Bioethics Discussion Blog: Use vs Abuse of Hysterectomy: Hysteria vs Realism

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Thursday, January 03, 2008

Use vs Abuse of Hysterectomy: Hysteria vs Realism


There are a number of topics on my blog (male infant circumcision, patient modesty as two examples), in which my visitor’s views and by implication that of others are expressed regarding patient autonomy, patient rights and what seems apparent to them the lack of interest by medical practitioners to answer all their concerns and attempt to try and meet the requests. In addition, the doctors, they feel, are attending to them with a different agenda than their own.

For this thread, I have selected another topic which is high on the concern of many patients: hysterectomy, the surgical removal of a woman’s uterus. There is an activist group which is attempting to educate women about hysterectomy. The group is called the HERS Foundation and described on their website as ”... an independent non-profit international women's health education organization. It provides full, accurate information about hysterectomy, its adverse effects and alternative treatments. “

A blog which supports the goals of HERS is hysterectomyinformation.blogspot.com and the January 1 2008 posting which critically analyzed the information provided about hysterectomy by the University of Pittsburgh Medical Center was particularly interesting.

I would encourage my visitors to go to the above links and read the views and information. The question is whether in surgical practice, there is generally insufficient information given to women regarding the need and outcomes or consequences of hysterectomies and whether too many unnecessary hysterectomies are performed suggesting actual abuse of this operation and perhaps suggesting that surgeons have a different agenda than that of the patient. What do you think? ..Maurice.

ADDENDUM 9-21-2008: GRAPHIC- Photograph taken by me today of a statue titled "Will Never Forget" located at the Los Angeles County Arboretum, Arcadia, California.
When I saw the statue, it appeared to me to represent much of what is written in the Comment section of this thread, the need for a woman to hold onto her womb and her sexuality and never forgetting what a loss of this may mean to her. If you read something different into the photograph, please write to us about it. ..Maurice.

AS OF JANUARY 27 2009 THIS THREAD WILL BE CLOSED FOR ALL COMMENTS. DO NOT ATTEMPT TO WRITE ANY FURTHER COMMENTS HERE. PLEASE GO TO "USE VS ABUSE OF HYSTERECTOMY: SECTION 2" TO CONTINUE COMMENTS. ..Maurice.

112 Comments:

At Friday, January 04, 2008 10:39:00 AM, Anonymous Patient X said...

This is a obviously a tough topic for women. In my case, there was no issue about my having a hysterectomy. 60 year woman with stage 3 ovarian cancer. But the examples cited in the HERS website are indeed troubling, even shocking.

I can only imagine what must be going through women's minds when told "this might develop into cancer". Who wants to take a chance on that possibility. Doctor: "Better safe than sorry." Panicky Patient: "Take it all out!" Besides the charges of hysterectomy as big business, deliberate castration or cynical domination over women, another reason could be doctors practicing defensive medicine. I am really angry if some people in the medical profession casually recommend hysterectomy to solve simple health problems, or even in some cases emotional problems. And I'm very sorry for the young women who will always be haunted if they made the right decision.

Checking the etymology of the word hysterectomy, here is the origin:


"Hysteric/hysterical entered English around 1615. At that time, they had a theory of vapours--that a womb that wasn't pregnant was an empty bag that trapped bad air that would rise through the body to a woman's head and create emotional and psychological problems. It was a term used only about women."

 
At Friday, January 04, 2008 6:52:00 PM, Anonymous FatLady said...

Yes it is a tough topic; thank you so much for bringing it up! In my opinion, surgical castration as a prophylactic measure is an absolute violation.

My story hasn't run its course yet, but I was recently advised to have TAHBSO for a diagnosis of complex atypical hyperplasia. No evidence of malignancy. No evidence of anything wrong with either cervix or ovaries. I'm 50 & obese but I'm also a newlywed so not really excited about the recovery period or the nasty, irreversible after effects.

After a few days of pondering, I began do research and I've been pretty steamed ever since. This doctor gave me the exact speech you outlined. She completely discounted any other therapies and insisted TAHBSO with NO HRT was the only way to prevent developing cancer.

Being in Canada, it took me 3 months to get the appointment to see her, another several weeks to schedule the D&C/endometrial biopsy, and 2 weeks to get the results. The TAHBSO on the other hand was already scheduled for 4 weeks out.

When I canceled the surgery and wanted to discuss hormone therapy, she refused to treat me and has referred me to an oncologist. I've been waiting nearly 3 months for that appointment.

Clearly, it's not such an emergency after all.

Yes. I question her motives. I suspect she is only interested in whatever fee she can collect for the surgery and not in following some patient through the hormone therapy. I submit that her time is more profitably spent doing the hysterectomies, vertical incision and all, on as many women as she can frighten into it with no regard for the well-being of the patient.

I have been so outraged at her attitude that I've started my own blog as a place to share my experiences and my research for anyone who might be interested. (http://www.fatinthefire.com)

It just seems to me that too many women are ignorant to the consequences of hysterectomy. I've read too many comments on too many blogs and social sites where women discuss elective hysterectomy the way one would discuss a new hairstyle or pair of shoes.

I'll be very interested in seeing all the comments generated here.

 
At Friday, January 04, 2008 7:54:00 PM, Blogger Maurice Bernstein, M.D. said...

Thank you both for starting the commentary on this thread. Some jurisdictions have begun to understand the potential impact of a hysterectomy decision on the woman patient in terms of lack of adequate informing the patient on the part of the physician and have created laws to make the physician responsible. Failure to fully and satisfactorily comply with the law may result in the termination of license to practice, if not other legal consequences initiated by the patient. I am only familiar with California state law which I have pasted below.

Of course, I wish the best in terms of their health to both of my initial visitors here. ..Maurice.



California Health and Safety Code
HEALTH AND SAFETY CODE SECTION 1690-1691


1690. (a) Prior to the performance of a hysterectomy, physicians
and surgeons shall obtain verbal and written informed consent. The
informed consent procedure shall ensure that at least all of the
following information is given to the patient verbally and in
writing:
(1) Advice that the individual is free to withhold or withdraw
consent to the procedure at any time before the hysterectomy without
affecting the right to future care or treatment and without loss or
withdrawal of any state or federally funded program benefits to which
the individual might be otherwise entitled.
(2) A description of the type or types of surgery and other
procedures involved in the proposed hysterectomy, and a description
of any known available and appropriate alternatives to the
hysterectomy itself.
(3) Advice that the hysterectomy procedure is considered to be
irreversible, and that infertility will result; except as provided in
subdivision (b).
(4) A description of the discomforts and risks that may accompany
or follow the performing of the procedure, including an explanation
of the type and possible effects of any anesthetic to be used.
(5) A description of the benefits or advantages that may be
expected as a result of the hysterectomy.
(6) Approximate length of hospital stay.
(7) Approximate length of time for recovery.
(8) Financial cost to the patient of the physician and surgeon's
fees.
(b) A woman shall sign a written statement prior to the
performance of the hysterectomy procedure, indicating she has read
and understood the written information provided pursuant to
subdivision (a), and that this information has been discussed with
her by her physician and surgeon, or his or her designee. The
statement shall indicate that the patient has been advised by her
physician or designee that the hysterectomy will render her
permanently sterile and incapable of having children and shall
accompany the claim, unless the patient has previously been sterile
or is postmenopausal.
(c) The informed consent procedure shall not pertain when the
hysterectomy is performed in a life-threatening emergency situation
in which the physician determines prior written informed consent is
not possible. In this case, a statement, handwritten and signed by
the physician, certifying the nature of the emergency, shall
accompany the claim.
(d) The State Department of Health Services may develop
regulations establishing verbal and written informed consent
procedures that shall be obtained prior to performance of a
hysterectomy, that indicate the medically accepted justifications for
performance of a hysterectomy, pursuant to this chapter.



1691. The failure of a physician and surgeon to inform a patient by
means of written consent, in layman's language and in a language
understood by the patient of alternative efficacious methods of
treatment which may be medically viable, when a hysterectomy is to
be performed, constitutes unprofessional conduct within the meaning
of Chapter 5 (commencing with Section 2000) of Division 2 of the
Business and Professions Code.

 
At Saturday, January 05, 2008 3:51:00 AM, Anonymous Anonymous said...

Unfortunately, informed consent laws are not enforced. Unless the risks, consequences and reasons for the proposed procedure are in writing, it simply becomes a he said she said situation after the fact. I was given an emergency hysterectomy without my informed consent. The doctor did not inform me of anything, and did not answer any of my questions. I was diagnosed with possible ovarian torsion. I was not bleeding, my vital signs were normal, and my only symptom was pain. Instead of the doctor attempting to untwist the ovary and save it, he amputated my healthy cervix, uterus, and both ovaries and fallopian tubes. After this was done to me, I ordered my medical records and saw that my consent form had been falsified. I also learned that the surgery was totally unnecessary. I was lied to and decieved but because of malpratice caps, it is difficult to find an attorney or expert willing to pursue a civil case. It really is the perfect crime.

 
At Saturday, January 05, 2008 9:17:00 AM, Blogger Maurice Bernstein, M.D. said...

Anonymous from today, though I am no lawyer, your experience sounds like a criminal act of battery and more, rather than simple malpractice, by the performance of unconsented surgery and associated with alteration of your written consent.

I think that if California law was copied and applied in other jurisdictions some of the unnecessary surgery would be prevented. I think that a written statement by the physician detailing the diagnosis, prognosis without treatment, benefit of surgery and comparison with other treatments and surgical risks and consequences after surgery including the affects on quality of life will protect the patient against uninformed consent. A verbal explanation is also required in the California law. In view of the ready availablility of portable recording devices, including as part of the ubiquitious cell phones, the verbal conversation between patient and surgeon can be recorded for later review or documentation. This recorded documentation between surgeon, patient or surrogate could also be created in emergency situations.

Of course, all information provided by the physician, either written or orally can be nuanced by the doctor and so, except in an emergency situation, the patient may wish to do her own research and talk to others who have experienced hysterectomies and attempt to obtain a second professional opinion.

Enforcement of laws like California depend, at the minimum, on the responsibility of patients and families or others reporting their concerns to the state medical board for investigation.

I would say that an activist approach to the problem of unneeded hysterectomies should start first with getting laws passed and then informing the public and women about the legal requirements and to challenge the doctors to follow those requirements and report those physicians who don't.

Patients challenging their doctors is an important component for fairness in the doctor-patient relationship and though many patients for various reasons may shy away from this action, there are many reasons to promote this behavior on the part of the patient. I think I will start new thread on the topic "challenging your physician". ..Maurice.

 
At Saturday, January 05, 2008 9:12:00 PM, Blogger Elaine said...

Unfortunately, the California Health and Safety Code Section 1690-1691 that was shown above falls far short of the necessary information a woman needs to make an informed decision about whether to proceed with a hysterectomy and/or oopherectomy. Much of the information doctors provide about the risks and benefits of hysterectomy, as well as about the medical condition the woman has, is given subjectively or doctors lie about it. For example, I was told that a hysterectomy and bilateral oopherectomy would “cure” my endometriosis, and that the hrt I would be prescribed due to my young age would not be enough to aggravate any remaining endometriosis. The doctor was so sure of this he wrote it down on my list of questions that I still have a copy of. Yet over two years after my surgery I still have the same pelvic pain. He left behind all the endometriosis on my bladder and ligaments surrounding my uterus, and merely removed my reproductive organs (I was told this verbally and it states this on my surgery report). Yet in much of the scientific research I have done on my own, there are many documented cases of endometriosis persisting after hysterectomy and ovary removal, whether the patient used estrogen replacement or not. I did ask my doctor before deciding on a hysterectomy if he would be willing to give me a second laparoscopy just to remove the endometriosis and leave my organs intact. I felt uncomfortable with having a hysterectomy at my age of 33 (the first laparoscopy I had a year prior to my hysterectomy was only a diagnostic laparoscopy and although I was told any endometriosis he found would be lasered off, it was left untouched since I was told it was “too extensive”). He refused, stating two reasons. 1. I did not desire to have children (even though I was childless and young and could change my mind) and that this procedure was generally reserved for women trying to conceive, and 2. In all probability the endometriosis would just come back within six months and I would be back in the same predicament.
I tried to seek out a second opinion at a facility not associated with the first one, only to find out my insurance would not cover it because it was out of network. This same thing happened when I tried to find a specialist in endometriosis care so I could preserve my reproductive organs. I am not rich. So I was left to seek a second opinion within the same practice, and the second doctor agreed with the first. I was told I had no other options as I already tried Lupron and at least two forms of birth control which made me sick. When I returned to my original doctor but did not say yes right away to a hysterectomy, he told me I had the weekend to decide if I wanted the hysterectomy and to let him know either way by Monday because he would be going out of town soon. If I did not want one, he said he would see me in one year for my annual pap smear. Those were his exact words. During the course of this visit, he had also performed a surprise pap smear which I found to be extremely painful and I was crying because of this. So it was hard to even think straight. I was in pain, desperate and vulnerable and should not have been left to make such a drastic decision on such a short notice. I could not get my insurance to work with me and the other doctors in the practice all seemed to follow his same philosophy. What else was I supposed to do?
Looking back, and knowing what I do now, I would have just chosen to suffer with the pain. After all, I did live with five years of suffering before I finally got a proper diagnosis of endometriosis (before I was told I had IBS and it was all stress related, even after being found in a public bathroom writhing on the floor in pain during my period and brought to the ER).
It is not always that women just don’t do their research enough (and they shouldn’t have to do it all on their own; doctors should provide them with basic facts at least). Often less drastic options are not offered/available and/or most doctors aren’t skilled or knowledgeable in performing them (such as myomectomies or excision surgery for endometriosis). A hysterectomy is cheaper for insurance reasons (it doesn’t require the type of skill the other surgeries I mentioned do) and more convenient for doctors as well as more profitable. For the patient however a hysterectomy is drastic and the consequences are permanent.
In addition, most mainstream medical books on hysterectomy still claim that sexual intercourse and orgasm are not affected by hysterectomy (or if the woman had both ovaries removed that hrt would fix her problems), that removal of the cervix does not cause prolapsed organs such as the bladder or rectoceles, that depression is not a direct effect of hysterectomy or oopherectomy. But for thousands and thousands of women who have ended up with these problems post hysterectomy that did not have them before, these problems do happen and are very real. Just visit the many hysterectomy forums on the internet (why would there even be a need for them if women really felt so much better and were told everything they needed to know by their doctors) and read the posts, or read books such as “Misinformed Consent” by Lise Cloutier-Steel or “Hysterectomy: The Best or Worst Thing That Ever Happened to Me” by Elizabeth Plourde. How are we supposed to be informed properly when most of the current studies on the negative impact of hysterectomy and or surgical menopause are not making it into the medical books offered to us? When we have doctors who are not even knowledgeable enough about our diseases?
Had I been treated as a whole person and all of my risk factors for having my ovaries removed been considered, I would not be dealing with severe osteoporosis at 35 years of age now, with a dexa scan score of -3.2 in my spine. I would not be dealing with a severe depression that has been very hard to treat despite the many antidepressants and hrts I have tried and the counseling I have been through. I would have an active sexual life. I might not be suffering with intense fibromyalgia brought on by loss of my ovaries at such a young age. Yes, I would definitely say my doctor had a different agenda than mine, and that we were not on the same wavelength…

 
At Sunday, January 06, 2008 4:52:00 AM, Anonymous Anonymous said...

