomy, please take a few minutes to complete this important survey. Then share the survey link with all of your friends. These data could save the life of another women. The Hysterectomy Survey.

To learn more about our research, click Take a Health Survey and sign up for our newsletter for updates on the latest research and new surveys.

Related posts:

bleeding disordersBleeding Disorders Overlooked in Women With Heavy Periods

You might be interested in

Hysterectomy: Impact on Pelvic Floor and Organ Function

Published on
60541 views
Pelvic floor anatomy

My life and health were turned upside down after my unwarranted hysterectomy. I touched on the internal and external anatomy changes in a previous article. I am going to go into more detail here on the effects of hysterectomy on the internal anatomy.

Female Anatomy

The uterus sits in the center of the pelvis held in place by four sets of ligaments. The uterus separates the bladder and the bowel and holds those organs in their rightful positions. Once the ligaments are severed and the uterus removed, the bladder and bowel drop down and, without the uterus to separate them, are now adjacent to each other. The nerves and blood vessels that are severed during hysterectomy may also alter the functions of pelvic organs. This female anatomy video explains the anatomical (and other) effects of hysterectomy.

What Every Woman Wants to Know about Hysterectomy

Pelvic Floor Disorders after Hysterectomy

What do medical studies say about the effects of these anatomical changes on the pelvic floor and organ function?

This 2014 U.S. study concluded that hysterectomy is one risk factor for developing pelvic floor disorders. The others are higher Body Mass Index (BMI) and greater parity. There are a number of studies that came to this same conclusion.

This large 31 year Swedish study concluded that hysterectomy, particularly vaginal hysterectomy, even in women with no vaginal births is associated with pelvic organ prolapse surgery. The number of vaginal births further increases this risk.

According to this large Swedish study, vaginal hysterectomy had a higher risk of surgery for pelvic organ prolapse or stress urinary incontinence than other modes of hysterectomy.

Of course, women who undergo pelvic organ prolapse surgery represent only a subset of those who suffer symptoms of bladder and/or bowel dysfunction.

Bladder Function after Hysterectomy

A number of studies have shown no short-term urinary adverse effects of hysterectomy. However, longer-term follow-up shows an increased risk. This large Swedish study over a 31 year period (1973 to 2003) showed a 2.4-fold risk of urinary stress incontinence surgery in women who had hysterectomies for benign conditions. This Danish study of women aged 40 to 60 years also showed a 2.4-fold risk of stress incontinence in women who had a hysterectomy. A small China study showed a 7.6% rate of pelvic organ prolapse and 67.4% rate of urinary incontinence 6 years post total hysterectomy.

A systematic review of 12 MEDLINE articles that used original data published over a 32 year period (January 1966 to December 1997) “was consistent with increased odds for incontinence in women with hysterectomy….Among women who were 60 years or older, summary odds ratio for urinary incontinence was increased by 60% but odds were not increased for women younger than 60 years.” Another review of this same data consistently found an increased risk of incontinence many years after hysterectomy.  However, this study also concluded that “Oral estrogen replacement therapy seems to have little short-term clinical benefit in regard to incontinence and is associated consistently with increased risk of incontinence in women aged 60 years and older in epidemiologic studies.”

The latter statement begs the question “Is the association of oral estrogen and incontinence solely from the oral estrogen or could it be that it’s caused by hysterectomy that prompted the use of estrogen?”

Hysterectomized women of ALL ages were at increased odds for urge (1.9) and bothersome urge (2.6) urinary incontinence (but not stress incontinence) according to this Netherlands study of 1,626 women. This French study of 1,700 women also concluded that hysterectomy increases risk of urge, as well as stress, incontinence regardless of age.

In contrast, this analysis of studies done on urodynamics before and after hysterectomy concluded that “Hysterectomy for benign gynecological conditions does not adversely impact urodynamic outcomes nor does it increase the risk of adverse urinary symptoms and may even improve some urinary function.”

