Hysterectomy is a popular surgery in American gynecology, particularly for a condition called uterine prolapse. Uterine prolapse occurs when the uterus and cervix, which are supposed to sit above the vagina, slip down into it. Most doctors recommend a hysterectomy to correct uterine prolapse, often without even considering other treatment options. Support for hysterectomy is based on three principles, all of which are worth closer examination. First, doctors recommend hysterectomy to treat prolapse, because a woman could develop cancer in her uterus and ovaries. In particular, ovarian cancer is aggressive and very difficult to diagnose. As such, doctors may recommend hysterectomy as both prolapse treatment, and as a preventative measure against gynecologic cancer. Because of this, hysterectomy may be the best way for an older woman with increased personal risks for ovarian or uterine cancer to fix her prolapse. But for the average woman over 60, ovarian cancer risk is as low 2 to 3 percent. Doctors also treat uterine prolapse with hysterectomy because of the misguided belief that the uterus will fall down again. But the uterus is held in place by supportive, sturdy uterosacral ligaments. The uterus doesn't fall down because it's heavy! It falls down because the ligaments are weakened. Surgery to repair the ligaments, fixes prolapse without removing the uterus. Finally, the idea that hysterectomy actually improves sexual function is the third reason doctors often suggest it for uterine prolapse treatment. Although several studies support this belief, it's more likely that removing the uterus simply stops the symptoms that make sex uncomfortable for some women who have hysterectomy for reasons other than uterine prolapse. For example, removing the uterus would also remove problems such as painful fibroids or inflamed endometriosis. But if a woman does not have conditions like these, removing her uterus may actually harm her sex life. One study found that 70 to 82 percent of women who underwent hysterectomy for vaginal bleeding reported a negative impact on libido and vaginal lubrication. Other research shows that hysterectomy reduces blood flow to the vagina and ovaries, potentially making it harder to reach orgasm. The bottom line is unless there is a sound and specific gynecological reason for hysterectomy, it's probably not the best option. Uterine prolapse, which can be treated with other methods, is not one of these sound reasons!
July 16, 2012