ORIGIN OF LIFE

As I entered the exam room, she was sitting anxiously on the end of the exam table. I felt this strong sense that she was looking for some answers, but was not hopeful. She had been down this road before with other doctors, in other exam rooms. Her voice cracked with emotion as her story unfolded...She was 41 years old. Two years ago she had been told that she had some abnormal cervical cells and an ovarian cyst. Her doctor advised her to have a hysterectomy and, as many of us would, she followed her doctor's advice. She had surgery that removed her cervix, uterus and both ovaries.

After the surgery, she learned that her organs were normal. She had not realized it at the time but it was all a senseless waste - needless castration. She had been robbed of her female organs and all that they provided her. These organs, which are the origin of life, were discarded as if they were trivial accessories.

Since that day, her health, sense of self, and personal relationships were anything but “normal.” She suffered from hot flashes and night sweats. She would wake in a sweat and had to change her clothes and bedding. Tasks that had been routine were now a struggle. She forced herself to take care of her home, family and job. She fought sadness that seemed without cause and tried not to snap at her family and friends. Gone was her desire for romance. Her ability to respond to affection had virtually disappeared. Sex resulted in pain. This left her partner confused and hurt. Didn't they love each other any more? She had been given estrogen pills but nothing changed. She decided that what she was feeling must be "in her head," and tormented herself for her "failures" and "obvious character flaws."

I reassured her that what she was going through was not in her mind, but very real. She was suffering symptoms of estrogen deficiency that some women experience after hysterectomy. This can happen even if the ovaries are left in place. For many women, removing their female organs may be their only choice and they do very well. However, this is not the case for all women, and this patient was not given any other choices. Unfortunately, estrogen pills did not work for her.

Some women do not do well with estrogen pills taken by mouth. When the ovaries are working properly, they provide estrogen in the bloodstream all day, every day, not once a day from the stomach. If pills do not relieve symptoms, most women will do very well with estrogen delivered a different way. I discussed three such options with this patient: estrogen from a patch, cream or a vaginal ring. She had questions about the risks of estrogen as well as the benefits. We discussed these questions and many more. I told her that risks, if present, are small. She decided to try the patches. The patch would give her estrogen absorbed through her skin.

After years of feeling as if she had lost herself, she soon started to feel as if she was reconnecting with the woman she had once been. Her energy and vitality were increasing as well as her mood and coping skills. She began sleeping better and her sense of self-esteem was blossoming.

What is the moral of this story?    Women have choices!

Hysterectomy should only be done after you understand all of your options.  Depending on your particular problem, medical treatment may be helpful, including antibiotics, hormonal balancing, thyroid treatment, anti-inflammatories and/or correction of anemia. For bleeding problems, endometrial ablation that preserves organs can decrease or end bleeding. Abnormal cervical cells and ovarian cysts can often be treated by the removal of the specific problem rather than all the organs. With advanced ultrasound tools, a more accurate picture of what is happening inside the female organs can help your doctor in advising possible treatments. In many cases, hysterectomy may be the best option. However, if hysterectomy is always used as the first solution, there is no going back. It's a one-way street.

My staff and I are sharing this patient's story with you to let you know that your female organs are a vital part of who you are. Of course, there are millions of women who have done very well after hysterectomy.  However, what about those who have not? Hysterectomy needs to become the answer of "last resort," not the first. Too many women don't know that there are other answers. Too many women think their organs aren't needed for anything other than having babies. Too many women have learned too late that another choice might have been better for them.  We want to support you in seeking the best answer to your problem.