Thanks for your response Dr. Bernstein. What the doctor and staff did to me is a crime. It is fraud, assault and battery at the very least. The problem is that the laws are set up so that civil suits are the only remedy and they are virtually impossible. Even if you win, the doctor is still not prosecuted. The worst that happens to him is that his insurance pays out a little money (since the caps are so low) and his life goes on as normal. The doctor can then continue to do more unnecessary surgeries. The doctor did not do this alone, there were a lot of staff involved. There is obviously no law against unnecessary surgery and no one policing it. This is being done to women on a daily basis in this country. There are many women who only consent to a cyst being removed and end up just like me, yet there is no recourse. Doctors at UCLA did a study about the appropriateness of hysterectomy in 2000 and they concluded that 70% were done inappropriately. It is now 2008 and what has the California Medical Board done to stop it? Nothing. This is not a medical issue, but a financial issue. Doctor's who are benefiting from the profits of unnecessary hysterectomy/castration are not going to police it. When you consider that the hysterectomy machine makes doctors, hospitals and pharmaceuticals over 8 billion a year, the motivation to keep this going is clear. It is crime for profit, and the medical boards are profiting also. Women are just the collateral damage I guess.

 
At Sunday, January 06, 2008 9:44:00 AM, Blogger Maurice Bernstein, M.D. said...

First, I would like every Anonymous commenter to identify themselves with a consistent pseudonym name or pseudonym initials in order to maintain continuity in the further comments and discussion.

Second, in response to Anonymous from 4:52am today, as I understand the role of the California Medical Board and state boards generally is that they don't define or establish the local standards of medical practice
(that is, establish or set through the board's literature research of risks vs benefits, for example, the value hysterectomy and under what conditions it should be offered.) As I understand it, the boards' role is to investigate the behavior of a physician with regard to attending to the standards of practice which is already set by and within the local medical community. For example, the best medical practice in the United States to exclude an acute and serious disease in a patient with a history and physical findings suggesting that disease would include an emergency MRI but the incident under investigation by the board was a patient and physician in a rural area far away from an available MRI. Despite research confirming that the use of the MRI was best practice, if other physicians in the area also would attempt diagnosis without MRI because of its unavailability, the physician under investigation would not have been found by the board to have deviated from standard of practice. On the other hand, that rural physician however who was performing female genitalia circumcision or treating a lobar pneumonia with acupuncture alone, procedures which were illegal or not an acceptable local standard of practice would be found liable for punishment.

Best medical practice is established by evidence based studies and consensus by specialists in the field and are communicated to physicians by the medical societies, specialty boards and medical literature guidelines. Best medical practices
are often slow to incorporate into routine practice unless rare laws are written to move them along. The role of hysterectomy as treatment for various conditions, despite what UCLA researchers decided was inappropriate in 2000, remains a procedure which has been left to the individual surgeon to advise and the patient to decide, with as much true information that laws like California can insure.

..Maurice.

 
At Sunday, January 06, 2008 2:26:00 PM, Anonymous js md said...

I have no professional opinion on the benefit or risks of hysterectomies.
But I did look at the hers foundation website and found it a one sided statement of 'facts' without references or sufficient info to make an independent judgment. How can you list all kinds of side affects without giving their frequency or clinical significance? I wouldn't put much faith in this particular website.

 
At Sunday, January 06, 2008 7:18:00 PM, Anonymous HERS said...

First, kudos to Maurice Bernstein, M.D. for moderating and encouraging an open, interesting discussion about hysterectomy and female castration. In the last decade on average 621,000 women were hysterectomized each year and 73% were castrated. This is the most important health issue facing women in this country today.

To js md

What is your medical specialty?

The "Facts" listed on the HERS Foundation web site are well documented in medical literature. It will not be difficult for anyone practicing medicine to locate these facts in medical journal articles, but please let us know if you are unsuccessful in finding them and HERS will provide you with citations. If this information is new to a medical practioner one would hope that someone practicing medicine would seek to find the data so readily available to them from the National Library of Medicine's online database in order to better inform the women they see in their practice. If they do not have a clinical practice, the women in their life, their mother, wife, daughter, sister and friends would benefit from having this information.

The Adverse Effects Data published on HERS web site reports the source of the data.

The 12-minute educational video on HERS web site was vetted by two gynecologists, an anatomy professor, and three three lawyers.

I agree with you that many of the facts about hysterectomy are one sided. The surgical removal of the female organs has consequences that are basic anatomical fact, they are not double sided. For example, the uterus is a hormone responsive reproductive sex organ. A woman who experiences uterine orgasm will not experience uterine orgasm when her uterus is removed. With the exception of subtotal hysterectomy the vagina is shortened, made into a closed pocket, sutured shut at the top.

The ovaries are the female gonads. Removal of the ovaries is castration. The functions of the ovaries cannot be replaced. The ovaries are biologically active glands whose removal cannot be compensated for. They have systemic, regulatory functions throughout life, which cannot be replicated artificially. Neither pharmaceutical hormones nor medical/surgical procedures can replicate this natural balance of hormone production, circulation and continual spontaneous adjustment to the body's needs.

When you visit HERS web site and click on "Blog" on the navigation bar you will find an enlightening discussion about what the contradictions some medical institutions provide to women about hysterectomy. You will also read, in their own words, how women feel about what they were told about the effects of hysterectomy and how the surgery has affected their lives.

Nora W. Coffey, President
HERS Foundation

 
At Monday, January 07, 2008 6:53:00 AM, Anonymous js md said...

Nora,
I have no professional opinion on hysterectomies because it's not my specialty and I'm not competent in it. I also have no professional interest in doing a research project on it. You should be providing the links to back up your statements, not asking blog viewers to do it. You must at least give some indication as to how frequent and troublesome are the 'facts' you list without discussion.
I am neither for nor against your position. All I'm saying is that your website was not convincing to me. Medical decisions are complex and people need to see both sides of the story to reach a valid decision.

 
At Monday, January 07, 2008 8:35:00 AM, Blogger Maurice Bernstein, M.D. said...

js md, OK..I am going to challenge you but just out of initiation of general discussion. Suppose a patient of yours, coming to you in your specialty, said to you "My gynecologist recommended that I have my uterus and all my ovaries along with the tubes removed to relieve the pain that I have from my endometriosis. You are my doctor too and I would like to know your opinion about the treatment of my pain. Will this recommendation for surgery hurt or help me?" Would you say "I have no professional opinion because it is not in my specialty"? But what if the problem you are managing with the patient could be adversely affected or improved by the operation? Should you maintain indifference?

Perhaps at the time you haven't been informed by the gynecologist about the details of the patient's gynecologic status, would you nevertheless tell the patient that you are aware that there is controversy regarding the need or value of hysterectomy in various gynecologic conditions but that you will find out more about her condition and treatment options. In other words, with this statement you have planted a "seed of caution" by introducing the word "controversy". Do you think that it is your professional duty, at that time, to plant the seed of that generally known and truthful information? I think this is an issue that all physicians have to think about when your patient asks for your professional advice. ..Maurice.

 
At Monday, January 07, 2008 8:53:00 AM, Anonymous Rick Schweikert said...

Getting back to the original topic of this post, there's no question that UPMC and many other hospital websites publish information that is contradictory and potentially harmful to women. We can only assume that if hospitals are making this mistake, then surely doctors are too. Although doctors get women to sign their name to a piece of paper that mostly protects the doctor and hospital, no woman can be said to have consented to hysterectomy unless she's first provided with all of the well-documented consequences of the removal of the female sex organs. UPMC's website doesn't do that. Why not? Is it greed? Power? Ignorance? Carelessness? And why do they continue to publish both true and false statements after the contradictory information has been pointed out to them? None of the reasons I can think of are acceptable when talking about an institution like UPMC that holds itself out as the women's health experts. Whatever the reason, the contradictions and omissions of fact are unconscionable and potentially criminal.

 
At Monday, January 07, 2008 11:44:00 AM, Blogger Maurice Bernstein, M.D. said...

Rick, if you haven't already done so, I would advise that you write directly to UPMC and request an explanation. That is the most direct way of attempting to get answers to your questions rather than simply writing your concerns here--of course,that's OK too, though you may not expect an answer. ..Maurice.

 
At Monday, January 07, 2008 12:55:00 PM, Blogger Joel Sherman said...

Maurice,
I assume that when you're not wearing your bioethicist hat, you do general medicine. I think any question put to a generalist is fair. How you answer it is completely dependent on your level of knowledge and comfort with any given question. I wouldn't criticize any tact you took. But asking me what I thought about having a hysterectomy would be like asking your dermatologist if you should have heart surgery. In my near forty years of practice, no one has ever asked for my opinion on a hysterectomy and I'm sure no one ever will. I could not competently give advice on a subject I have not kept up with for 40 years. I do give advice on general operative risk, but not on the specifics of the surgery.
If it was my family, I would take the days needed to thoroughly examine the issue, not so I could give definitive advice, but so that I would know what questions I need to ask of the physicians involved. If doubts persisted, I would get a second opinion from a competent physician I trusted.

 
At Monday, January 07, 2008 3:39:00 PM, Blogger Maurice Bernstein, M.D. said...

js md, I fully understand your view and I did ask you this question based on the fact that I know you are not a generalist. But if the patient was waiting for a reply from you, would you simply say "I have no professional opinion because it is not in my specialty"? But, if your specialty was relevent to risk and outcome of all major surgery, shouldn't the doctor say a bit more. For example, wouldn't it be appropriate to mention something about the element of public and medical controversy, about which you are aware, involving hysterectomy for various gynecologic conditions? Or do you think that a physician mentioning this would be non-constructive and potentially non-beneficent for the patient. Or as I previous said, you might be planting a seed of caution, caution which is pertinent to all patients undergoing any major surgery (and even some minor surgery). Would this represent interfering with the advice and directives of the patient's gynecologist?

I realize that this discussion is not strictly related to the topic of hysterectomy as Rick pointed out. However, as a teacher of medical students in the doctor-patient and doctor-doctor relationships, I need to hear what other doctors and patients consider appropriate communication in those relationships.

As I have noted in other threads, such as patient modesty, that I learn a lot from the discussion by the visitors which I can apply to my medical student teaching. ..Maurice.

 
At Monday, January 07, 2008 4:52:00 PM, Anonymous js md said...

Maurice, I would not say that I couldn't respond because it is not my specialty. I would say that I can't respond because I don't know the answer. Bad advice is worse than no advice. I would respond if I could say something responsible.
You're asking questions from both sides. No one believes a physician is god like anymore. The other part of that is that physicians don't always know the answer. You can't have it both ways. I would be reluctant to raise doubts in a patient's mind unless I was sure I knew what I was talking about. The patient's gynecologist almost certainly knows more about her relevant condition than I do. This is an example where I most definitely would not offer any advice.

 
At Monday, January 07, 2008 11:57:00 PM, Anonymous FatLady said...

JS,

I don't think you realize the influence you have with your patients. No, we don't think you know all the answers. We don't think you're a god--but at our most vulnerable--naked but for the paper gown, possibly in pain, maybe losing a scary amount of blood--you may as well be god. In fact, you are more than a god--you're a Doctor. What we need--we patients--is for you doctors to leave your egos in the hall. We need you to tell us the truth and if the truth is that you don't know the answer, it's ok to say that. Maybe you aren't a gynecologist and you don't want to advise a patient, but if she trusts you enough to ask your opinion, I think you have a responsibility to at least communicate to the woman that there is a great deal of controversy on the subject and point her in the direction of someone who can help her make her decision. Don't you have a friend, a golf buddy or someone you can refer her to for another opinion? Can you extend yourself just a bit to help her get the information she needs? What we patients most need from our doctors is not to be gods, but to be human beings.

 
At Tuesday, January 08, 2008 10:03:00 AM, Anonymous js md said...

'fatlady,' just as I would do for my own family I would try to facilitate a proper referral.
I would take no stand on the controversy as I don't know the pertinent facts.

 
At Tuesday, January 08, 2008 5:58:00 PM, Blogger Maurice Bernstein, M.D. said...

js md, I want to make my point clear. All I suggested is that the physician, out of beneficence to the patient, should indicate to the patient, if the patient is unaware, that there is controversy regarding the indications for total hysterectomy for some gynecologic conditions or with regard to the debility that occurs to the woman after hysterectomy. The controversy is driven both by the public but also by the profession. The details of the controversy itself and what views are valid or erroneous is not what I would expect all physicians to be able to detail to the patient nor do I think they are all proven one way or another.

I think that suggesting to the patient that a controversy exists, and it obviously does, is not "over-informing" the patient but as I said "planting a seed of caution" for the patient and also the patient's doctors to do a little further investigation instead of assuming everything is known about the procedure. ..Maurice.

 
At Tuesday, January 08, 2008 11:45:00 PM, Anonymous FatLady said...

Well said, Dr B. You made my point better than I did.

Thanks JS, MD for clarifying for me that you would do as much for the patient as your own family. I like that you think that way; clearly not all physicians would do as much. I do strongly agree with Dr B that just planting the seed of caution might be exactly the right course of action for the Doctor to take.

 
At Friday, January 11, 2008 12:29:00 AM, Blogger Marina said...

Dr. Bernstein,

Could you explain who introduces and changes laws, regulations, procedures in medical practice? Which steps can be done to make uninformed, unconsented hysterectomy illegal?
Thank you!

 
At Friday, January 11, 2008 7:47:00 AM, Blogger Maurice Bernstein, M.D. said...

Marina, see my comment of January 6,2008 regarding your question about introduction and changes. There are different ways which they are handled in other countries. My experience is only with the United States. The city, county, state and federal government can create the laws, regulations are set mainly by state and federal government agencies and guidelines for approved procedures are intitated by medical societies and specialty certification boards and other consensus groups. It is up to the doctor finally to follow all the laws. regulations and guidelines in medical practice. The whole process is sometimes very slow.
In a democratic society, laws and regulations can be initiated by input to the governing powers and reglatory boards by the people directly or usually through their representatives. Court decisions based on malpractice suits can also influence medical practice either productively or negatively. This is the best I can do to answer your question. Perhaps other visitors have other answers. ..Maurice.

 
At Thursday, September 11, 2008 1:07:00 PM, Blogger Gracie said...

Castration seems like a hush word for doctors to use, but according to the dictionary, castration is the removal of ovaries and testicles. As someone who underwent a castration, I am speaking from personal experience.

To cut out a healthy uterus and healthy ovaries is cruel and abuse of women! Doctors know perfectly well the importance of the uterus, ovaries and cervix for a woman's well being and her sexual life.


I was very energetic and always did things at full speed, never complained and worked very hard. I had dreams and I was fulfilling them once at a time. One of my dreams was to open my own salon up. I went to school and had two small boys and maintained a 4.0. Then I became a victim of this life altering surgery. And, all I had was a pea-sized fibroid.

It has been twenty years of getting to know a different me because your whole life and body changes after this surgery. My life as I knew it would never be again because that was taken from me that day!

I was never given any alternative surgeries and I was lied to about the after effects. The doctor said I didn't need my ovaries or uterus because I was done having children and would probably get cancer. I along with millions of women across the country do not know enough about our bodies and put total trust in our doctors.

I was told everything that was happening to me was in my head and that it wasn't from the surgery. After a couple of years of searching I came across an article in the McCall's Magazine about hysterectomies and The Hers Foundation. I immediately called and asked if anyone was feeling like I was after their surgery and was told that they were getting 500 calls daily. This was 20 years ago.

Why would a doctor do this? Care to speculate? A synecologist makes his or her money by performing hysterectomies/castrations. We need to stop worshiping medical doctors as if they alone can make informed decisions for us. Every woman in the world should have the right to know what is being done to her body when she has a hysterectomy/castration and every OBGYN should have to inform her first of the options and alternative surgeries, then of the possible complications and after-effects of the surgery.

With the help from the Hers Foundation, I am able to learn, communicate with other women and speak at conferences about my experience. They saved my life! When you loose 20 years of your life, your career, your dreams, your family life and your finances, you definitely need someone to turn to for help and in my case, it was the HERS FOUNDATION.

