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THE UTERUS: A NECESSARY LOSS?
Part 2 of 2

Janice Stensrude
published March 1996 in A Friend Indeed, Vol. XII, No. 10

Janine O'Leary Cobb, editor of A Friend Indeed at the time this article appeared, constructed this two-part series by editing down (by more than half) the popularized three-part version that appeared in Uptown Express under the title "The No-Longer Ubiquitous Uterus:Necessary Losses?" Both the Friend and the Uptown versions were based on an unpublished academic paper completed January 1995. If you are only going to read one version, I would recommend the academic paper, which did not suffer from restraints of size imposed by publishers and has a more complete discussion and fuller listing of source materials.

The first part of this two-part article discussed the value of the uterus and possible reasons why hysterectomy rates are so high in North America. Part 2 looks at the measures available to women who have already had a hysterectomy and a wide range of effects that hysterectomy may incur.


Is it too late?

For women looking back at a possibly unnecessary hysterectomy and surveying the wreckage, can anything be done? The answer is a resounding "Yes!" It is never too late to take charge of your health, educate yourself, and institute positive changes.

"The doctor-knows-best attitude is flattering to physicians, but it can be dangerous to patients.(1)" A key point. We are medical consumers, and the market will react to our demands. If we choose to abandon our own ignorance, we have much to gain -- primarily our health. Women must be willing to do their own research and to design their own health programs. This doesn't necessarily mean that women become their own doctors, but it does mean that when they need a doctor, they will be more likely to be able to judge the competence and knowledge of the physicians they choose.

There is no dearth of information on the subject of hysterectomy. There are useful steps that one can take after the operation(1a):

1. Give yourself time to grieve your loss. Use your anger to help other women.
2. Get your medical record. Find out what was removed.
3. Make an extra effort to promote sexual desire if you want to be sexually active.
4. Avoid caffeine, sugars, salt, alcohol, and red meat. Eat small meals high in protein or complex carbohydrates every two to three hours. Take supplements of B complex vitamins and vitamin E.
5. Exercise is an antidote to depression and will build stronger bones.
6. Take hormone replacement therapy (HRT) until the time of natural menopause.
7. Work to get a state or provincial hysterectomy law.

There are many fine books on the market, and a number of organizations that act as support to women who are facing life without a uterus. The best-known is Hysterectomy Educational Resource Services (HERS)(2), founded in 1982 by Nora Coffey after her life-destructive experience with hysterectomy. HERS gathers research and anecdotal information on hysterectomy and alternative treatments for the many conditions for which hysterectomy has been applied as a cure. Women facing hysterectomy can call for the name of a doctor for a second opinion, get copies of any of the thousands of medical journal articles kept in the library, or simply receive the comforting affirmation of someone who believes the symptoms are real. HERS does not give medical advice, but they do give information and emotional support. (Only about 2% of the women who call HERS and subsequently seek a second opinion end up having the surgery.)

A short reading list of resources that are readily available in bookstores and libraries are listed at the end of this article. These books contain current expanded reading lists. The message to women who have already had a hysterectomy is clear: Take charge of your body. Accept responsibility for your health choices. Become an educated medical consumer.

[P]eople who feel helpless do not have strong immune systems, and a new scientific field called psychoimmunology is forming. Taking action -- that is, taking control of your life -- is likely to build your sense of empowerment and to enhance your immune strength.
Personal power comes not from demanding it but from acquiring knowledge and skills as ways to courteously and competently assert your health rights as you interact with medical professionals(3).

One gynecologist has commented:

I'm afraid the American way of hysterectomy tells us a lot more about doctors than it does about disease. The surprisingly outdated attitudes doctors harbor toward female patients are a big part of the problem. Some very old-fashioned views remain embedded in medical training. It may take a few more decades and more medical consumerism on the part of women before the old attitudes give way to a more rational and scientific basis for hysterectomy(4).

A Spiritual View

In natural menopause, body changes are gradual. The climacteric, the period during which a woman's body begins changes in anticipation of menopause, begins around age 35, and continues till menopause (the last menstrual bleeding) at around age 50. There is a gradual and progressive physical change, both before and after the actual menopause, that prepares a woman physically and emotionally for a new life after the childbearing years. Surgical menopause leaps past the years yet to be lived to menopause, catapulting an unprepared woman into a foreign physical and emotional state. Even in postmenopause, amputation of the uterus has profound effects.