This small study compared incontinence / continence at 1 to 3 years post-hysterectomy and again at 4 to 6 years post-op.  Interestingly, some women went from being continent to incontinent while others went from being incontinent to continent.

Why the conflicting results? There are a few things that come into play, the more obvious ones being study design and size as well as the follow-up period. Mostly, the results depend on the reason for the hysterectomy and whether a bladder suspension was done at the same time. Two common reasons for hysterectomy are fibroids and uterine prolapse. Both conditions can cause urinary symptoms such as frequent urination and incontinence. So symptoms may improve after hysterectomy and if the bladder was suspended at the time of hysterectomy (in the case of prolapse), that would also explain improvement.

Bowel Function after Hysterectomy

Some studies show that hysterectomy negatively affects bowel function. While this small and short-term 2004 study (comparing pre-operative to 6 and 12 months post-operative) concluded that vaginal hysterectomy does not increase incontinence or constipation, abdominal hysterectomy may increase risk “for developing mild to moderate anal incontinence postoperatively and this risk is increased by simultaneous bilateral salpingo-oopherectomy.” In contrast, this small 2007 study found that vaginal hysterectomy significantly increased anal incontinence at the three-year point and at one and three years for abdominal hysterectomy. However, there was “no significant rise in constipation symptoms or rectal emptying difficulties in either cohort through the follow-up.”

This contradicts this small case control study that showed significant short-term decreased bowel frequency and increased urinary frequency after hysterectomy. It also contradicts this larger Netherlands retrospective study in which 31% of women reported severe bowel function deterioration and 11% reported moderate bowel changes after hysterectomy. In the control group which consisted of women who underwent laparoscopic cholecystectomy, 9% reported “disturbed bowel function.”

Constipation, straining, lumpier stools, bloating, and feelings of incomplete evacuation were reported by women who had undergone hysterectomy in this small study.

Abdominal hysterectomy is associated with a significant risk of fecal incontinence and rectoanal intussusception according to this small retrospective study.

Post Hysterectomy Fistula

Hysterectomy increases risk of fistula as documented in the below excerpt from this article:

The uterus precludes fistula formation from the sigmoid colon to the urinary bladder.

As well as this excerpt from this article:

The most common types of fistula are colovesical and colovaginal, against which the uterus can act as an important protective factor.

Diverticulitis is a known risk factor for fistula formation. This large study looked at the risk of fistula formation in hysterectomized women with and without diverticulitis using data from women hysterectomized between 1973 and 2003. Women who had a hysterectomy but no diverticulitis had a 4-fold risk of fistula surgery compared to women who did not have a hysterectomy or diverticulitis. Women who had a hysterectomy and diverticulitis had a 25-fold risk of fistula surgery whereas non-hysterectomized women with diverticulitis had a 7-fold risk.

Vaginal Vault Prolapse

The International Continence Society defines vaginal vault prolapse as “descent of the vaginal cuff below a point that is 2 cm less than the total vaginal length above the plane of the hymen.” This Obstetrics and Gynecology International article states that “it is a common complication of vaginal hysterectomy with negative impact on women’s quality of life due to associated urinary, anorectal and sexual dysfunction.”  The article cited above explains the mechanism for this common complication in section 2 titled “Anatomic Background.”

Table 3 in section 12 compares vaginal and abdominal corrective surgery outcomes using a 5 year follow-up.  Vaginal had significantly higher post-operative incontinence and recurrence rates. The re-operation rate due to recurrence was 33% in the vaginal group versus 16% in the abdominal group.

Surgical mesh is used for many pelvic organ prolapse surgeries. And as shown by the TV ads, surgical mesh has high complication rates. It can cause infection and the mesh can protrude into the vagina leaving sharp edges having obvious negative effects on male partners. And removal of all traces of mesh may be impossible because tissue grows around the mesh.

Women who have not had a hysterectomy and have pelvic organ prolapse may choose to use a pessary instead of undergoing surgery to suspend the uterus (and bladder) or undergo hysterectomy. But a pessary may be difficult to hold in place in women who have had a hysterectomy since the walls of the vagina are no longer supported by the uterus and cervix.