Unless you have confirmed cancer, please pursue and exhaust all other treatment options before you allow your vital female organs to be removed. Men don't have their non-cancerous penis and testicles removed as elective surgery.

Go to Hersfoundation.org and watch the DVD 'female anatomy', sign the petition for a law that every doctor must provide this DVD before she consents to this surgery. Let each woman make the decision, not her doctor as to whether she is going to allow her female organs to be removed.

I want to thank the Hers Foundation for all their help through the years when it was so difficult to go on. I know my life will never be what it was before my surgery, but I am full speed ahead to get a law passed for other women who are faced with decit and lies from their doctors about this surgery.

 
At Thursday, September 11, 2008 4:21:00 PM, Anonymous Anonymous said...

What concerns me is that laws aside, doctors seem to have a practice to remove female reproductive/sexual organs given the slighest opportunity.
We are debating the fact that women are regularly and in various forms
as evidenced by HERS website analysis of hospital websites and women's experience provided misleading information as to their diagnosis and
the necessity and consequences of surgical intervention.

For me at my initial consultation with a doctor for fibroids, I made it
clear that my purpose was to have my diagnosis confirmed and to have the
treating physician decide if she agreed with myomectomy as the course
of treatment, as hysterectomy was not an option for me. I wanted a
doctor who was comfortable with myomectomy over hysterectomy. Unfortunately, I had been unsuccessful in finding a doctor to work with me on
alternative treatment that didn't involve surgery, so I was now going down the surgical path.

So there was never any discussion of hysterectomy by the doctor or me, but there it was on my consent form to my surprise. I was totally unprepared for this turn of events and already had my hands full with
preparing for surgery. I inquired why it was on my "Myomectomy Consent
Form" and was I in danger of having a hysterectomy. To this, the doctor remarked no - waving hands and head to the negative. To assure me she edited the consent form. The doctor discussed the (bikini) incision she planned to make and explained how unnecessary it was for
me to store my own blood before surgery.

I was given a total abdominal hysterectomy because of two fibroids via
a 9-inch veritcal incision. I enjoyed maybe 3 months of following my
home-made recovery plan and getting back to my normal life of work, school, supporting mom and great-nephew - before a light switch was turned off. The resulting disability that I've endured since that
time is like havng a short-circuit in the body. Like when you have a short-circuit in an iron, it doesn't matter whether you have 2 items of clothing to iron or 20, it doesn't matter if you use 120V or 240V, it doesn't matter if the iron has water to the fill line or half-way, or
the temperature setting - the iron is no longer functional as an appliance.

This is what has happened to me, all the functions (conscious and unconscious) that made me the person I was before surgery are now lost.

A number of curious things I can share with other women:

- the justification for surgery; fast growing fibroids (but in order to
make this statement one would have to have monitored fibroid growth over time, right?)
- doctor remarked that I had a "virginal pelvis" (I had not had children,
nor any previous pelvic surgeries)
- I made it clear hysterectomy was not an option for me at 35 years old (that did not seem to matter)
- I was asymptomatic, in spite of the fibroids (no pain, no sexual issues, no heavy bleeding, etc.)
- now many doctor visits and many $1,000s of dollars later is virtually
impossible to be safely treated; doctor's cannot consider my post surgical state in thier recommendations and I have had to learn how fragile
my post-surgical state has made me (it's been 11 nightmarish years)
- HERS has provided the balanced view of this issue that is not provided by the treating physician, not admitted by other specialities. This has allowed me to bring
clarity to my situation and to realize the incredible vastness of destroyed lives. TQ

 
At Thursday, September 11, 2008 7:41:00 PM, Anonymous Lynn said...

Women considering having a hysterectomy should think first and not become a victim to a surgeon's knife due to a lack of information. No drugs or other treatments can replace ovarian or uterine hormones that are essential to a woman's health and well-being throughout her life.

I have listened firthand to many horrifying stories of women ages 20 to 80. A young lady of only 21 captured my heart. She cannot believe what is happening to her body.

I was fortunate to be with my young daughter who had some bleeding and polyps. She did find an alternative doctor in Iowa City, Iowa with the help of the Hers Foundation. Her doctor performed a polypectomy. No D & C, no hysterectomy, no castration. She had several doctors who wanted to do a hysterectomy and castration on her. I said no way!

Just today I was reading in a woman's magazine about breast cancer and doctors trying to convince women to get castrated so they don't get ovarian cancer. What a horrible thing to do to women! Do doctors say to men you have lung cancer so lets castrate you. Why are women always the victims?

I have to thank the Hers Foundation and Nora for saving my daughter Jenny's life. She can now go on living with her very important organs that are placed in her body for a reason.

I have learned alot from the female video on the Hersfoundation.org web site and also attending the Hers Foundation Conferences. I have also learned what this surgery does to a woman's life and her health because for many years I have watched my sister suffer. You need to go to the web site and read some of the stories women are writing about their lives before you submit to having your uterus, ovaries and cervix removed.

 
At Thursday, September 11, 2008 10:16:00 PM, Anonymous Mattie said...

It is frightening to listen to doctors talk about women's sex organs like they don't know what they are. It is frightening to learn that the ovaries are part of the endocrine system and then be told "I have never heard of that before" by many gynecologists. I have learned more in the past two years about my sex organs, amputated by deceit, and my endocrine system, than it seems many medical doctors claim to know or will publicly admit.
This is not "The Emperors New Clothes". Hysterectomy/Castration by deceit is the most important, critical and urgent woman's health issue concerning the female population in America today. I personally feel hysterectomy/castration by deceit is a national emergency. Hysterectomy/Castration effects every member of the hysterectomized woman's family in a negative and destructive way. It has been so life altering physically, mentally, sexually, psychologically, creatively and spiritually to me. I did not believe it was possible for a doctor to take advantage of my poor endocrine health (hyperthyroid storm) and strip me of my sexual organs by legally lying profusely, but in reality that is what was done to me. I have suffered unimaginable pain over the past two years. Pain I am sure a skilled medical doctor can imagine when discussing removing a woman's cervix, uterus and one ovary; with no medical basis for a 6cm benign Fibroid Tumor. My husband is so devastated by what was done to us, that I don't know how he is functioning.
Thanks to the Hers Foundation for preventing my post total hysterectomization suicide.

 
At Friday, September 12, 2008 11:37:00 AM, Anonymous Kiwi said...

What is the price of a person’s health? Physicians can take away your health with out fully informing you of all your option, and consequences. Then you make a decision based on what the doctor has told you. You can do research but the general population trust doctors. What happens when the doctor violates your rights and there is nothing you can do? Now you try to tell people your story and they don’t want to believe that a doctor would violate your rights like that. Not until it happens to you, do you start to believe what has happened to thousands of women. So what do I need to tell you that hysterectomies should never be done? What will it take to explain what is happening to the medical establishment? Safety has been thrown out the window and replaced with profit potential. Ethics have surrendered to greed. Kiwi

 
At Friday, September 12, 2008 1:30:00 PM, Anonymous Mattie said...

It is frightening to listen to doctors talk about women's sex organs like they don't know what they are. It is frightening to learn that the ovaries are part of the endocrine system and then be told "I have never heard of that before" by many gynecologists. I have learned more in the past two years about my sex organs, amputated by deceit, and my endocrine system, than it seems many medical doctors claim to know or will publicly admit.
This is not "The Emperors New Clothes". Hysterectomy/Castration by deceit is the most important, critical and urgent woman's health issue concerning the female population in America today. I personally feel hysterectomy/castration by deceit is a national emergency. Hysterectomy/Castration effects every member of the hysterectomized woman's family in a negative and destructive way. It has been so life altering physically, mentally, sexually, psychologically, creatively and spiritually to me. I did not believe it was possible for a doctor to take advantage of my poor endocrine health (hyperthyroid storm) and strip me of my sexual organs by legally lying profusely, but in reality that is what was done to me. I have suffered unimaginable pain over the past two years. Pain I am sure a skilled medical doctor can imagine when discussing removing a woman's cervix, uterus and one ovary; with no medical basis for a 6cm benign Fibroid Tumor. My husband is so devastated by what was done to us, that I don't know how he is functioning.
Thanks to the Hers Foundation for preventing my post total hysterectomization suicide.

 
At Friday, September 12, 2008 4:00:00 PM, Blogger Maurice Bernstein, M.D. said...

You know, I was looking back at my discussion with js md in January of this year and I think he was really stressing that we all should be considering what is the last part of the title of this thread "hysteria vs realism". This thread has been saturated with the very uncomfortable experiences of a number of visitors. But, in fact, are we seeing and hearing the whole picture? How does one explain that there are no writers to this blog who have found hysterectomy with or without ovariectomy an effective but also benign therapeutic procedure? I mean effective in the sense that the pathologic process and symptoms have been sucessfully removed. I mean benign in the sense that the patient was not harmed or made symptomatic by the procedure. Where are those women? Is it because there are virtually none or is it because they are involved in other interests now and not concerned with a blog thread that is dealing with the hysterectomy issue and not interested to spend their time reading or writing on the subject? This is the problem with obtaining a statistical overview by just looking at the comments to a blog or website. I am not saying that the suffering of the individual writers here are not real but of all the hysterectomies performed how many are really unsuccessful or the patient is left injured for life? Could there be as the title of this thread suggests a possibility of more hysteria than realism regarding the outcome of hysterectomy? ..Maurice.

 
At Saturday, September 13, 2008 2:45:00 PM, Anonymous HERS Foundation, Nora Coffey said...

Maurice, your suggestion that there is a possibility that the women who posted their experiences after hysterectomy is more hysteria than realism is tantamount to saying that the changes experienced by a person whose leg was amputated are more hysteria than realism if only the negative impact is posted. Would you need to hear from people who say it cured the pain in their leg and now they feel they are better off and that their artificial limb is superior to the one that was amputated?

Consider the facts. When a hysterectomy is performed the uterus is amputated and removed from a woman’s body and its functions are permanently lost.

It is common and unjustified practice for surgeons to remove normal ovaries and fallopian tubes during a hysterectomy, a surgery called bilateral salpingo-oophorectomy, which is female castration. The ovaries are a woman’s gonads. According to the National Center for Health Statistics, 73%-76% of women every year for the last decade were castrated during hysterectomy. There were an average of 621,000 hysterectomies performed per year in the last decade.

Neither hysterectomy nor oophorectomy is constructive or restorative surgery. By medical definition, they are destructive procedures. There is no treatment which is able to restore, replace or compensate for the functions of the missing organs.

The immediate and life-long complications induced by these operations have been widely documented in the scientific and medical literature since their introduction into the surgical armamentarium.

The Medical and scientific literature say that operative deaths are about 3,000 women each year from anesthesia, hemorrhage, embolisms, and shock during the surgery, and later deaths during hospitalization or shortly after discharge.

Amputation of the uterus and cervix compromises vaginal function and configuration in every woman. The vagina is shortened by surgery, sutured shut at the top and made into a closed pocket. The normal vagina-to-cervix connection is severed and the structural support normally provided by an intact pelvis is forfeited. Women who experienced uterine orgasm will not experience it after the uterus is removed.

Physical damage, functional loss and endocrine abnormality are inescapable and irrevocable consequences of hysterectomy and/or castration. No one can predict in advance which women will suffer the least or the most profound consequences or disability. One of the few things that can be predicted is that a woman who never experienced uterine orgasm will not have lost it if her uterus is removed. You can only lose what you have.

There are no hormonal drugs (pills, injections or patches) that equal or replace hormones produced by the uterus and ovaries. The dangers of hormone treatment are heavily documented in medical and scientific studies. No dosage or combination of hormonal drugs can eliminate these dangers.

Before surgery doctors tell women that hysterectomy and oophorectomy (I have yet to hear of a doctor who has told a woman that he/she is going to castrate her) are safe. They say that life is improved by hysterectomy and that women’s organs are “not needed” except for childbearing and that the ovaries “die” after menopause. Doctors say that natural menopause and oophorectomy have the same effects and that hysterectomy alone will not induce premature menopause or adversely affect ovarian function. They say that hormonal drugs are safer than having ovaries and that hormonal drugs can be given in a way that mimics the body’s own production and “replace” the body’s natural hormones.

After hysterectomy and/or castration doctors tell women that they “never heard” of problems like those she is experiencing, that her problems are “all in her head”, that she should see a psychiatrist, internist, rheumatologist, endocrinologist, neurologist, and the list goes on. They tell women that they are just as much a woman as they were before the organs which defined their sex and gender were amputated.

Hysterectomy are often not the end of a woman’s medical problems, it is often only the beginning. The adverse effects of hysterectomy and/or castration are not character flaws, they are symptoms of the biological havoc wrought by the surgery.

It is only possible to suggest that the removal of the female organs is inconsequential because the functions are not visible, unlike the male organs. Kinsey and Masters & Johnson were among the first researchers to document the physiological changes that occur during female sexual arousal which include “…the uterus contracts in a throbbing or rhythmic way.”

To summarize, hysterectomy’s damage is life-long. Among its most common consequences, in addition to operative injury, are: 7X greater incidence of myocardial infarction than women with intact uterus and ovaries; osteoporosis; joint and muscle pain and immobility; loss of sexual desire, arousal, sensation and uterine orgasm; painful intercourse and vaginal damage; displacement of bladder, bowel, and other pelvic organs; urinary tract infections, frequency, and incontinence; chronic constipation and digestive disorders; loss of short-term memory and impaired congnition; blunting of emotions, personality changes, despondency, irritability, anger, reclusiveness, and suicidal thinking.

Anyone who holds themselves out as an expert in gynecology or any aspect of women’s health should be familiar with the medical and scientific literature. It took me two years of daily immersing myself in the medical and scientific literature at the University of Pennsylvania’s medical library to educate myself about these issues. But it is 26 years of counseling hundreds of thousands of women at HERS who had been told they needed hysterectomies when they were unwarranted and women who they had their female organs removed without being informed of the consequences of the surgery that fully informed me and completed my education.

Because I tried to not make this longer than it is essential to respond to Maurice's hypothesis, I have only scratched the surface of the anatomical, physiological, economic, political and societal issues surrounding hysterectomy. I hope this discussion continues. I appreciate the the opportunity for everyone to question and express their understanding, views, and experiences.

 
At Saturday, September 13, 2008 10:14:00 PM, Anonymous Anonymous said...

In my opinion, in order for hysterectomy with or without ovariectomy to be an effective but also benigh therapeutic procedure - removing pathologic process and symptoms without harm - there would have to be no loss of uterine or ovarian function, no anatomical support or structural alterations, and no compromise of various systems (immune, metabolic, sexual, endocrine, neurological, etc.) over the lifetime of the woman in comparison to healthy women who have never had this procedure. I don't think the hysteria is with the outcome of hysterectomy as noted by the posters, but instead - it may be with the rational that says removal of function(s) needed for a woman's health and well-being is an answer to symptoms of a benign and localized imbalance. But then again, your particular reality may say that these organs are not of importance. TQ

 
At Saturday, September 13, 2008 10:16:00 PM, Blogger Maurice Bernstein, M.D. said...