The depressed feelings that often follow hysterectomy are frequently marked by psychological crisis and spiritual growth. One thirtyish woman told me about a kundalini-rising experience that shocked her system and left a circle of white hair at her crown. At the same time, she began to have experiences that could be labeled "psychic." Another, in her early thirties, began having dreams that unearthed previously repressed memories of early childhood abuse. Spiritual growth can occur at any phase of life, but the women with whom I spoke needed time to understand what had happened to them. They began to understand the impact of their hysterectomies only about the time they would have reached menopause naturally.

Susun Weed has described a woman's progression through the climacteric and menopause as a rising of kundalini energy, and the uterus as a holder of the heat of the kundalini. According to Weed, women recycle this energy throughout their lives in childbirth and menstruation. When menopause occurs, the energy is redirected. Hot flashes are then caused by rising kundalini energy, a process she calls "crone-ing"(5).

The experiences of women who spoke with me about their hysterectomies suggest that more than hormones are involved in a woman's transformation at menopause. Even though hysterectomized women have physical and emotional changes typical of natural menopause, these changes have little meaning outside the context of life as it is at age 50. Just as there is frequently post-hysterectomy grief over the loss of childbearing ability (even when it makes no logical sense), there is also frequently a similar postmenopausal grief, even among women who rejoice in their empty nests. At 50, a woman is usually more prepared to experience her loss and move on to the excitement of a new stage of life, a stage of life that may be many years in the future for a hysterectomized woman.

Musing on the differences between surgical menopause and natural menopause gives rise to many interesting theories about what may be occurring with hysterectomy. One theory is that body, mind, and soul represent three cycles progressing in parallel fashion and in harmony throughout life. Disharmony results when one of these cycles is disturbed while the others continue at their natural pace. Removing the uterus accelerates and disrupts a natural body cycle, throwing it out of sync with mind and soul cycles. Until mind and soul catch up to this prematurely accelerated body cycle, the woman bereft of a uterus will be out of balance.

Studies on natural menopause have found that, although atrophying, the uterus and ovaries continue to produce low levels of hormones for about 25 years after menopause. A woman's hormonal status, with accompanying body changes, rapidly transforms during the first two years after the last menstrual period, then remains relatively unchanged until about age 75(6). A change at this stage of life suggests that the entire process of preparation for the spiritual tasks of age is not complete until age 75. In other words, menopause may be seen not as the doorway to age, but rather the passage into midlife, a period that lasts longer than we currently tend to think. It is proposed that midlife extends to age 75, the age at which we may ascend to the status of wise woman if we have wisely used our midlife years to prepare. Rabbi Schacter-Shalomi and Ronald Miller, in their thoughtful book, From Age-ing to Sage-ing, call the final stage of human life "elderhood"(7). Elderhood, they say, is a time for serving society and using one's acquired wisdom to benefit all of humanity.

Current literature on aging suggests that our natural lifespan may be from 110 to 130 years(8). With 60 to 80 years to live past menopause, it seems reasonable to advance the gateway to age past 65 -- the age that we currently associate with retirement and the onset of "old age." Hindus celebrate their 84th birthday with a coming-of-age party(9). Clearly our usual Western ways of thinking about age are being challenged.

Organ of Mystery

There is still much to know about the uterus. We are only beginning to identify and do not yet fully understand the many ways these organs affect our health and our sexuality(3a). Under the entry for "uterus," The Oxford Modern English Dictionary simply states "womb: 1. the organ of conception and gestation in a woman and other female mammals; the uterus. 2. a place of origination and development."

The use of the word "womb" in our language is rich in metaphor -- frequently and elegantly used in literary reference. It is a word of poets and mystics, a word that inspires visions of warmth, nurturance, growth -- life! On the other hand, "uterus", the term used most frequently by medical professionals connotes a body part -- blood and tissue, stained underwear, cramps. How did these two words become so emotionally divorced?