Hysterectomy Consequences

Hysterectomy can have serious consequences on bladder and bowel function and increase risk for future surgeries, but the research is mixed, primarily due to differences in methodology.  Pelvic organ prolapse is also a possibility. Important variables that increase or decrease the risk for future problems include the reason for the hysterectomy and pre-operative bladder and bowel function. If endometriosis, fibroid or other conditions compromise or affect bladder and bowel function pre-surgery, then odds are they will be affected post-surgery and whether there is improvement or further damage depends upon a number of factors, including the surgeon’s skill. In contrast, and I think where most women are interested, is whether these problems can arise post-hysterectomy when no such problems existed pre-surgery. The answer is yes, there is an increased risk for both urinary and bowel incontinence post hysterectomy.

Additional Resources

This RadioGraphics article details the pelvic organ sequelae that can be caused by obstetric and gynecologic surgeries and the imaging techniques for diagnosing them.

This Medscape article details the Long-term Effects of Hysterectomy.

 

 

Related posts:

hysterectomy heart diseaseHysterectomy: Bad for the Heart and Much More

You might be interested in

What if Endometriosis Was a Men’s Health Issue?

Published on
4390 views
Jordan Davidson

As a health journalist and a co-founder of Endo Warriors, a support organization for women with endometriosis, I often get asked “what is endometriosis?”

Which is funny since it is estimated that 176 million women worldwide have endometriosis and yet no one knows about this global health issue.

Sometimes I say “it’s a secondary autoimmune disease where the lining of the uterus is found outside of the uterus and throughout the abdominal cavity — to varying degrees — causing chronic pain and infertility.

And other times I say “it sucks.”

Nancy Peterson of the ERC said “If 7 million men suffered unbearable pain with sex and exercise and were offered pregnancy, castration or hormones as treatment, Endo would be a national emergency to which we would transfer the defense budget to find a cure.” And, I don’t disagree.

If 7 million American men had unbearable pain every time they ejaculated, no one would ever suggest chopping off their balls. If they went to a health clinic that also offered pregnancy prevention services, we wouldn’t shut those clinics down. If 7 million American men were in pain every time they masturbated, urinated or tried to have sex we wouldn’t tell them “it’s all in their head” or “to take the pain like a man.”  No, we would listen and try to find them a cure that didn’t include castration or drug-induced de-masculinization.

But that’s not the case.

Instead we have 7 million American women with chronic pain related to the tissue in their uterus and their menstrual cycle. 7 million American women who have pain before, during and after their menstrual cycle. 7 million American women who experience pain while exercising, having sex and going to the bathroom. So we offer them chemical-menopause and hysterectomies and when those don’t work we throw our hands up in the air and say “well, at least I tried.” Better luck in your next life, perhaps you’ll come back as a man.

The menstrual cycle is the butt of all jokes directed towards women. Bad day? Is it your period? Is Auntie Flo in town?

Seeing red? Are you on the rag?

No, actually I’m just mad that the idea of healthcare for women makes people want to cover their ears and run screaming.

Free birth control for women?

Great idea!

That is until some political pundit insinuates women should just learn to shut their legs.

Maybe instead we should learn to listen to the myriad of women on birth control for issues beyond planning pregnancies. Maybe women should just get easy access to low cost birth-control without having to recite their medical record.

October is health literacy month and when it comes to health literacy, Americans are kindergartners trying to eat the paste off their fingers.

We think Obamacare and the Affordable Care Act are two different things; getting outraged at the notion of Obamacare yet think the idea of ‘affordable’ healthcare is quite nice.

Access to low-cost health care for everyone? Let’s shutdown the government!

Rather, if we want the government out of our private healthcare, then how about they get out of our uteri as well?