Nora, I am in no way saying that hysterectomy with or without ovariectomy is in every case appropriate for the clinical situation and that there may be unwanted consequences for the patient from the procedure. What I am saying is that there may be more women who are satisfied with their operations despite that none have written to this blog. One cannot tell by reading the responses to this thread. Now it could well be that these women who may be satisfied are ignorant of the consequences which have been described here and happen to be without symptoms which they can attribute to the surgery. I don't know. We have the same situation on my patient modesty threads where virtually all the writers have complaints about physicians ignoring their modesty issues and few if any are expressing total satifaction with the way they were treated. What are we to make of that? All the we can say from reading the blog is that there is a population of patients who are sincerely concerned about their being ignored about their modessty or the need for gender selection of the healthcare providers. It is the same on this blog with those who are deeply concerned about the hysterectomies which were performed on them. None of these visitors should be ignored by us. In fact, as I have written on the patient modesty threads and as I would like to express on this thread, if there is abuse of gynecologic surgery it should be brought to the attention of those who set standards for practice. That is why I would agree, if HERS has valid statistical and pathophysiologic basis for their concerns, actions should be taken for change. For my visitors to the patient modesty threads, I would encourage them to set up an activist group like HERS.
..Maurice.
p.s.- I am not sure that comparing hysterectomy with leg amputation is a realistic analogy. Leg amputation is virtually always performed for infection or ischemic gangrene both potentially lethal conditions and not for pain.

 
At Sunday, September 14, 2008 6:17:00 AM, Anonymous Anonymous said...

Guess who is on the board who sets the standards for practice? A lot of Doctors!!

As far as the women who don't complain-they are told it is all in their heads so they don't speak up. Women don't speak up because they don't want their husbands to know they don't enjoy sex anymore. Women don't speak up because their friends call them crazy. Women don't speak up because it may take years before their symptoms appear.

There is no way you are going to come out of this feeling better. In the long run, things are going on in your body that you can't control. You may be satified at first especially if you have been bleeding for years, but you don't have to wait too long before the after-effects take over.

If a woman tells you that having a hysterectomy/castration is the best thing that ever happened to them, they are lying. We feel ashamed and embarrassed that we let anyone castrated us. Why didn't we know more about our bodies and why didn't the doctor tell us he was going to castrate us. That is the word they use for men when they take their testicles.

I only hope Hers can pass a law for doctors to hand the DVD 'female anatomy' to every woman faced with this surgery. I know all the women that have written on the Hers blog would not have had the surgery if they had seen the DVD. And, why does it take so many years to get this accomplished if it isn't a man's world? If this was being done to men, there would have been a law already, wouldn't you agree?

 
At Sunday, September 14, 2008 8:28:00 AM, Anonymous HERS Foundation, Nora Coffey said...

In my opinion the only appropriate hysterectomy is one where the woman is informed of the functions of the female organs and the consequences of their removal. Informed consent cannot be given without accurate information. HERS short educational video “Female Anatomy: the Functions of the Female Organs” was vetted by two gynecologists, a medical school professor of Gross Anatomy, and two lawyers. The video has been viewed about 400,000 times and can be seen free on HERS web site and several web sites that post videos. HERS receives emails and phone calls daily from women who are grateful for the information they learned watching the video and viewing the accompanying anatomy charts so that they can make an informed decision. With one exception, they’ve said that they would not undergo hysterectomy. The exception, an RN who viewed the video nearly a year ago, called last week to say she had the surgery eight months ago and it was the worst decision she’s made in her entire life. Before the surgery she told the gynecologist about HERS video and he said “Oh don’t believe that, it’s not true, you’re not having any more children so you don’t need your uterus, it’s just a baby bag”. She is no longer working in her profession as a nurse, she’s on disability due to the myriad of problems she’s experienced since the surgery. She was apologetic to me during counseling for not having believed the video. Of course, the only apology should be from the gynecologist to her for removing her female organs without informed consent.

I used the analogy of amputation of a leg because few people would dispute that the loss of the functions of a leg are visible and obvious to most people. It is doubtful that a doctor would feel a need to tell them that they would no longer be able to walk on the leg they're going to amputate because it is self-evident. Regardless of the reason for the surgery, a person might choose not to have it, even if their condition was life-threatening.

But because the uterus and ovaries are not visible the consequences of removing them are not self-evident, one cannot see the functions that are lost when they are removed. It is the responsibility of the gynecologist who recommends the surgery to fully inform women.

If in a 12-minute video HERS provides information about the functions of the female organs and the consequences of removing them surely gynecologists, internists, family doctors, etc. could do the same. It is unacceptable that doctors misinform or do not inform women about the effects of the surgery. This information is required for women to decide what they will, and will not, allow to be done to their bodies.

 
At Sunday, September 14, 2008 9:33:00 AM, Anonymous Mattie said...

It would be almost as traumatizing to wake up from surgery and learn that your leg had been amputated unnecessarily. But unfortunately it would not be as traumatizing as a man having his prostate gland, his testicles and a portion of his penis amputated unnecessarily. Don't you think? How well would a man function sexually after this was done to him?. Now this is a sincere medical question and I expect to get an answer, please.
Since this is a back door issue, then let's go in the back door. This is down right embarrassing for the medical industry at this point, all of you. Get it over with, end this medical lie now, sign the Hers petition and stop embarrassing yourselves. Let HERS put and end to this mute medical point, because you don't have a medical leg to stand on and sound ridiculous.

 
At Monday, September 15, 2008 9:55:00 AM, Blogger Maurice Bernstein, M.D. said...

Toni wrote me that she was unable to get the following commentary published here which she wrote yesterday. I will post it below. However, as you have seen, there are a host of stories written here in the last few days of the horrors of hysterectomies and removal of the ovaries both from the symptom point of view but also from the view that unnecessary procedures are being carried out by surgeons and without fully and validly informed consent by the patient. I feel these stories are important to tell and are personally tragic but from a bioethics discussion aspect, formal discussion should consist more than personal stories, the points and issues that are made should be documented with facts and original resources where statistically significant studies have been performed either epidemiologic or pathophysiologic to support the writer's points and issues. HERS provides an excellent activistic medium but for ethical discussion on a blog like this, we need facts. ..Maurice

I had a hysterectomy at the very end of 2003.
This was due to Fibroids in my uterus. The
doctor was adamant that I needed a Hyst. and
"RIGHT AWAY". I had faith in this doctor, and
because he scared me with the factor I was losing
so much blood each month, and I was so anemic,
I had the Hyst. He made it sound that there was
no choice, and I would possibly die if I did not
have one. Family was concerned, and I, looking
back on this time, felt I was pushed into having this
surgery from what the doctor said. I had the surgery
done, and it is a long story I can tell, but here are
the most important points I wish to make:

One being - I did not need the surgery. There were
alternatives for me to pursue and try. I was never told
about these;

Two being - I was not given any information about the
after effects of a Hysterectomy; i.e., what I might realize
with what this could (and did) do to my body;

Three being - I have never felt worse. Ever since the Hyst.
my whole life has changed for the "worst". I feel like
"damaged goods". I feel physically awful, have awful
abdominal pains, feel as if I am in a constant 'flu', and
am always fatigued. I don't see how women can even
work after a Hysterectomy, if they feel the way I do;

Four being - My sexual drive has completely diminished.
I am talking of a FANTASTIC sex life with my husband
before I had the surgery. It has completely changed. I
was never told about this. I mean great love making, and
I was one to instigate it a lot of the time. We are talking
red lingerie, fishnets,and French Maid outfits. That is
gone now. I can't even remember the last time my husband
and I made love. It has been at least seven months where
it was twice/three times a week prior to the surgery. I have
no desire or drive to have intimate relations with him. My
poor husband;

Why wasn't I been made aware of the alternatives, the
problems which can happen with a hysterectomy, and
the pain worse that I feel now than before it? Why was
I not told about the loss of sexual drive?

I thank you for your blog site. I will continue reading the
posts. I hope mine can be. Women need to know this and
hopefully, stop this "Perfect Crime" of doctors... I just do
not understand how doctors can get away with this.

Thank you,

 
At Monday, September 15, 2008 3:23:00 PM, Anonymous Mattie said...

"pathophysiology...date: 1947, noun.: the physiology of abnormal states ; specifically : the functional changes that accompany a particular syndrome or disease."
No need for pathophysiology research about female sex organ amputation. At this point doctors are just trying to save face and a black-balling from the industry, by keeping the medical truth obscured. It is so medically obvious what ob/gyn's are doing, completely causing the endocrine system to go into a chaos and ruining a woman's sexuality, it is a medical fact. No blurry line here!. Why not do a study of the psychopathic minds of gynecologist surgeons who lie to perform unnecessary hysterectomy/castration's by deceit, by the millions. Now there is the study that needs to be done.

To all doctors on Maurice's blog: Please do not "sacrifice" over a million more women in the next two years before you sign the Hers Foundation "Petition" to end un-consented hysterectomy/castration. You can not save the reputation of generations of gynecologists, it is not possible when the truth is revealed.
Would this even be a discussion if we were talking about the question I asked in my last post: a man having his prostate gland, his testicles and a portion of his penis amputated unnecessarily. How well would a man function sexually after this was done to him?. The answer to the above question is the answer to the current question, it is all medically documented already. I learned the functions of the female anatomy and the inevitable side effects, I was experiencing in excruciating pain, from the Hers Foundation, while the doctors were insulting me and telling me to "get some counseling". The doctors dismissed me as a life-long patient after the operation because I wouldn't go to a major hospital within weeks of the operation to be treated for "vulvodynia". Look that one up and then go ahead and laugh, while you are signing the Hers "petition.
You may have a copy of my medical records where the proof is.

 
At Monday, September 15, 2008 7:41:00 PM, Anonymous Jeanne said...

I would like to thank Dr. Bernstein for hosting this blog and opening a line of discussion for this very important topic. Here are some facts I would like to point out:

Fact: There is no educational website on the whole internet (other than HERS Foundation) which describes the extensive damage done during a hysterectomy procedure. Below is a factual summary of exactly what is done during a hysterectomy surgery:

A hysterectomy is performed by transecting (to cut across; dissect transversely) the round ligaments, incising (to cut into) the anterior leaf of the broad ligament along the bladder, dissecting (to cut apart) the bladder off the lower uterine segment (displacing the bladder from its natural position and causing injury), severing the uterine arteries, transecting the uterosacral ligaments and cardinal ligaments, amputating the uterus and cervix, sewing up the vagina into a closed pocket (shortening the vagina), leaving said ligaments hanging in a women's pelvic cavity (compromising pelvic support), leaving an empty hole for the bowel to shift down into (displacing the natural position of the bowel), severing all the nerves from the genital area to the internal sex organs and spine, and amputating ovaries which causes increased risk for heart attacks, osteoporosis, dementia, etc., and which causes sexual dysfunction. A hysterectomy is performed by transecting (to cut across; dissect transversely) the round ligaments, incising (to cut into) the anterior leaf of the broad ligament along the bladder, dissecting (to cut apart) the bladder off the lower uterine segment (displacing the bladder from its natural position and causing injury), severing the uterine arteries, transecting the uterosacral ligaments and cardinal ligaments, amputating the uterus and cervix, sewing up the vagina into a closed pocket (shortening the vagina), leaving said ligaments hanging in a women's pelvic cavity (compromising pelvic support), leaving an empty hole for the bowel to shift down into (displacing the natural position of the bowel), severing all the nerves from the genital area to the internal sex organs and spine.

Fact: This is the ACOG's description of a hysterectomy from their online pamphlet: "Hysterectomy—removal of the uterus—is a way of treating problems that affect the uterus. Many conditions can be cured with hysterectomy." That is very misleading and inaccurate as you can tell from the actual description of this surgery above. It fails to disclose the extensive damage to ligaments, nerves, blood supply, and bladder.

Fact: In the "Risks" section of the ACOG pamphlet it states: "Early menopause (if ovaries are removed)" That statement is false. Since menopause is the decline of ovarian function over time, a woman cannot go through menopause if she does not have ovaries. What a woman experiences when her ovaries are amputated (castration) is the loss of ovarian function, NOT menopause. The loss of ovarian function (castration) has many detrimental effects on a woman's endocrine system and sexuality.

Fact: The ACOG also states: "If the ovaries have not been removed, the outer genitals and the vagina are not affected." This statement is false. The vagina is sewn into a pocket and shortened, and all the nerves and blood supply are severed from the genitals to the internal organs. Even if the cervical stump is not amputated, it still severs the nerves and blood supply to the genitals. How could the outer genitals not be affected?

When a person obtains a mortgage to purchase a home, there is a form called "Truth in Lending" which by law has to disclose the Annual Percentage Rate of the mortgage and be signed by the mortgagee. When a woman is told she needs a hysterectomy by a gynecologist, there are no documents stating in writing why the procedure is being suggested, what the benefits and risks are, and what alternatives were discussed. Hospital consent forms are very vague. They are tricky in having a woman sign a form stating she has been informed all the risks and side effects by her doctor, yet how would a woman know if she was given all the pertinent information? Only the doctor would know that.

Without going through the whole ACOG pamphlet, which would prove to show more misleading and false information, I will conclude in saying that all this misleading and false information has become fact in mythic proportions in the United States. The ACOG clearly intends to mislead women and not disclose the actual facts of this surgery and the gynecologists follow suit. When this is allowed to go on in the United States, and women who speak out about it are quieted, how could we ever get to the truth of the matter?

 
At Monday, September 15, 2008 8:29:00 PM, Anonymous Anonymous said...

Dr. B, I believe Nora did answer your question and explains why no further study is needed:

1) she spent two years immersed in reviewing the medical and scientific literature on this issue, there's your documentation
2) given the destructive nature of hysterectomy, an anatomical chart is all that's needed for self-evidence of its anatomical harm, not to just some women but to all women
3) an understanding of how hormones are produced in the body (necessary constituents) and the hormonal cascade is all that's needed for self-evidence of the issue surrounding hormone replacement and that this activity is best left to the wisdom of the body
4) an understanding of reproductive health is self-evident that reproductive health and therefore optimal women's health cannot be obtained with the removal of reproductive function

The posters experience serve to show not a random selection of isolated misapplication of standards, but to show their experience is actually the standard.

As HERS has found over thier 26 years, women who sought counseling both pre and post-opt ran into the same problem. The consequences and facts concerning hysterectomy were minimized, the benign nature of symptoms exaggerated, and options restricted.

The real work needed surrounding this issue before more surgeries are performed revolve around:

- women informed about the information provided in the HERS anatomy video so they can have access to the facts
- studies showing quality of life and risk of disease for women who don't under-go hysterectomy for common benign gynelogical conditions
- studies show conservative treatments that work to restore reproductive health
- studies demonstrating what constitutes reproductive health
- studies demonstrating what maintains reproductive health

In my research, women have raised this issue in the 60s, 70s, 80s, 90s, and 2008. This is decades of massive lost not just to the women affected, but their families, careers, finances, futures, lives, etc. all things that if 600,000 doctors were threatened in the same fashion - would definitely be a cause for hysteria.
TQ

 
At Monday, September 15, 2008 9:14:00 PM, Blogger Maurice Bernstein, M.D. said...

Those writing to this thread on hysterectomy may be interested to know that I have referred my visitors who come to my threads on patient modesty come to this thread. They have been deeply concerned about the lack of medical professional interest in their patient modesty issues and their desire to obtain gender specific assistants and nurses. What has been lacking in their expressions of frustration has been the lack of group activism. I have recommended they become more activistic and in that regard perhaps looking at and perhaps contacting the HERS program may provide them assistance in this regard. By the way, though the effects are more immediate and perhaps less long term, their emotional concerns about modesty issues is just as intense as your concerns about hysterectomy. ..Maurice.

 
At Tuesday, September 16, 2008 10:19:00 AM, Anonymous HERS Foundation, Nora Coffey said...

Maurice,

In response to your comment that “…from a bioethics discussion aspect, formal discussion should consist more than personal stories, the points and issues that are made should be documented with facts and original resources where statistically significant studies have been performed either epidemiologic or pathophysiologic to support the writer's points and issues. HERS provides an excellent activistic medium but for ethical discussion on a blog like this, we need facts.”:

To provide the voluminous quotes, statistics and the citations from which they were extracted would require indicating possible flaws such as a weakness in the methodology, an author’s financial conflict of interest (some studies were funded by manufacturers of the instruments and devices used in performing hysterectomy), and the pharmaceuticals that profiteer from the hormones women are given when their endogenous production of hormones is stopped by castration.

