A hysterectomy – removal of the uterus – can be a life-saving operation for women with certain types of cancer or uterine hemorrhage. It has also improved the quality of life for thousands of women each year who experienced abnormal uterine bleeding and noncancerous growths of muscle tissue in and around the uterus (fibroids), or the falling of the uterus from its normal position into or outside of the vagina (uterine prolapse).
When the ovaries are also removed, a hysterectomy can relieve the pain of endometriosis – the growth of the tissue lining the uterus (endometrial tissue) outside the uterus.
High Incidence of Hysterectomy
More than one in four U.S. women will have a hysterectomy by the time they are 60 years old, according to the Centers for Disease Control and Prevention (CDC). The United States has one of the highest rates of hysterectomy in the world, with about five out of every 1,000 women each year having the operation. Other industrialized countries show lower rates; in England, for example, the rate is less than three per 1,000 women annually. In Norway, it's less than two in 1,000.
Some are concerned that many hysterectomies are done unnecessarily in this country. "There are some cases where hysterectomy is the only option, for instance, for some types of cancer," says Anthony Scialli, M.D., with Georgetown University Hospital in Washington, D.C. "But I think we perform too many hysterectomies. It's a matter of American gynecologists being accustomed to performing a hysterectomy and American women being accustomed to getting one – based on their mother or other female relative having one. The one thing in favor of a hysterectomy is that it works for abnormal uterine bleeding – but it should be the last step, not the first step."
More than one-third of hysterectomies in the United States are performed to treat fibroids or abnormal uterine bleeding.
Options
Today, women have other options – new medications, technologies, and procedures – to treat non-cancerous uterine conditions. Some of these less invasive procedures carry lower risks, offer quicker recovery, and are less expense. And some preserve the woman's ability to get pregnant, unlike hysterectomy.
However, these procedures also have the disadvantage inherent with any new treatment – a lack of long-term data demonstrating safety and effectiveness. "But it's never a bad thing for a woman to ask a doctor for alternatives," says Scialli. "She should ask, 'What other options are there to manage this problem, and what are the pros and cons?'"
Non-Hysterectomy Treatments for Uterine Fibroids
A fibroid tumor is a common uterine condition and is more prevalent in older women. It’s estimated that more than 30 percent of women who are 40 to 60 years old have fibroids. Most women who have these non-cancerous growths have mild or no symptoms. But about 25 percent of women with fibroids have abnormal bleeding – sometimes quite severe bleeding – and extreme cramping before and during menstruation. Tumor sizes vary – from microscopic to grapefruit size. Treatments for fibroids, other than hysterectomy, include:
Myomectomy – Surgical removal of the fibroid tumor. This leaves the uterus intact.
Embolization – Surgical insertion of a thin tube that is threaded into the uterine artery. Radiographic material is injected into the artery, which blocks the blood flow to the fibroids, "starves" them, and causes them to shrink.
Hydrotherapy – Alternating hot and cold sitz baths can stimulate blood circulation in the lower abdomen, which can help deliver nutrients to the cells and clean away waste products. Warm castor oil packs applied to the lower abdomen can also help.
Nutritional Therapy – Diet and supplements can stabilize, even lower, the level of estrogen in the body. As estrogen levels drop, existing fibroids might shrink, and new ones might be prevented from forming.
- Foods to avoid: refined sugar, meat, dairy products, eggs, alcohol, caffeine
- Foods and supplements to eat: fresh vegetables and fruits, whole grains, soy, nuts, raw seeds, B vitamins (especially B6)
Acupressure – Targeted points are along the liver and spleen channels.
Herbal Medicine – Blue cohosh, dong quai, and wild cherry can help relieve symptoms. |