Related posts:

birth control side effectsHormonal Birth Control Solves Everything Right? Wrong. endometriosisThe Reality of Endometriosis in the ER Endometriosis, Lupron, Fluoroquinolones and DysautonomiaEndometriosis, Lupron, and Fluoroquinolones: A Recipe for Autonomic Disintegration thoracic endometriosisThoracic Endometriosis

You might be interested in

Birth Control vs Hysterectomy in Catholic Hospitals

Published on
6670 views

I was raised Catholic but did not agree with some of Church doctrine and left the Church as a young adult. In my wildest dreams, I never imagined that I would have a hysterectomy and be castrated in a Catholic hospital (or any hospital for that matter) for a benign ovarian cyst. You can read about my Unnecessary Hysterectomy here. I suspect many other women have had healthy organs removed at this greater metropolitan Catholic hospital or some other Catholic hospital. With hysterectomy the second most common surgical procedure and the prevalence of Catholic hospitals growing, millions of women likely have had unnecessary hysterectomies at Catholic hospitals. This made me wonder, why would the Catholic Church condone (and profit from) unnecessary hysterectomies but prohibit contraception. It seems a bit hypocritical at least, unethical at worst.

A Spider Web of Contradictions in Catholic Hospitals

Catholic doctrine prohibits contraceptives. Yet, Catholic hospitals perform hysterectomies and ovary removals (castrations) for benign conditions that can typically be treated with less drastic measures such as contraceptives. Hysterectomy is permanent birth control. So is removal of ovaries. How is hysterectomy justified but not contraceptives?

In an article entitled Do Religious Restrictions Force Doctors to Commit Malpractice, the hazards of treatment at religious hospitals are discussed. In the case of a potentially fatal ectopic pregnancy, removal of the fallopian tube which negatively affects fertility complies with Catholic doctrine while an injection of methotrexate that preserves the tube and fertility does not.

According to Catholic moralists, an injection that destroys an ectopic embryo is a direct abortion, while removing the part of a woman’s reproductive system containing the embryo is not.

But the end result is the same – a pregnancy is terminated. So why not at least preserve the woman’s fertility and health-promoting hormone production by administering the drug versus removing her fallopian tube?!

Another story in the cited article involved a woman with Lupus who was pregnant with a nonviable anencephalic fetus. Although continuing the pregnancy risked the woman’s health and her very life, pregnancy termination was denied.

The above situations would be considered medical malpractice since they caused harm to the patients. And what makes even less sense is that neither of these were viable pregnancies. Catholic Church dogma caused (intentional) harm to these women.

Another treatment done in Catholic hospitals that has me scratching my head is endometrial ablation. Although it reduces fertility, pregnancy can still occur but can be dangerous to mother and unborn child. So some form of birth control is recommended after ablation if tubal ligation was not also performed. Yet according to Is the Novasure System Ethical?, Novasure ablation has been given a passing grade by the Catholic Church. With the Church’s mandate against contraceptives, I wonder how many women are prescribed contraceptives to treat their heavy bleeding BEFORE this procedure is offered. However, in defense of the article, it does state that drug therapy is typically the first-line treatment after doing a full work-up to determine the cause of the bleeding. And if that fails then D&C should be the next step which should include polyp removal if polyps are found. However, it does not mention removal of fibroids despite being a common cause of abnormal bleeding. Although the article recommends starting with conservative treatments, the high rate of unwarranted hysterectomies and ablations indicate poor compliance with these standards.

According to a study published in 2008, the long-term problems caused by ablation too often lead to hysterectomy, the rate being highest (40%) for women having the procedure before age 41. This is further discussed in Endometrial Ablation – Hysterectomy Alternative or Trap?. However, again, in defense of the above cited Novasure article, it was published in 2005, three years prior to this study on the long-term effects of ablation. And, in addition to surgical risks, the article does mention the long-term risks of accumulation of blood in the uterus and the risk of impeding diagnosis of endometrial hyperplasia or cancer. Despite this 2008 study showing the long-term harm of ablation, the use of this procedure does not appear to be declining.

According to Catholic Doors,

To obtain a hysterectomy is a mortal sin.