The reiteration of what has been published and therefore has been known and ignored for more than a century is not likely to change the status quo. It would contribute to the continuation of a fruitless discussion for another century, all the while missing the forest for the trees.

We need to think outside the box.

If a man’s penis is amputated he will not be able to experience an erection that may culminate with an orgasm. If a woman’s uterus is amputated she will not be able to experience uterine vasocongestiion which may culminate with an orgasm. A study designed to determine the number of men who experience erection and orgasm post-penile amputation would reveal that 100% of men will no longer experience erection that may lead to orgasm. A study designed to determine the number of women who experience uterine vasocongestion and orgasm post-uterine amputation would reveal that 100% of women will no longer experience uterine vasocongestion that may lead to orgasm.

To establish credible statistics one would need to demonstrate the number of men who never experienced erections prior to penile amputation and the number of men who did. Because it is self-evident there’s no need to quantify the loss of the ability to experience an erection after penile amputation.

A study is not required to prove their experiences of sexual changes and loss. Such demands for proof from women who report that they can no longer experience uterine orgasm without a uterus are equally demeaning and unreasonable.

But sex is only one of the many important functions of the uterus. In the citations listed below articles about sexual loss have been excluded because the loss of uterine orgasm and the damage caused by surgical shortening of the vagina are self-evident.

These are but a few of the numerous citations that document the increased incidence of heart disease after hysterectomy (there’s a 7.2 times greater incidence of myocardial infarction after castration), and a few citations that document the bladder and bowel changes after hysterectomy. Heart disease, bladder, and bowel problems are only two of the myriad of common post-hysterectomy problems reported in the medical and scientific literature:

1. Rosenberg L, Hennekens CH, Rosner B, Belanger C, Rothman KJ, Speizer FE. Early menopause and the risk of myocardial infarction. Am J Obstet Gynecol 1981;139:47-51.
2. Centerwall BS. Premenopausal hysterectomy and cardiovascular disease. Am J Obstet Gynecol 1981;139:58-61.
3. Colditz GA, Willett WC, Stampfer MJ, Rosner B, Speizer FE, Hennekens CH. Menopause and the risk of coronary heart disease in women. N Engl J Med 1987;316:1105-1110.
4. Centerwall BS. Early posoperative mortality following hysterectomy. A Danish population based study, 1977-1981. Br J Obstet Gynaecol 1992;99:350-351.
5. Shelton JD. Postacyclin from the uterus and woman's cardiovascular advantage. Prostaglandins, Leukotrienes, and Medicine 1982;8:459-466.
6. Parrish HM, Carr CA, Hall DG, King TM. Time interval from castration in premenopausal women to development of excessive coronary atherosclerosis. Am J Obstet Gynecol 1967;99:155-162.
7. Small-bowel obstruction secondary to traumatic lacerations of the uterine supports (The Allen-Masters Syndrome). Diseases of the Colon & Rectum 1969;12:253-255.
8. Hanley HG. The late urological complications of total hysterectomy. Br J Urol 1969;41:682-684.
9. Parys BT, Woolfenden KA, Parsons KF. Bladder dysfunction after simple hysterectomy: urodynamic and neurological evaluation. European Urology 1990;17:129-133.
10. Parys BT, Haylen BT, Hutton JL, Parsons KF. The effects of simple hysterectomy vesicourethral function. Br J Urol 1989;64:594-599.
11. Tanagho EA. Effect of Hysterectomy and Periurethral Surgery on Urethrovesical Function. In: Ostergard DR, ed. Gynecologic Urology and Urodynamics- Theory and Practice. 1985:537-543.
12. Thakar R, Manyonda I, Stanton SL, Clarkson P, Robinson G. Bladder, bowel and sexual function after hysterectomy for benign conditions. Br J Urol 1997;104:983-987.
13. Neuman M, Eidelman A, Langer R, Golan A, I B, E C. Iatrogenic injuries to the ureter during gynecologic and obstetric operations. Surgery, Gynecology, and Obstetrics 1991;173:268-272.
14. Tarkington MA, Dejter SW, Bresette JF. Early surgical management of extensive gynecologic ureteral injuries. Surgery, Gynecology, and Obstetrics 1991;173:17-21.
15. van Dam JH, MJ G, Drogendijk AC, Hop WC, Schouten WR. Changes in bowel function after hysterectomy. Scandinavian Journal of Gastroenterology Supplemental 1997;40:1342-1347.
16. Wiersma TG, Werre AJ, den Hartog G, Thies JE, Tytgat GN, Mulder CJ. Hysterectomy: the anorectal pitfall. A guideline for evaluation. Scandinavian Journal of Gastroenterology Supplement 1997;223:3-7.
17. Roe AM, Bartolo DC, Mortensen NJ. Slow transit constipation. Comparison between patients with or without previous hysterectomy. Digestive Diseases and Sciences 1988;33:1159-1163
18. .Taylor T, Smith AN, Fulton PM. Effect of hysterectomy on bowel function. Br J Urol 1989;299:300-301.
19. Prior A, Stanley KM, Smith AR, Read NW. Effect of hysterectomy on anorectal and urethrovesical physiology. Gut 1992;33:264-267.

 
At Tuesday, September 16, 2008 7:48:00 PM, Anonymous Anonymous said...

Over a decade ago, I had a hysterectomy and ovary removal because I was given "the cancer scare." My pathology report showed only a very small fibroid and a single, benign ovarian cyst. Only later did I find out that had my surgeon truly thought me at any risk, he would have been obligated to refer me to a cancer specialist. The "bikini" incision that he used also said that he was confident that I did not have cancer. You see, if cancer is suspected, then the surgeon should do a larger incision for a better operating room examination.
I've never felt like myself since the surgery. I had never had high blood pressure before but I had it within weeks of the TAHBSO.
Hubby and I had always enjoyed a great sex life...that, too, disappeared (never to return again!) within those first few weeks. That was enough to bring on depression but my despair went so much further. Whatever it was that used to buoy me up was, all at once, now non existent.
The first year brought hormonal havoc that continues still. Oh, and my bowel and bladder prolapsed into my vagina-- no doubt due to the surgical hole in my pelvic floor.
Another physician said that he could correct it and I immediately knew that I would never, ever be in anyone else's power like that ever again.
And a decade later, I haven't been. I gave up my career and stay at home for days at a time. I no longer see any gyn as I have no parts left that they "specialize" in. I go to a physician's assistant for the hbp med. I avoid the medical profession as much as possible. I warn other women and I warn the public whenever I can.
By some miracle, hubby and I are still together. We rarely talk about the surgery, about all the unwelcome changes that it brought. It is simply too painful to do so.
But just the other day, hubby unexpectedly made a point of telling me that he hadn't forgotten what had been so needlessly done to me ... done to us. sign me as "trust lost forever"

 
At Tuesday, September 16, 2008 8:40:00 PM, Anonymous Jeanne said...

At the bottom of the ACOG Hysterectomy Pamphlet, it has a Glossary. This is what it states about Menopause:

"Menopause: The process in a woman's life when ovaries stop functioning and menstruation stops."

This statement is false as it relates to ovaries. It is common medical knowledge that the ovaries function all of a woman's life. Why would the ACOG state otherwise? Is it reasonable for a group of doctors educated and trained in women's reproductive healthcare to make such a glaring error in their pamphlet, or would it be more probable that this misinformation was put there deliberately?

How would it affect business as usual if the ACOG disclosed the truth to woman?

1. Ovaries are gonads and to remove them would be castration. It would be the same as castrating a male, removing his testes.

2. Ovaries function all a woman's life.

3. Ovarian production protects women from heart attacks at any age.

4. Ovaries are part of the endocrine system and are necessary for the health and well being of a woman.

Either the ACOG is totally misinformed about their own field of expertise, or they are purposely trying to mislead women. I think that the posts on this blog and the HERS blog show proof that the latter is more plausible.

When you understand that the ACOG itself is misleading women (which is verified in their own pamphlet), then it is not hard to believe that individual gynecologists are doing the same on a large scale.

 
At Wednesday, September 17, 2008 7:58:00 PM, Anonymous Mad as Hell said...

I too made the life altering mistake over two years ago of trusting my long-time ob/gyn of 20 years. He told me I had a cystadenoma on both ovaries but the pathology report showed only one and it was benign. I had no uterine problems whatsoever and never had female issues until I had the one day of unrelenting pain that cost me this nightmare. He also referred me to a gyn oncologist but then didn't follow the recommendation of the oncologist whose report stated "possible" TAH/BSO.

Odd thing is that the oncologist's report stated that I had a sister that had ovarian cancer. This is NOT true. So I wonder if this was done to "cover" for the ob/gyn. It certainly wouldn't surprise me!

Ever since this surgery, I've felt like I'm living in a nightmare. My after effects listed here are evidence that the loss of the uterine and ovarian hormones is permanent and not treatable (e.g. hormones and supplements I'm taking do not alleviate the symptoms). I suffer from depression, anxiety, thoughts of suicide, insomnia, loss of appetite, inability to concentrate, irritability, blunted emotions, no motivation, bowel problems, distended abdomen, hair loss (I've lost over 1/2 of it and now wear a hairpiece), hair graying, skin thinning, loss of libido and loss of sexual response. Mind you - I had NONE of these problems pre-hyst.

In Stanley West's "The Hysterectomy Hoax", it states that up to 70% of hysterectomized women suffer from depression/anxiety which is oftentimes permanent. I suspect that this is primarily due to the effects of hormone loss on the brain but some of it must also be from the profound loss of our former selves. Who wouldn't be depressed after being castrated?

Everyday, I mourn the loss of my sunny, vibrant personality, intact, beautiful physique and the feelings of love I used to have for my husband of 28 years, children, family and friends. The very life has been sucked out of me.

Sadly, I too am now very distrustful of anyone in the medical profession. And the "code of silence" only cements that distrust.

Why aren't these lies considered fraud? In most states, the attorney general investigates allegations of fraud by businesses. However, when I submitted this ob/gyn practice to the attorney general's office to be investigated, I was told that they forwarded it to the medical board. Doctors disciplining doctors - I don't have a lot of faith in that process!

I also loath those women who could have and SHOULD have warned me of the horror of hysterectomy but chose to remain silent. It's difficult to be around them. I only wish I could tell them how I feel; someday maybe I'll get the courage.

I have risen above my shame and embarrassment to warn other women about the devastation of this surgery. Sadly, like the one woman who submitted to a hyst after consulting with HERS, one woman I spoke with trusted her doctor and went ahead with the surgery. I even referred her to the HERS Foundation and she did look at the website. Funny how her surgery was going to be for excessive bleeding but when that was under control, her ob/gyn found a cyst.

And it's obvious that the insurance companies consider the doctors more clients than patients. Otherwise, wouldn't they be putting some procedures in place to reduce these surgeries? There was a period (I believe in the 90's) where some of them were requiring second opinions. I don't know how much that helped. I have written the Clinical Policy group at my insurance company about this issue but have not received a response (not that I expected one).

All I can say is that I will continue to fight to stop the unnecessary mutilation of women!

 
At Wednesday, September 17, 2008 9:49:00 PM, Anonymous Anonymous said...

Is there any other surgical procedure performed today that incites such outrage? Not that I know of.
When I was 37, I had a terrible "stomach pain". No prior history of "female problems". Zero.
10 days later (and after the pain had disappeared), a doctor performed a total abdominal hysterectomy with both ovaries, tubes & cervix removed-- for endometriosis. Pathology reports say all my organs were "normal". Prior to surgery, I had never been given a diagnosis of endometriosis. No heavy periods or cramping-- I didn't have a history of problems. I never got to try other, conservative options.
I am experiencing all the horrible effects of castration. My life has been destroyed. I can never have the daughter I always wanted. I am not the same person I was before.
Maurice- thank you for providing this forum.

 
At Friday, September 19, 2008 6:12:00 AM, Anonymous Jeanne said...

This is a complicated subject and I believe there are some common phrases that are used which keep this issue in such a state that the general public does not understand what is actually happening to women.

One of the common phrases used is "unnecessary hysterectomy". What does "unnecessary hysterectomy" actually mean? The definition of "unnecessary" is: "not necessary or essential; needless; unessential." The definition for "hysterectomy" most commonly used is: "the removal of the uterus". From the definitions, we can conclude that it describes "a needless removal of the uterus". Is that an accurate description? That doesn't sound so bad, does it?

I don't believe that the words "unnecessary hysterectomy" together or separately accurately describe the purposeful extensive physical and emotional damage that is done to a woman when it is performed without medical basis. First, in order to get a woman who does not need surgery into a surgical room, a doctor would have to tell her something that was not true. The doctor would have to purposefully make her believe that something was wrong with her to the extent that she would submit to a major surgery. That would constitute fraud. After that she signs a consent form stating that she has been given all the information about this surgery, including alternatives, risks and side effects. How would an average woman know if she was informed of all the pertinent information? Regardless, she is then put under anesthesia where she has no control over what is done to her. At that time, a doctor cuts her open and proceeds to cut all her ligaments, arteries, nerves and other organs that attach to her uterus and cervix while removing them and sewing her vagina into a closed pocket (as fully described above in a previous post).

Similarly, if a man gives a woman a date rape drug and rapes her, it is not referred to as "unnecessary sex." Women do not go to the police and say that a man had unnecessary sex with me, and unnecessarily drugged me. If that was how rape was described, it is clear that it would never be acknowledged as a crime or be prosecuted. The similarity also exists in that because the woman is drugged or under anesthesia, she may not ever completely realize what was done to her.

It is important to distinguish the difference between something that is unnecessary, as opposed to an act that is purposely done under fraudulent circumstances with the knowledge that it will cause harm. If a woman was abducted on the street, knocked out, and woke up on the curb with all her sex organs missing, the public would be horrified and outraged. What if this was being done to millions of women? The police would have a task force devoted to finding the criminal and prosecuting him. However, that is basically what is happening to women in the United States every day at the hands of gynecologists. The difference is that it is done through a doctor's office behind closed doors, and in a hospital where women assume they are safe. If a woman submits to surgery under fraudulent circumstances, and her internal organs are amputated and mutilated, what would an accurate statement be for that? If doctors who did this were accused of fraud, violence and mutilation, instead of unnecessary hysterectomy, it would shed light on the violence that is being committed and allow the criminal justice system to prosecute these cases just like any other violent crime.

The United States now acknowledges rape as a crime, but in many other countries the woman is still blamed for it. I believe that in the United States that most women are being blamed now for hysterectomy/castration, even though they were deceived and misled into a surgery room, and it was done to them while they were not conscious. If it is ever going to be stopped, we have to call it what it is. It is surgical violence against women. If a woman is raped, it creates emotional scars and sometimes physical damage that heals. When a women is violated surgically by a gynecologist, she is mutilated and the her health and well-being are permanently taken away.

 
At Friday, September 19, 2008 9:31:00 AM, Anonymous Mad as Hell said...

Jeanne - Excellent explanation! This is basically "legal" condoned rape. Sad thing is it's worse than rape since, like you said, our health is much more compromised than that of a rape victim as we've been robbed of life-giving/maintaining hormones!

I stated in my complaint to the medical board that I would have rather been raped and kicked to the curb because at least I'd still have my organs, the removal of which can never be overcome.

Based on their mission statement, any doctor that is deceptive or lies about a patient's condition is of immoral character and should therefore be disciplined.