Though poised on the brink of enormous change, Western society, and particularly North American society, continues to overvalue left-brained, masculine thought, closeting the feminine, right-brained thinking with the unexplained, the undefinable, the enigmatic -- anything that does not submit to the rigors of scientific, reductionist thinking. After centuries of the "scientific method," of taking things apart in an attempt to understand how nature works, humankind is entering a new era of science and philosophy. This new epoch is marked by the remarriage of the parts, the recognition that parts in isolation behave differently from parts working in concert. This new thinking -- or perhaps, more accurately, return to old thinking -- is labeled (w)holistic.

This is not to dismiss reductionist science and left-brained medicine. It is not the participation in these endeavors that has created problems, but rather a peculiar thing that happened on the way: As a body of knowledge grew through scientific research, we began to behave as if we knew everything. That which we knew was fact; that which we did not know was fiction, or all too frequently, nonexistent -- a figment of psychological disturbance. The human uterus has become the victim of this linear and limited thinking. The effect of our devotion to modern medicine, particularly since the early 1970s, has been destructive for our wombs.

Perhaps if we think of the uterus as a womb, we will be reminded of the respect that this uniquely female organ deserves. It really doesn't make any difference what came first -- the disrespect or the separation of the word from its right-brained meaning. Clearly the importance of the uterus is making itself known through the painful experiences of millions of women who have gone through hysterectomy. "The uterus plays a powerful role in keeping the ovaries working," Cutler tells us(3b). In emphasizing the importance of the ovaries, we may be ignoring a hidden and fundamental power.

Some time ago, I watched an interview with Dr. Stanley West, chief of Reproductive Endocrinology at St. Vincent's Hospital in New York, and author of The Hysterectomy Hoax, and Michelle Battistini, M.D., Assistant Professor of Obstetrics and Gynecology at the University of Pennsylvania Medical Center(10). Battistini disagreed with West's contention that 90% of hysterectomies were unnecessary, arguing that while a proportion could be treated with alternative therapies, both medical and surgical, many of the women who receive so-called "unnecessary" hysterectomies would be satisfied with the outcome. West agreed that many women are satisfied with the result of their hysterectomies. The problem with hysterectomy, he said, is that there is no way to predict which women will be helped and which women will suffer disabling after-effects. With the variety of safe, effective alternatives to hysterectomies available today, West maintained that hysterectomy should be reserved for cancer and other life-threatening illnesses.

This surely is the point.

The vast majority of women are not being informed by their physicians that there are alternatives to hysterectomy. How many women would undergo hysterectomy if their doctors said to them, "There are other alternative treatments, but I think hysterectomy is the best one for you. With hysterectomy, you will never again have to fear unwanted pregnancy, menstrual cramps, or stained underwear; you will have a 54% chance of continuing satisfactory sexual relations and only about a 30% increase in risk of heart disease."

Now run that by me again, Doc??

References

1. Reider, Dorothy Krasnoff. Hysterectomy & Oophorectomy. In The New Ourselves Growing Older: Women Aging with Knowledge and Power, PB Doress-Worters & DL Siegal (eds.) New York: Simon & Schuster, 1994
Return to text at (1). Return to text at (1a).

2. Coffey, Norah. Hysterectomy Educational Resource Services (HERS), 422 Bryn Mawr, Bala Cynwyd, PA 19004. Tel. 215-667-7757
Return to text at (2).

3. Cutler, Winnifred B., Ph.D. Hysterectomy: Before & After. New York: Harper & Row, 1988.
Return to text at (3). Return to text at (3a). Return to text at (3b).

4. West, Stanley with Paula Dranov, The Hysterectomy Hoax. New York: Doubleday, 1994.
Return to text at (4).

5. Peyser, Randy, Susun Weed: An Interview with Randy Peyser. Heart Dance, November 1994. (Susun Weed is the author of Menopausal Years: The wise woman way. Woodstock NY: Ash Tree Publishing 1992)
Return to text at (5).

6. Cutler.
Return to text at (6).

7. Schacter-Shalomi, Zalman, and Ronald S. Miller. From Age-ing to Sage-ing: A Profound New Vision of Growing Older. New York: Warner Books, 1995
Return to text at (7).

8. Chopra, Deepak. Ageless Body, Timeless Mind. New York: Harmony Books, 1993
Return to text at (8).

9. Coburn, B. Aama in America. New Age Journal, Vol. 11, No. 4, July/August 1995, pp. 69-75
Return to text at (9).

10. Good Morning America, October 1994
Return to text at (10).

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