The ruling by the Congregation for the Doctrine of the Faith stipulates that the only time a woman is morally permitted to have a hysterectomy is when the uterus is so damaged it presents an immediate threat to her health or life. [National Catholic Reported; August 12, 1994]

In general, an hysterectomy is morally justified if the removal of the uterus is necessary for grave medical reasons. It is not justified when the purpose is direct sterilization.

Therapeutic means which induce infertility are allowed (e.g., hysterectomy), if they are not specifically intended to cause infertility (e.g., the uterus is cancerous, so the preservation of life is intended). [Humanae Vitae]

Unnecessary Hysterectomy, Ethical Principles and the Hippocratic Oath

Birth control issues aside, how do all these overused gynecological procedures comply with the three ethical principles of the Catholic Church – respect for persons, beneficence, and nonmaleficence? For that matter, how do they comply with the Hippocratic Oath to “first, do no harm?” Since they cause harm, they violate the three ethical principles of the Catholic Church as well as the Hippocratic Oath. One must question if women are getting INFORMED CONSENT in any facility, religious or secular, but that is a topic for another day.

Ascension Health defines beneficence as follows:

As a middle principle, the principle of beneficence (and nonmaleficence) is the basis for certain specific moral norms (which vary depending on how one defines “goodness”). Some of the specific norms that arise from the principle of beneficence in the Catholic tradition are: 1) never deliberately kill innocent human life (which, in the medical context, must be distinguished from foregoing disproportionate means); 2) never deliberately (directly intend) harm; 3) seek the patient’s good; 4) act out of charity and justice; 5) respect the patient’s religious beliefs and value system in accord with the principle of religious freedom; 6) always seek the higher good; that is, never neglect one good except to pursue a proportionately greater or more important good; 7) never knowingly commit or approve an objectively evil action; 8) do not treat others paternalistically but help them to pursue their goals; 9) use wisdom and prudence in all things; that is, appreciate the complexity of life and make sound judgments for the good of oneself, others, and the common good.

Why is Hysterectomy So Pervasive at Catholic Hospitals?

For Catholic hospitals with accredited Graduate Medical Education (GME) programs, resident minimum surgical requirements may very well increase the rate of unwarranted hysterectomies. But that is certainly a poor excuse for removing an organ. Even so, if they can get around the GME abortion requirements for religious reasons (Catholic hospitals will not perform abortions) they should be able to do the same for hysterectomies, 98% of which do not meet the “grave medical reasons” test.

Hysterectomies and ablations (that too often lead to hysterectomy) are big business. Hysterectomies are estimated at generating $5-16 billion annually, and so revenues may be another reason Catholic hospitals prefer gynecological procedures over medical (pharmaceutical) intervention (birth control or other). Refusing to prescribe contraceptives may increase their ablation and hysterectomy business and therefore their bottom line. So the 76% of hysterectomies that don’t meet ACOG criteria may be even higher in Catholic hospitals. And the ongoing negative health effects of these procedures further contribute to the bottom line of these “health care” conglomerates.

Could profits trump Catholic doctrine on contraceptives and Catholic ethical principles when it comes to performing destructive gynecological procedures in Catholic hospitals?   

My experience certainly proves this as all my sex organs were removed for a benign ovarian cyst, certainly not a “grave medical reason.” I can say the same for many other women with whom I’ve connected since my unwarranted hysterectomy and castration. And the overuse of ablation appears to be just as rampant. This procedure is being done on women in their 20’s and 30’s, many of whom are now considering hysterectomy or have had one to get relief from the post-ablation pelvic pain.

Just as a man’s sex organs have lifelong (non-reproductive) functions, so do a woman’s. Any procedure that disrupts their normal functioning can cause permanent adverse effects. At least medications can be stopped if the side effects outweigh the benefits.

For more information on the necessity of the uterus beyond the childbearing years, watch this video.

 

Participate in Research

Hormones MatterTM is conducting research on the reasons for and outcomes of hysterectomy. If you have had a hysterectomy, please take this important, anonymous survey. The Hysterectomy Survey.