The mission statement says "The mission of the State Board of Registration for the Healing Arts is to protect the citizens of the state through the licensing of physicians and other health designated professionals, assessing their competence to practice and their moral character. It is also the board's duty to investigate all complaints against its licensees in a fair and equitable manner."

 
At Friday, September 19, 2008 9:40:00 AM, Anonymous Anonymous said...

Here's the evidence of how these ob/gyn's "collude" to continue their revenue stream from female castration.

In 1994, a reknowned Dr. that performs uterus-sparing procedures wrote of attending a seminar on medical economics: "The topic was how to care for women in order to maximise our fee. The experts who led the discussion reminded us that gynaecologists make the most money by doing surgery and that the highest fee we can generate come from hysterectomy. With that in mind, we were urged to 'cultivate' our patients carefully. Initially care would require advice on contraception. Then, in the normal course of events, we would supervise their pregnancies and deliver their babies. Once a patient had completed her family, we were advised to plant the idea that she might some day need a hysterectomy. The culmination of our years of care would be the hysterectomy. The culmination of our years of care would be the hysterectomy. With proper planning, our advisers suggested, each year of practice would produce a lucrative 'crop' of women ripe for hysterectomy.26

26. West, ibid., pp. 28-29

 
At Friday, September 19, 2008 10:32:00 PM, Blogger Maurice Bernstein, M.D. said...

I am not going to say that the individual stories presented here are not tragic. The are. But if all the deception, abuse, physical battery and rape is occurring as described as part of the occupational intent and malicious and criminal behavior of physicians and as indicated here such has been going on for years where is the effective response of the medical boards, the specialty boards, the medical associations, the state and federal governments, the police and the courts to bring an end to all this and punish those who are guilty? Where is the press who have publicized the maltreatment of returning service men and women who were injured in the current war? Shouldn't every case, every event of criminal or unprofessional behavior on the part of any physician be reported to the police or medical boards or both? Shouldn't every victim publicize each and every instance of the police or other regulatory agencies who fail to investigate the case be publicized? Shouldn't every instance of where the police or regulatory agencies fail to clearly explain to the victim the reason that the physician is not prosecuted be publicized? Look at all the social inequities along with isolated criminal acts which has been publicized in recent years and yet I read or see nothing in the news media related to, if what is written here is true, this long running unethical and unprofessional and, if the words used are reflective, criminal behavior. So what is next?

Yes, patient education by HERS and others will be helpful and should stimulate women to challenge their doctors BEFORE the surgeries. But what else? On reading all the comments here, the injuries both physical and emotional as described sound catastrophic. So again I ask "what is next?" ..Maurice.

 
At Saturday, September 20, 2008 5:48:00 AM, Anonymous Mattie said...

What to do to stop hysterectomy/castration by deceit for profit is the question and it is a, National Emergency.
A law requiring every woman to view, Hers "Female Anatomy" video before she is tricked would stop a large portion of the unnecessary hysterectomy/castration's in the U.S. If women and their husbands knew what the lying predator ob/gyn's were really doing to them, they would run for their lives, in masses, this is a fact. I am a victim of "pretend cancer scare tactic mutilation, by deceit, by an ob/gyn practice." When I was being educated by Hers Foundation (after I was seriously mutilated and tortured by deceit by the ob/gyn's), Hers Foundation asked me; Would you have agreed to have this surgery if you knew what you know now...I answered a solid (NO). I had no cancer and what the ob/gyn said about not being able to find the cancer, until after it was removed was a blatant medical lie. What the ob/gyn said about not being able to remove the scary "tumor" was a medical lie.

OB/GYN'S are legally pretending to be cancer specialists and the general population and women do not know this. Woman blindly go in every year for a pap smear, while the majority of ob/gyn's give them no information about why they are taking a pap smear. They are not given the low statistics of female sex organ cancer and they are not given the correct information about their sex organs, endocrine function, hormones and menopause. Woman are following the, pap smear scare tactic ritual, which builds cancer fear regarding her sex organs progressively over the years subconsciously in the woman and her family.

Do any of the doctors on this "ethics blog" know why it is legal for an OB/GYN to pretend they are a cancer specialist?

 
At Saturday, September 20, 2008 8:11:00 AM, Blogger Maurice Bernstein, M.D. said...

Jeanne left a comment which contains the text of an entire article. The reference information of exactly where the article was originally published is not given. I cannot put up the text because of copyright concerns. Perhaps Jeanne will write a comment simply with a link to the website where the article was originally published and then we can all go there and read it. Nevertheless Jeanne, thanks for making me aware of the article. ..Maurice.

 
At Saturday, September 20, 2008 8:29:00 AM, Blogger Maurice Bernstein, M.D. said...

Mattie, All gynecologists must be able to manage from a surgical aspect all gynecologic cancers. That is part of their training and certification as a gynecologist. This doesn't mean they can advertise themselves as "cancer specialists" and that doesn't mean they can handle all the non-surgical aspects of gynecologic cancers. (In fact, there are gynecologic oncologists who are able to do all the cancer management and who have specific sub-specialty training.) It is unprofessional to hold oneself as having the skill and knowledge to diagnose and treat conditions for which one has had no training or certification. Period. ..Maurice.

 
At Saturday, September 20, 2008 10:04:00 AM, Anonymous Jeanne said...

Hi Maurice, sorry about the copyright issues.

Below are the links to the articles that I sent earlier. One is from the AARP July/August 2008 Magazine, and the other from a group called "What Doctors Don't Tell You." These articles corroborate what the women on this blog and the HERS blog are saying about being misled and deceived into hysterectomy/castration surgery. There are many more articles by major media all over the internet stating the same thing and since I am adding links I will add another one that came out recently from CNN "5 Operations You Don't Want to Get" (Hysterectomy being #1 on the list). One has to wonder with all this media coverage why no one steps in to stop this? I think this is because it is reported as "unnecessary surgery" or "suggested inappropriately" instead of being described as a violent crime, totally unethical and a betrayal of public trust.

http://www.aarpmagazine.org/health/
health_care_costs.html

http://www.cnn.com/2007/HEALTH/
07/27/healthmag.surgery/index.html

http://www.wddty.com/
03363800369774060019
/hysterectomy.html

 
At Saturday, September 20, 2008 2:20:00 PM, Blogger Maurice Bernstein, M.D. said...

Jeanne, thanks for the URL's that you now posted. Unfortunately they were not written in a link HTML code. Therefore I will rewrite them here as links. ..Maurice.


http://www.aarpmagazine.org/health/
health_care_costs.html


http://www.cnn.com/2007/HEALTH/
07/27/healthmag.surgery/index.html


http://www.wddty.com/
03363800369774060019
/hysterectomy.html

 
At Sunday, September 21, 2008 4:01:00 PM, Blogger Maurice Bernstein, M.D. said...

Jenny wrote today:
I had a polypectomy done at the [name deleted] hospital in Iowa City, IA by [name deleted]. I am glad for the help of the HERS Foundation and the great advice I received! Thanks and Blessings, Jenny


Please avoid, on this blog, naming names. Yes, when you contact the investigative bodies name all the names you want. But, I have no way and no time to be contacting the "names" to let them know what a visitor has written and allowed the named to present their side of the story. Investigative bodies are responsible and have the investigators to get the facts from all involved. This blog is definitely not an investigative body. It is simply a place for discussion of the general issues but not that of the issues as applied to specific others beyond the visitor themselves. ..Maurice.

 
At Tuesday, September 23, 2008 7:40:00 PM, Anonymous Mattie said...

Thank you for your previous comment to me and for your concern regarding the issue of informed consent.
I know there are no drugs or manufactured hormones to replace my body or mind to their previously happy condition.
"So what is next?" concerning hysterectomy/castration by deceit.
How about, DNA testing?; to prove this degenerative disease called hysterectomy and castration by deceit is not only degrading but medically degenerative.
If the medical community is still not willing to admit that hysterectomy/castration leads to a degeneration of the endocrine system and overall health and well being of a woman, let alone the loss of uterine orgasm and vital hormones, how about some forensic proof. With the advances in DNA testing is this possible?

 
At Tuesday, September 23, 2008 10:07:00 PM, Blogger Maurice Bernstein, M.D. said...

Mattie, I am not aware that it would be DNA testing to validate your conclusion.

With regard to "degeneration" of aspects of the patient's previous normal physiology, I think that there should be no argument about that if the ovaries and uterus/cervix are removed. With regard to the "overall health and well being", it depends on what was the pathology and associated symptoms which led to the advice for surgery and the acceptance by the patient. Certainly removal of a cancer, the stopping of excessive bleeding, the reduction of intolerable pain in some patients would actually represent an improvement in that patient's evaluation of their health and well being. The weighing of the benefits of the procedures vs the clinically known and unwanted results is a very personal matter and is something that patients should be informed about in advance and be seriously considered by the patient prior to any acceptance of the surgery.

On the other hand, hysterectomy and removal of the ovaries for speculative reasons or reasons not related to conditions previously shown to require these procedures for recovery, is to be condemned.
..Maurice.

 
At Wednesday, September 24, 2008 10:03:00 AM, Anonymous Mattie said...

Condemned and illegal would be better!, but thank you.
I know I am one of millions of women who were tricked and maimed for life. I was legally medically and surgically attacked as the previous poster has mentioned. What is so severe about this is that I am so medically harmed that I wish I would have died during the unnecessary surgery. My body and my life have been ruined along with millions and millions of other women given incorrect medical information legally by deceit for profit.
I often think about being dead now, that is the only way I will not suffer anymore and I was never a suicidal person before this was done to me. It is that I am no longer me, seriously there is no other way of saying it and I am in physical and mental anguish and pain.
If this legal attack called hysterectomy/castration by medical deceit isn't made illegal, it will go on. Woman after woman will be attacked and maimed by deceit and have their lives and bodies severely damaged or ruined. The consequences of this surgery are heinous and life altering.
Is it really necessary to keep torturing women for profit by deceit by the medical community,?
My feeling is that this is widely known by the medical community and everyone has stayed silent, this has become the largest silent legal crime in history by the nature of the subject.
Please keep speaking out about this, Dr. Mo, and all doctors reading this blog. Go on national television and warn women, this is not just a couple of women we are talking about here, it is an epidemic atrocity called hysterectomy but really it is a heinous de-sexing, mostly for profit by deceit.
Don't let these gynecologists trick women and men any more. Speak out, talk to every organization you can think of to stop this surgery by deceit. Work with Hers Foundation to end this legal medical lie.
You are one of the only doctors telling the truth about this publicly and doctors have the power in numbers to stop this living nightmare. Let me know what your thoughts are about contacting the medical community as a whole and the national media to end this nightmare would be?

 
At Wednesday, September 24, 2008 8:25:00 PM, Anonymous Anonymous said...

What's next.......

I believe HERS is doing the what next in moving the discussion and understanding of this issue from the individual counseling of women to the challenge of full disclosure to doctors and the analysis of patient information. This issue has, previous to now not come from a patient-centered perspective and has been detrimental to women and their families. We have the opportunity of correcting this long-held practice and provide women with true informed consent.

On the issue of "overall well-being" post-surgery - no matter the previous benign symptoms, one cannot swap these for the pre-disposing disease condition once reproductive/sexual organs have been removed and then claim that "well-being" has been improved.

This would clearly be a Faustian bargain in the end.
TQ

 
At Thursday, September 25, 2008 9:55:00 AM, Anonymous Mattie said...

I envision a nationally televised advertisement with a medical doctor and Hers Foundation, ending the myth of hysterectomy/castration. Simply by stating the facts and acquainting the general masses to the subject, before they become a statistic.
The advertisement would be aired during prime time. Perhaps during the evening news broadcasts and again during the most watched television programs. My thoughts are the television advertisement would fast forward the life-saving information HERS provides, save millions of women, and prompt the passing of a law to end un-consented hysterectomy/castration.
A donations fund through the medical doctors and Hers Foundation would need to be discussed. My thoughts on this are that I believe a very ambitious group of medical doctors who wanted to see an end to un-consented hysterectomy/castration, could circulate a donations fund for the Hers Foundation through hospitals and other medical organizations nationally. There must be groups of medical doctors who don't want this legal hysterectomization to continue through their careers and become their legacy some day. In history this will be the legacy of the medical doctors who practiced during this epidemic legal crime of hysterectomy/castration, by deceit. I'm hoping that many donations would be made by medical doctors who want to be known as those who stopped the epidemic and did not turn their backs to the statistically proven hysterectomy/castration epidemic.

 
At Saturday, September 27, 2008 5:52:00 AM, Anonymous Jeanne said...

In response to Mattie's post of 9/25/08 @ 9:55 a.m., I think it is a very good suggestion for doctors who want to see this medical crime ended to anonymously donate to the HERS Foundation to give HERS the power to educate the masses by creating commercials much like the presidential campaigns. I am quite sure that are many good doctors who are appalled that gynecologists have amputated the sex organs of 1/3 of the women in the United States. It only takes common sense to see that there is something very wrong about de-sexing one-third of the female population. While there are articles all over the internet about this, and this controversy has been discussed many times on TV, there still has not been enough media coverage to bring the truth out to all the citizens of the United States. This harmful medical procedure has been thrust upon the American public and disguised as a safe and simple surgery that is "needed". Women are not being told that it is an optional surgery. Instead they are being told it must be done, and it is given as the only option. Even when women ask about myomectomy, or cystectomy, they are told that those procedures are not possible for them and that hysterectomy is the only answer. This deception and the barbaric womb snatching for profit needs to stop. It may be quite difficult for any individual doctor to stop this, but if they would form a group, or just donate to the HERS Foundation anonymously, we could end this very soon. I would hope that all doctors reading this blog would think about this and take the steps to help protect the women of this country.

 
At Tuesday, October 07, 2008 2:27:00 PM, Anonymous Kiwi said...

I have a question to anyone out there if they would know the answer. On my consent form is reads an abdominal hysterectomy and I received a vaginal hysterectomy. One of the repairs that were done to me is not on the consent form. One doctor told me I can charge the surgeon with battery charges. If I understand this right I have to file a malpractice lawsuit to charger her with battery charges. If I don’t file a lawsuit what are my other options? The surgeon also told me that I told her to take my cervix and I don’t remember telling her to do this. This is a small part of my story. I feel what was done to me is considered a criminal offence. This violates an ethical standard of what the doctor was going to do before surgery. How can we stop this crime and is there any consequence for the doctors who do this.
Kiwi

 
At Sunday, October 12, 2008 6:58:00 PM, Blogger Maurice Bernstein, M.D. said...

Here is a worthy commentary by Jeanne which I received today. I am posting this myself since her link to the ABC video was not written correctly. ..Maurice.

The problem with this subject is that any discussion about it falls silent. First there are the women who post about their individual horror stories (which no one seems to want to hear). What follows are facts from medical journals, the major media and even doctors, yet nothing ever changes. There is a video on ABC news with a doctor specifically stating that this is done to women for profit and both the doctors and insurance companies are to blame. You would think that the powers that be would be outraged that women's sex organs are being amputated for profit, but yet, every discussion about this falls on deaf ears.

Here is the link to the video: http://abcnews.go.com/Video/playerIndex?id=3892479

 
At Monday, October 13, 2008 5:18:00 PM, Blogger Maurice Bernstein, M.D. said...

Kate wrote the following to me today by e-mail and gave me permission to publish it here. ..Maurice.


