Unnecessary Hysterectomies -- Research Summary

THE FACTS: Hysterectomies are the second-most common operation done in the United States. There are 600,000 hysterectomies performed on women of all ages in the United States each year. One in three women has had a hysterectomy by the time she is age 60. It's not a surgery targeted only to post-menopausal women either. According to the Hysterectomy Educational Resources and Services Foundation (HERS), twice as many women in their 20s and 30s have hysterectomies as women in their 50s and 60s. HERS also cites 98 percent of the women they have referred to board-certified gynecologists after they were told they needed hysterectomies did not actually need one. Bruce McLucas, M.D., from UCLA, says hysterectomies vary from region to region and state to state. He says: "The numbers vary. I guess that's a concern to me. There should be a confidence that I would want if I were a woman, you know, going into anyone's office anywhere in the United States, that I'd be given the same options." The rate of hysterectomies in the United States is high compared to other industrialized countries. American women are twice as likely to have a hysterectomy as women in England and four-times as likely to have one as women in Sweden. Doctors in France almost never perform a hysterectomy for fibroids, which accounts for one-third of the hysterectomies done in the United States. Dr. McLucas says, "Hysterectomy is not an easy procedure to recommend, and it shouldn't be the first thing we talk about with our patients."

THE RISKS: Dr. McLucas says when hysterectomies are done to remove the uterus, the ovaries are often removed at the same time. Among the most common complications of a hysterectomy, HERS lists heart disease, osteoporosis, loss of sexual desire and fatigue. Some hysterectomies are necessary, but Ernst Bartsich, M.D., from New York Weill Cornell University Medical College, says, "Eighty-five percent are not necessary." Many experts agree. Unless cancer is threatening a woman, experts like Dr. Bartsich and Dr. McLucas do not see a need to remove an entire organ and risk the complications.

ALTERNATIVES: Dr. McLucas says one-third of all hysterectomies are done to treat uterine fibroids -- a common condition that affects up to 40 percent of women. Fibroids can cause pain, heavy bleeding, infertility and multiple miscarriages. Dr. McLucas says uterine artery embolization, which has been studied for more than one decade, is a safe and effective alternative to hysterectomy for the treatment of fibroids. During the procedure, tiny particles are injected into the uterine arteries. Once there, they block blood flow to the fibroid tumors, thereby shrinking them. Dr. McLucas says, "The fibroids are going to shrink at least 50 percent, and they'll never come back." Women may be told they need a hysterectomy to fix other problems such as endometriosis, heavy bleeding, uterine prolapse and chronic pelvic pain. While uterine artery embolization won't help these conditions, Dr. McLucas says hormones, medications and conservative surgeries should be tried before hysterectomy is an option. However, most doctors strongly agree that when cancer affects the pelvic organs, a hysterectomy is often warranted to save the woman's life.

MISINFORMED CONSENT: A good resource is the book, "Misinformed Consent: Women's Stories About Unnecessary Hysterectomy," by Lise Cloutier-Steele.

This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/.

If you would like more information, please contact:

Bruce McLucas, M.D.
The Fibroid Treatment Collective
100 UCLA Medical Plaza Ste. 310
Los Angeles, CA 90095
(866) 362-6463
inquiry@fibroids.com
http://www.fibroids.com