To take one of our other Real Women. Real Data.TM surveys, click here.

To sign up for our newsletter and receive weekly updates on the latest research news, click here.

Related posts:

No related posts.

You might be interested in

Endometriosis After Hysterectomy

Published on
11691 views

My name is Rosemary and I have been dealing with endometriosis for the past 21 years.

I had my first laparoscopy in 1992 due to sudden onset of pain from a ruptured ovarian cyst. They found endometriois on the right side. Over the years, the endometriosis spread to the left side, bladder and intestines.

I had a total abdominal hysterectomy in 1995, when I was only 28 years old and only two months after having my youngest daughter. My daughters are miracles and I am extremely lucky to have them despite these issues. I was convinced to have the hysterectomy after the 6th laparoscopy for endometriosis. This was after the right ovary, tube and appendix were already removed and I had tried many techniques for pain management including acupuncture, acupressure, hormones, Lupron, Depo Provera, meditation and many strong medications. I would try anything, I told one doctor that I would sacrifice a chicken in the corner if that would help. Unfortunately the pain was relentless. It was and is a constant, stabbing, twisting pain.

During the hysterectomy they found Stage 4 endometriosis all throughout the abdominal cavity. Unfortunately the doctor didn’t remove the endo during the surgery. They just removed the left side ovary and tube, uterus and cervix. The day after the surgery I was given Premarin. The pain returned with a vengeance within 6 months. This is when the real “fun” started. I had to find a doctor that understood endo after hysterectomy. I have had 14 more surgeries since the hysterectomy. In each one and over ten years after the hysterectomy they found live endometriosis. The hysterectomy did not resolve my endometriosis. The endometriosis was deep in the peritoneum, along the bladder, on the intestines and it kept returning. After each surgery I would get about 12-18 months of relief.

I worked with many different doctors from OB/GYN’s to renowned reproductive endocrinologists and general surgeons who specialize in adhesions. During each surgery they found many thick adhesions gluing my insides together. I had my last surgery in Atlanta last year at the Center for Endometriosis Care and they were fantastic. I had relief for about 13 months. Unfortunately the pain has returned.

I have returned to pain management doctors. This is such a frustrating disease. I have had many doctors tell me I was “just stressed,”  or that because I am a single Mom with two daughters, I’m just depressed and the pain is in my head. I have also had amazing doctors who have listened and explained the disease and how they can help. I have had countless tests that show nothing and yet every laparoscopy has shown either severe adhesions or residual endometriosis or issues that need to be corrected.

The best advice I can give is trust yourself! You know your body better than anyone and if you aren’t getting a doctor to listen, find another one! Be your own advocate and educate yourself on this condition. There has been tremendous progress made in the last 10-15 years. I am sure they don’t give Premarin right after hysterectomy anymore and I would hope they are removing the endometriosis during the surgery and not leaving it to grow as they did with me.

There are a whole list of issues with not being able to take hormones. I have tried many substitutes including soy and phytoestrogens and some combinations work better than others. There are some very good holistic treatments and everyone has a different experience.

I hope this has provided some insight. I am not a medical person, I am actually a finance executive and through research and articles from great sources I have learned a lot about endometriosis. There needs to be more awareness and discussion on this, as there are way too many women suffering. Good luck and God Bless!!!

Participate in Research

Hormones MatterTM is conducting research on the side effects and adverse events associated with Lupron. If you have taken Lupron, please take this important survey. The Lupron Side Effects Survey.

To take one of our other Real Women. Real Data.TM surveys, click here.

To sign up for our newsletter and receive weekly updates on the latest research news, click here.

Related posts:

lupron osteoporosisLupron Induced Osteoporosis? Endometriosis, Lupron, Fluoroquinolones and DysautonomiaEndometriosis, Lupron, and Fluoroquinolones: A Recipe for Autonomic Disintegration hysterectomy consequencesThe Long Term Repercussions of an Unneeded Total Hysterectomy birth control side effectsHormonal Birth Control Solves Everything Right? Wrong.