I was the patient of a N.Y.C. gynecologist. He was recommended to me by a neighbor whose husband was the president of the hospital. I thought I was going to a top doctor. I was in excellent health and ran 4 miles every morning. I had a pedunculated fibroid with no symptoms. The doctor recommended a hysterectomy. I refused telling him I felt perfectly well. On a routine visit about 2 years later, he announced that the fibroid had grown and needed to come out for "analysis". I asked him to remove only the fibroid for analysis. He became angry and agitated, saying,"there's no choice, no option and no alternative. If you do not listen to me, you'll be in serious trouble. I'll do a meticulous operation and be assisted by my partner, also an expert. There will be absolutely no complications and you'll completely recover. Tell your husband that you must have this operation now. I asked to see the consent form. He replied that - that's done only at the hospital. I'll go over everything with you and your husband there. A few days before the operation, his financial office called to explain that because I was having this world expert, he would require several thousand dollars over what BC/BS would pay - and they put this fee on my master card. I again asked if I could see the consent form. "No, the doctor will go over everything with you at the hospital" .
At the hospital, the intake nurse handed me a consent form. I told her the doctor would be coming to go over evrything with me and my husband and I refused it. She told me to undress and sit on a folding metal chair. After 7 hours, they called for me. They brought me through the labyrinth corridors and onto a public elevator. I felt embarrassed to be walking through the halls undressed. My husband was brought somewhere else. I was taken to the basement where the operating rooms are. Fist-pumping rock and roll music came blasting from the operating room. I was stunned and felt fear and confusion. After sitting there for one more hour, the anesthesiologist brought me into the operating room. He started an iv- I thought the doctor and his partner would be coming any moment. Instead, the anesthesiologist motioned to the door and a team came to the table- a fellow and two residents and started to operate on me. I tried to scream but it was too late. In recovery, the nurse said I could not have any pain medication as I had already stopped breathing once.The next day, I awoke to something wrong with my legs, my feet, my vagina and bladder. I was overwhelmed by what had happened. At home, I had vertigo for one week. The doctor would not return my calls. I consulted with nuerologists about a constellation of nuerological problems. I was diagnosed with acute onset of MS from the trauma of the hysterectomy. Stunned and devastated I traveled to another major medical center in another state. They concurred with the diagnosis. I brought a case against this well connected doctor but a friendly court dismissed my case and also another woman's. I appealled. My appeal was denied. I believe this happened for three reasons-1) money- this is quick easy and lucrative opertion 2) unknown to me this doctor was a director of resident training- I was a body for them to practice on 3) misogony- you really need to hate women to inflict the suffering the removal of their sexual organs causes. Imagine th outrage if a doctor removed recklessly the sexual parts of a man.
Kate

 
At Wednesday, October 15, 2008 3:48:00 PM, Anonymous Jeanne said...

Kate, I want to thank you for sharing your horrific and devastating experience. I am so sorry. I am sure it was very difficult to write it down. It's taken me time to respond because when I read your post, it just took my breath away and made me sick. I am just speechless in so many ways. I just do not understand how hospital staff can stand by and watch this done to women? It's one thing to have a mentally ill criminal doctor, but it's another thing for nurses, anesthesiologists and doctors to go along with it. I've often wondered how Hitler was able to get so many people to do such horrible things. I am finding more and more that this mentality is going on in our U.S. hospitals. They are literally attacking unsuspecting women. Why is everyone going along with the madman? It is mind boggling that these cases are only being pursued in a civil court when they are clearly criminal cases. We hear about corporate crime everyday, but what we don't hear about is medical corporate crime which is far more wicked. How is it that the medical community is immune to the laws that everyone else has to abide by? By any other standard, this would clearly be assault and sexual mutilation. A serial rapist and mutilator would have no medical basis to do this to a woman, and either does a doctor, but the doctor completely gets away with it and even gets paid for doing it! What do we do when every institution that is supposed to protect people fails us? Why isn't anyone doing anything to stop this besides the HERS Foundation?

P.S. Thank you Maurice for fixing my link and posting my comment.

 
At Tuesday, October 21, 2008 4:00:00 PM, Anonymous Anonymous said...

First, I want to express my admiration for the many women that have bravely and truthfully spoken out on the subject of unnecessary hysterectomy and castration. One of the greatest obstacles in this is the vast number of women whose silence serves to perpetuate this most vile of disparities in healthcare.
Simply put, men are not routinely treated this way. Medical guidelines call for male sexual, reproductive,and endocrine organs to be treated as conservatively as possible. It is understood that the male is not meant for castration. Small boys playing t-ball will have a protective cup to guard that which is priceless.
Sadly, our society doesn't teach women the same as regards to their sexual, reproductive, and endocrine organs. Absurd, isn't it? That we should allow that a male's organs are of import, but not a female's? Absurd that we see in our own yards the effects of hysterectomy/spaying, castration on our pets... but refuse to acknowledge that women suffer the same?
I think that it is these connections that keep so many women in denial on the subject of hysterectomy and castration. To me, there is nothing more alienating than castration.
The medical profession has no such quarter as the quiet, victimized woman does. The medical profession has studied hysterectomy and castration from the onset. Old gyn texts reveal an awareness of the outcomes that leave the reader in a state of disbelief, shock, and distrust. But don't take my word for it, buy a couple of the old books on ebay and read it for yourself.
Now I want to post on something that I think the medical profession has refused to address: the female psyche and hysterectomy and castration.
I read a medical study where attendees at a soccer game had their testosterone levels measured going into the game and again going out of the game. The results showed that half had higher levels leaving, while half the attendees had lower testosterone levels upon leaving.
What, you might well ask, was the deciding factor in someone having higher or lower levels? Was it the men whose levels were higher? No, those whose team had won had higher levels while those whose team had lost had lower testosterone levels: male and female alike.
My point? What if you don't have gonads to give you that range of testosterone/emotion? Isn't that a large part of being alive?
The female gonads also produce oxytocin-- often referred to as the hormone of mating and maternal behaviours. What if you don't have ovaries and, therefore, the ovarian production of oxytocin?
Is anyone out there naive enough to think that that does not impact not just the woman, but her husband, her children, as well?
I hold little hope for the nation that allows such an attack on the family unit.
Woolsey has shown in studies on monkeys that estrogen deprivation of ten days permanently reduces the dendrite spines of brain cells. Yes, sex steroid receptors are located throughout the body, so isn't it again absurd to hold their removal as inconsequential?
Before anyone says HRT, let me remind that the ovaries monitor the blood 24/7 continuously injecting just what you need of multiple steroids. Steroids, like oxytocin, that are not even available with HRT. Certainly not available in a dynamic "respond to the soccer game" way. Nope, no pill, patch, or creme is gonna give you that. It is no wonder that depression is inherently a part of hysterectomy and castration. And the medical profession and big pharma know/knew that...ages ago.
Our national economy now lies
failing due to the greed and graft of a relative few. What were accepted and legal practices are now, in the cold light of public hindsight, known to be unsound from inception. Protections that would have prevented this financial flu were foolishly cast aside for a quick monetary fix or a short political pull.
Allow me to suggest to you that the medical community is behaving much the same as the financial and political circles have. The consequences to them, to us, are even more terrifying.
Leading a Congressional inquiry, Senator Grassley was quoted as saying, "After questioning about 20 doctors and research institutions, it looks like problems with transparency are everywhere. The current system for tracking financial relationships isn't working."
Understand that, while Congress can investigate financial relationships, it cannot police doctors and medical procedures. No, the medical profession alone must police themselves.(sigh) I cannot help but believe that today's ever growing medical transgressions had their start in the profession's blind eye on unnecessary hysterectomy and castration. Evil is like that. It flourishes best seen but not challenged.
The best start towards medicine's policing their own, would be for the medical profession to take to heart what it actually means to be someone's medical advocate. Treat your patient as you yourself would want to be treated. Tell your patient what you would want to be told. Value their anatomy as you do your own. Use conservative measures whenever possible and, before using destructive techniques, be frank with your patient about the possible outcomes and explain why.
No one should be castrated without being told that is what is to be done to them,--like I was. The mental trauma alone was torture.
And here's a good bet: if a physician is truly their patient's medical advocate, then med mal claims won't be an issue.

The HERS Foundation is hosting their 27th Hysterectomy Conference on Saturday, Nov. 15, 2008, in Atlanta, Ga. at the Westin. Please see www.hersfoundation.org for more information. trust lost forever

 
At Thursday, November 06, 2008 10:01:00 AM, Anonymous Gracie said...

The 27th HERS Foundation Conference will be held on Saturday, November 15, 2008 from 9-6 at the Westin Buckhead Hotel in Atlanta, Georgia.

The conference will provide information not generally disclosed by physicians about the surgery, such as: Fibroids are benign and not a disease. A hysterectomy is never needed for fibroids unless you have the wrong doctor. Removal of the uterus, with or without removal of the ovaries, elevates a woman's risk of osteoporosis, osteoarthritis, heart disease and other pathological conditions,. Removal of the uterus causes the loss of uterine orgasm, an irreversible consequence. Removal of a woman's ovaries, the female gonads, is castration, with effects that are the same as removal of a man's testicles.

Hysterectomy is an unproven operation, neither its assumed worth nor its necessity have ever been scientifically proven. Register online at www.hersfoundation.org/conference.html or call HERS at 888/750-4377.

I have been at Hers Conference and if you have had or are considering a hysterectomy please attend this conference.

 
At Saturday, November 08, 2008 9:01:00 AM, Anonymous Anonymous said...

I would like to add two other little known or thought about reasons that propel unnecessary hysterectomy and castration. The first is ageism. Texts little more than twenty years old reference the forty year old woman as being geriatric.
Then, if it is even possible, there's an even uglier prejudice. In 1965 there was a conference held at John Hopkins that is detailed in the book, "The Social Responsibility of Obstetrics and Gynecology". This conference outlined a policy designed to address the problem of the population growth of what was termed "the second class human machine". The book goes on in detail as to how blacks score lower on IQ tests. The book states that population control cannot be accomplished by political man or by theological man and so must be undertaken by the gynecological discipline. There is a picture of a uterus nearly halved by an IUD and with resultant abnormal cells; yet, this is advanced as acceptable birth control. The John Hopkins conference is advocating for hysterectomy, sterilization, and for legalized abortion. The book concludes that birth control of "the second class machine" is necessary if the world is to remain "a fit place for them, for their children, and for their grandchildren". Them being the gyns. I suggest to you that this medical discipline continues on with a generational so called social responsibility that has also proved to be very profitable. You see, once a professional train of thought is on the wrong tracks, it is almost impossible for that same train to jump the track and right its' course. trust lost forever

 
At Friday, November 14, 2008 4:07:00 PM, Anonymous Jeanne said...

I am willing to bet that if this was being done to men, the title wouldn't read: Male Castration, Shortening of Penis & Prostate Removal vs. Hysteria. If this was done to a man, would he ever be described as hysterical? Of course not. There wouldn't be any controversy over it because men would not be telling other men that they feel much better and their sex life is even better after castration. Serial rapists and child molesters are given the option of castration for early release to steer them away from re-offending. The innocent women of the United States aren't given an option but wake up castrated and mutilated without committing a crime. What's wrong with this picture?

 
At Saturday, November 15, 2008 8:27:00 AM, Anonymous Mattie said...

"The American Female's New Clothes"
So obvious and socially and ethically perplexing, but why is hysterectomy/castration accepted like "The Emperors New Clothes" in our modern society. Just like the fairy tale "The Emperors New Clothes"; The crowds go along with the lies to protect women from public embarrassment and shame and to not appear stupid. But the swindlers (gynecologist surgeons and medical doctors) know all along they are medically deceiving tens of millions of women for profit.
The ob/gyn surgeon feeds the women incorrect medical information about her female organs legally and tells the woman "You are going to feel better than you ever have" and "a woman doesn't need her uterus and ovaries after child bearing" and "sex will be the same or better" and "you may have cancer, we won't know until it is found during surgery".
The gullible woman having symptoms she doesn't understand medically believes the surgeon who has dollar signs and hate disguised in their eyes as caring authority. The woman needs medical help and believes she is getting it.
Then the woman agrees after her sex organs are amputated by deceit "I feel better than I ever have and sex is great". She doesn't understand why she looks and feels so physically bad and can't climax the same, but complies with the knowing doctor and other women so as not to be perceived as dismantled sexually (Naked and Ashamed or Stupid).
Then a person knowing the medical facts shouts, "You are de-sexed and can no longer achieve a uterine orgasm/removing the ovaries is castration" and the woman is standing (truth and shame revealed/she was duped) naked in front of the world.
Is an embarrassing fairy tale acceptable medical treatment in the greatest nation in the world in 2008? Embarrassingly, YES!
The legacy of the doctors practicing today, as well, until this fairy tale turned reality is ended by law.

 
At Wednesday, November 26, 2008 11:12:00 AM, Anonymous Anonymous said...

Great analogy, Mattie!

Yes, that’s why this horrific assault on women continues to the tune of $17B a year! It’s the medical profession’s “Dirty Little Secret.” And, as you stated, the public also perpetuates it especially other women that have been victimized and don’t speak out or do speak out but say that they are doing fine/great! We now know better albeit much too late!

And we know that the states’ medical boards (which are comprised of medical professionals) also perpetuate it. The state medical boards are supposed to protect the citizens of their states but instead protect the doctors (at least in Missouri).

In my case, my LSOS surgeon didn’t even follow the recommendation of the oncologist to whom he referred me. But from what I understand, the only person the medical board interviewed was the surgeon. That’s like confronting a lying child. Of course he’s not going to admit he’s lying! And although the oncologist stated that a TAH/BSO MAY be needed (if cancer was found), his records stated that I had a family history of ovarian cancer when no one in my family has had ovarian cancer or any reproductive cancer! All my sisters and my mother still have all their parts and neither of my grandmothers had any type of cancer. So this makes me wonder if the oncologist was “covering for” the surgeon. It certainly wouldn’t surprise me based on the horror stories I’ve read! Just shows how much doctors protect each other sometimes to the point of colluding with each other!

And this all happened in my city’s Catholic “baby factory” hospital that probably doesn’t allow abortions but they sure as hell have no qualms about “killing” women via castration. I guess that’s the Catholic Church’s acceptable form of birth control!

The following comment in the 11/8 post is so true
“… it is almost impossible for that same train to jump the track and right its course. Trust lost forever.”

I suspect that’s part of the reason why you’ll never hear of a medical board disciplining a doctor for performing a hysterectomy. How do you change course from performing this surgery on 1 in 3 women to stopping it?!?

 
At Saturday, November 29, 2008 6:04:00 AM, Anonymous Anonymous said...

I would like to question how ACOG and the gyn field can ethically have two different sets of guidelines: one, which is more conservative, for the woman desiring children, and two, which is more radical/destructive for the woman who is no longer interested in childbearing. A woman's immediate thoughts on childbearing should have no bearing on her course of medical treatment. Women should be given the full range of therapies from the conservative to the radical and the consequences-not complications-of each.

Certainly, men are normally given such choice without any unknown artifical divide that relies only on their current thinking concerning children. Folks, people change their minds on these issues! And today's technologies leave that door open much longer than ever before!

The current gyn stance parades women as much like cows-- with these going into the chute for slaughter and these going into the chute for calving.

While I am on the subject of ethics, how ethical is it for women to be castrated without being told in plain English that that is what is intended?

And for those women having a hysterectomy only? Aren't men told that having their prostate removed can result in impotence and incontinence? 'Cause I know that I found this information blaring on a free educational post card at my grocery store! Why is the same material so hush-hush for women?
I suspect that men are even warned that prostate removal might cause gonadal failure. Why is a male "informed consent" so much more informative than a female's?

Personally, I believe that the reason is the same as why women desiring children are treated more conservatively: because, if it goes to court, then the awards can be very punishing. Which turns out to be a very strong argument against so called "tort reform".

The gyn field has had decades upon decades to treat women in an equal and ethical manner and has not yet lived up to its' moral obligation. To include the HERS video as an integral part of informed consent would be a great start to truly providing informed consent...and to ending this discrimination. trust lost forever

 
At Wednesday, December 03, 2008 8:27:00 PM, Anonymous Mattie said...