You might be interested in

Why Hormones Matter

Published on
4428 views

I’ve been writing for Hormones Matter for several months now and I’ve been thinking a lot about just how much hormones really do matter. After all, we’re all only alive because of hormones when you get right down to it. Yet, most of us give very little thought to our hormones or why they matter until we’re forced to do so for some reason.

As young adolescents, we’re taught mostly in health class that hormones prompt our bodies to develop into those of men and women. We recognize that underarm and pubic hair growth is an indication that all is going well. Boys voices deepen and girls develop breasts. New sexual feelings slowly emerge and the world takes on new meaning and all things become more colorful. We become alive as it were and suddenly have another purpose – that of connecting sexually and of reproducing at some point. There’s a good amount of information about how hormones influence sex and reproduction. Sadly, the information seems to mostly end there. It wasn’t until my hormone-producing organs were removed through an unconsented hysterectomy and bilateral salpingo oophorectomy that I began to realize how much my hormones had mattered.

In simplest terms, hormones are chemical messengers which travel through our blood and enter cells, tissues and organs where they turn on switches to the genetic machinery that regulate everything from reproduction to emotions, overall health and well being. Certain hormones have an effect on particular cells known as ‘target cells’. A target cell reacts to a particular hormone because it bears receptors for that hormone. This is why there’s never a time in a woman’s life when she doesn’t need hormones. Hormones can be thought of as the life giving force that ‘animates’ us physically, mentally, emotionally and even spiritually. When a woman undergoes hysterectomy, hormone-producing organs are permanently removed and hormones are lost forever. It’s important to know that hormones aren’t only involved in the production of a new life (as in baby in the womb new life), they sustain all life.

Realizing How Much Hormones Matter

At the time of my father’s death from a massive heart attack in 2009, I was still reeling from hysterectomy and ovary removal in 2007. I’ll never forget the first time I saw my father’s body after he passed away. It hit me really hard to see him full of life one day and then see him completely and utterly lifeless the next. It hit my son Christopher even harder I think. I’ll never forget his comment as he looked at his grandfather’s ‘lifeless’ body just before the dreaded funeral. He said matter-of-fact like “Papaw’s spirit is gone. There’s no more animation.” Christopher’s observation was a very profound one indeed. In a very real sense, I suppose that is what death means – no more animation. I’d never thought of it exactly like that before.

Suddenly, I couldn’t help but think about how much I had changed since hysterectomy. It was as if the very life had been sucked right out of me too. I wasn’t dead, but I wasn’t really alive either – at least not in any way that mattered. Along with the loss of my female organs, I had lost my animation in many ways too. My eyes no longer sparkled. My skin no longer glowed. All things became dry, dull and lackluster. Everything became an effort and ‘feelings’ were no longer present. Remember how it felt when you became sexually aware? Well think of the opposite of that. While I once viewed the world in living color, things appeared mostly grey to me after hysterectomy and the loss of hormones. In short, I lost my animation.

Beyond reproduction and the other physiological functions ovarian hormones control, in many ways, these hormones animate us. They provide the subtle nuances that make life interesting – a life giving force that colors our physical, mental, emotional and even spiritual selves. To be animated is to have life, interest, spirit, motion and activity. What happens when a woman undergoes hysterectomy and castration? Pretty much the same thing that happens to a man who is castrated, she loses her animation, her color – everything that makes life interesting and worth living disappears. And this is on top of the health issues that arise from the loss of hormones.

There can be no question that hormones matter. It is too bad that we don’t know this until after they are gone. Please give this much thought before ever agreeing to removal of your hormone-producing and life-sustaining organs. Always weigh the benefits and risks.

Hysterectomy Research

Hormones Matter is conducting research on hysterectomy outcomes. If you have had a hysterectomy, please take a few minutes to complete The Hysterectomy Survey.

Related posts:

hysterectomy secret - figure changesHysterectomy’s Best Kept Secret: Figure Changes

You might be interested in

tangled ribbons poverty mammography

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

1 … 3 4 5 6 7