"A woman's immediate thoughts on childbearing should have no bearing on her course of medical treatment. Women should be given the full range of therapies from the conservative to the radical and the consequences-not complications-of each."
Trust lost forever...you have uncovered their scam.

 
At Sunday, December 07, 2008 1:55:00 PM, Anonymous Jeanne108 said...

Beware! While builders, plumbers, electricians, etc., all are required to have liability insurance, and we all have to have auto insurance by law, in some states such as Michigan and Florida, there is no law that doctors have to have medical malpractice insurance. Hospitals allow doctors on staff who are uninsured to perform major surgeries on patients. The laws are set up so the hospital is not liable for these subcontractor-doctors, and if they maim, kill or perform unnecessary surgeries, there is no recourse. To describe this as the "medical mafia" would be an understatement.

 
At Friday, December 12, 2008 1:34:00 AM, Anonymous Mattie said...

Dr. Mo, Can you tell me what a doctor who sexually mutilates women for profit, legally by deceit, would be called in psychological terms?
I have been trying to research this subject and need to know what terms I should use to continue to research this.
I assure you I wouldn't be asking a professional if I could find the explanation easily on the internet.

 
At Friday, December 12, 2008 8:30:00 AM, Blogger Maurice Bernstein, M.D. said...

Mattie, I am all in favor of activism to promote a view and it should be done if change is needed--and indeed I have advocated activism to those visitors writing on my patient modesty threads. However, just as it would be an uncivil (and illegal) approach for activists to be throwing fire bombs in the street to make their point, I also feel that it is wrong to express views for others to understand and attempt to accept in grossly inflammatory terms.

Whatever doctors do to treat gynecologic or reproductive conditions, they are not "sexually mutilating women". There is nothing sexual in the intent or behavior of the surgeon. The doctor is altering or removing a reproductive organ or structure for disease or prevention of future pregnancy with the consent of the woman. If the word "mutilation" is appropriate for any surgical cutting, tissue removal or alteration of the human body then so be it. To claim that such procedures are performed "legally by deceit" is a claim which should be substantiated in court where, in our society, legal issues are resolved.

Yes, there may be need for changes in standards of gynecologic practice perhaps including the need for fuller informed consent if not all options are given to the woman, but to color physicians as some sexual attacker and mutilator of women is I think "over the top" even for a principle promoted by activism. But that, of course, is only my opinion. ..Maurice.

 
At Friday, December 12, 2008 8:06:00 PM, Anonymous Jeanne said...

Maurice, based on your opinion and the last two posts, I would like to ask you a question. Please think about it and really try to imagine how you might feel under the circumstances of my question. Let's say you go to the doctor and you are told you have a lump in your testicle. The doctor tells you that it's probably cancer, but he won't know for sure until he goes in there. He asks you if you are done having children, and you say yes not really understanding why he would ask. You agree to surgery based upon the fact that it might be cancer which any reasonable thinking person would do. When you wake up, you find that both of your testicles and prostate have been amputated and your penis shortened. The doctor comes to your bedside soon after and assures you that it is good news, that no cancer was found. What would be your reaction?

After that was done to you, you might think that it was an isolated circumstance, but as you research, you find that this has been done to 1/3 of the male population in the United States. Wouldn't you be shocked? When you try to bring a lawsuit, you find it difficult to find an attorney because of malpractice caps, and even more difficult to find a doctor to testify. Eventually the statute of limitations runs out and while you can find no justice, you see every day that this is being done to more and more men. You find that the very doctors who are doing this to you don't call those organs your sex organs, but reproductive organs so that it doesn't sound so bad. How would you feel? How would you feel to live out the rest of your life without being able to have an orgasm, without getting aroused, all the while feeling the side effects of the deprivation of the hormones from your testicles. Is it possible that when you see that in the grand scheme of things that this is being perpetrated onto men, that you might feel that it is male sexual mutilation done legally by deceit?

Lastly, you've learned that all you had was a cyst in your testicle that could have been removed with minor surgery, but now you are totally mutilated for no good reason. How would you feel?

Female sex organs are the same as female reproductive organs (but it is a well hidden secret). This is what is being done to women to the tune of over 600,000 per year in different variations, but the end result is always the same.

 
At Saturday, December 13, 2008 7:32:00 AM, Anonymous Mattie said...

Dr. Mo,
You have said, "To claim that such procedures are performed "legally by deceit" is a claim which should be substantiated in court where, in our society, legal issues are resolved".
I am researching the psychological condition describing the characteristics necessary for a medical doctor ob/gyn surgeon to perform the "standard of care" and medically accepted treatment concerning hysterectomy (sex organ removal)/Castration. (which everyone on this blog knows is based on medical impossibilities).
One of the most glaring questions a judge, legal expert or hysterectomized woman would be interested in knowing is how? How can ob/gyn surgeons morally do this to women? A necessary question and part of an outline to be used in court to obtain a law to end the accepted current epidemic and standard of care of hysterectomy/castration.
1. Standard of care
2. The medical facts
3. The statistics
4. The history
5. The psychological makeup of the ob/gyn surgeons responsible for the epidemic

I researched and found a web site called: allacademic, which is the start of understanding the question:
How can ob/gyn surgeons morally do this to women?
excerpt:
"The Psychopath Goes To School: Examining psychopathic personality traits in different fields of study" Paper presented at the annual meeting of the American Society of Criminology"
The term “psychopathy” has often been considered synonymous with criminal behaviour. There is an emerging literature, however, that suggests that individuals with psychopathic traits might be finding non-criminal ways to express their charming, manipulative, and unemotional personalities. Babiak (1995) has explored case studies of individuals in the business world who score in the psychopath range (according to accepted measures of criminal psychopathy). The psychopaths Babiak followed were not only successful in the business context; they flourished. Entertaining the idea that particular contexts might encourage psychopathic personalities, our research examined the psychopathic personality trait tendencies of students in differing fields of study. If particular careers allow psychopaths a non-criminal avenue for expressing their personalities, then we would expect individuals with greater psychopathic personality clusters to flock to these particular fields of study. Data are presented to support this claim.

This explains it for me, how about you? Thank you for your efforts, Dr. Mo.

 
At Saturday, December 13, 2008 8:25:00 AM, Blogger Maurice Bernstein, M.D. said...

I am absolutely not denying that there are psychopaths in the medical profession, gaming the patients in ways that may at first seem reasonable but actually are satisfying the physician or nurses or other healthcare provider's unprofessional psychic needs. Who knows how many doctors enter the profession with this as a conscious or unconscious motive? And, of course, psychopaths can appear in other professions and other societal work.. perhaps even as a governor of some state.

However, it seems that there is commentary on this thread here that is painting the entire specialty profession of gynecology with the same brush. If my interpretation of the comments here is valid, is calling all gynecologists, in essence, psychopaths really ethical? Is it just?

What a visitor here might consider psychopathic behavior of every gynecologist might simply represent physicians following,as they are required, standards set up by the profession, the standards of which may need to be changed, but certainly don't represent an example of psychopathology of each gynecologist.

Mattie, thank you very much for your research and presenting it to me and to the visitors to this thread. I always look forward for my visitors to present documentation to support or reject claims made during a discussion. Again, thanks. ..Maurice.

 
At Saturday, December 13, 2008 5:59:00 PM, Anonymous Mattie said...

All medical doctors know what the ob/gyn surgeons are doing to women by de-sexing them, the medical doctor went to medical school. A General Practitioner knows one in three of their general practice patients has no sex organs. Every medical doctor from a gastroenterologist to a urologist and heart specialist is not surprised to see Hysterectomy/Castration in their patients history.
There is no defending the current standard of care concerning hysterectomy/castration. The medical facts are blatantly false and contrived thievery, an abusive maiming of the worst kind.
Why don't the non-predator medical doctors stop it...Why? The entire medical industry cashes in on the de-sexed altered woman, it causes problems, major medical problems...being passive does not make them not responsible or innocent. They are in the company of legal criminals and they know it and they have the power to stop them, why don't they?...because they profit or because they would be black-balled for rocking the money boat.
One in three women in the U.S.A, 22 Million Women Alive Today, did not become de-sexed by being told the truth. The women are being lied to medically and the numbers of de-sexed women in this country prove it.
Good point, Dr. Mo, I agree not every ob/gyn surgeon is a predator, just the majority of them. The remaining ob/gyn's stand by and watch the destruction, in my opinion that is just as heinous.
The good medical doctors of the U.S.A, need to circle the wagons and sign the, Hers, petition to end un-consented un-warranted sex organ removal/castration and fast. This is down right embarrassing for the medical doctors of this country.
Any women or woman and her partner told the medical truth about what an ob/gyn was really doing to them would run for their lives and rightly so. Passing the Hers law to end this tragic nightmare will do justice to the future generations of medical doctors, continuing to obscure the truth is beyond the boundaries of inhumanity.

 
At Sunday, December 14, 2008 1:38:00 PM, Anonymous Anonymous said...

How does one explain the removal of a healty uterus and healty ovary for a benign cystadenoma on one ovary when the oncologist I was referred to by this ob/gyn recommended TAH/BSO only if cancer was found?

Why did the Missouri medical board not discipline him?

Because the hysterectomy industry is alive and well in Missouri as it is in most other states. And, the reputable doctors don't have the "balls" to speak out! Plus, the road into the "baby factory" hospital where the surgery was done bears the doctor's name (which I believe is for his ob/gyn father). Could this be because he generated so much revenue for them?

 
At Sunday, December 14, 2008 4:04:00 PM, Anonymous Anonymous said...

Finding the word "castration" much too distasteful and graphic, gyns deceitfully came up with the euphemism of "surgical menopause". While there is everything surgical about castration, there is nothing menopausal about it. Menopause does not end ovarian function; however, castration certainly does.
Much in the same manner- and for the same reasons- gyns have shied away from the term "female genital mutilation"or "FGM". Which is not to say that the profession is not fully aware that their procedures are often the same, or have the same effect, as various modes of FGM regretfully practiced in different regions throughout the world. It is for this reason that whenever FGM laws are written that the gyn profession insists upon layer upon layer of legal protections so as to "differentiate" what they do from what is to be made illegal.
Now if any surgeon touches a patient without truly informed consent in a non essential surgery, then legally that surgeon may be charged with assault. So, legally, why shouldn't the gyn, having failed to give truly informed consent in an unnecessary procedure, not be legally liable for the crime of female genital mutilation?
Dr. Mo, I was heartened to see that you allowed that the medical profession may, in fact, have those whose minds are not well. With its' pay, prestige, and power, I suspect that the medical profession harbors many more than its' share of unsound minds. Sadly, in competing to get into medical school, I fear that those who are caring are all too often elbowed out of the way by those who can't comprehend compassion as it is its' own reward.
As to whether painting all gyns as psychopaths is really ethical, I can only begin by answering that numbers don't lie. One of three women being hysterectomized pretty much says it all. A 17 billion dollar a year business again says it all. If the profession were forthcoming with women, if it offered conservative treatment, would you have those kind of numbers? If the consent form said "castration," if it said female genital mutilation, do you still believe that you would have those kinds of numbers?
There's a book titled, "A Woman in Residence" by Michelle Harrison. It is the story of a general practitioner who goes into training to become a gyn. She writes about observing a gyn in the OR. He is between a woman's legs and rocking himself in what can only be described as a sexual
motion. In the hospital's hallways, another doctor pleads for ovaries upon which to experiment. These are but two of many examples that she details. In the end, horrified, she flees the gyn training.
The question that I have for you is this, "Do you really believe these incidents to be isolated?" And, before you answer, think of the answer that, 1 in 3 women and 17 billion dollars a year shouts.
This blog has already correctly noted how complicit every medical discipline is in their wide silence on and acceptance of these practices. Remaining silent when you are one of the few who can speak with authority against unnecessary hysterectomy and castration... Someone please tell me how that is ethical or moral?
And, you know what? However a person knowingly furthers a grave injustice, well, we've just reached my definition of a psychopath. It is far too late for me to believe in any more of medicine's self serving definitions. trust lost forever

 
At Sunday, December 21, 2008 9:59:00 PM, Blogger Maurice Bernstein, M.D. said...

Mad as Hell, wrote the following today. The link which was included was not reachable and thus I have deleted it. ..Maurice.


This is a joke! It indicates that the primary issue with informed consent is a language barrier or reading disability. We all know too well that it's much more than that!

There's a woman featured that was deceived into having a hysterectomy but didn't realize she had one until her post-op appointment. Nothing shocking to those of us that were also deceived into having healthy organs removed!

 
At Monday, January 12, 2009 1:48:00 PM, Anonymous Jeanne said...

There is news all over the internet about "Sherry Johnston" who is related to Sarah Palin because her daughter is pregnant by Sherry's son Levi. The news is that she sold drugs to a state trooper, but the real story here is about a woman who was given a hysterectomy who has had SEVEN operations following it because of pain. There are a lot of cruel messages being posted about Sherry from the uneducated public, but it's not uncommon for women who have been hysterectomized and castrated to be in pain the rest of their life, not to mention loss of sexual function, be at a greater risk for heart disease and osteoporosis, and many other symptoms. It doesn't seem to be any stretch that a woman in her condition could easily end up on drugs thanks to the handy work of an ob/gyn.

Here is the link:
http://www.parentdish.com/2009/01/09/levi-johnstons-mother-tries-to-explain-drug-arrest/5#c16491623

 
At Monday, January 12, 2009 2:58:00 PM, Blogger Maurice Bernstein, M.D. said...

Jeanne wrote the following to be posted here today:

On the Hers Foundation blog there is a new topic. "Name That Doctor and Hospital" It is way past time that the doctors and hospitals who are doing this to women be named to the public. In all these cases, these women were deceived and misled into an unnecessary surgery. There are new names posted almost every day, check it out.

Ironically, at the top of the website is the following: BLOG GUIDELINES: Discussion, debate, and respectful civil disagreement are encouraged. Comments containing abusive language will be edited and re-posted, or deleted. If you would like to post anonymously, please do so with an alias so that anyone who wishes to respond to your specific comment can address it to your alias.

I'm taking no sides on the issue of hysterectomy on this blog (despite virtually all the postings I have allowed to be posted here appear to have one stand) but I must say I fail to see civility in naming names of physicians and hospitals regarding alleged actions taken upon individuals who as anonymous writers have refused to fully identify themselves on that blog and take thus take the full responsibility for their accusations. I see no way for the doctors and hospitals to publicly defend these specific accusations outside of a courtroom or medical licensing board because of HIPAA regulations(in the U.S.)and the absence on the blog of a specific invitation for the accused physician or hospital to reply. I see no civility.

What I see is the potential for a legal libel suit as a response. Remember these comments about specific doctors are not simply going over the fence like one neighbor talking to another about their doctor and experience, it is being broadcast across the nation and the world.

The cause of HERS Foundation may be valid but this method of approach to this cause is improper,unwise and maybe illegal.

Anyway, this is my opinion as moderator of my blog and I am identified: Maurice Bernstein, M.D. Associate Clinical Professor of Medicine, Keck School of Medicine, University of Southern California.

 
At Wednesday, January 14, 2009 7:52:00 PM, Anonymous Anonymous said...

I, too, was dismayed over the number of far from understanding comments to outright ugly comments concerning Sherry Johnston.

Generally speaking, I think that we as human beings tend to be too judgmental. Faced with chronic pain and economic desperation (not only for yourself, but, for your family as well), who can say with absolute certainty what they would, or would not, do? Don't forget to factor in that mental states are always altered with severe pain and with the very drugs used to treat that pain. Science is in its' infancy when it comes to understanding what stimulates or depresses different areas of the brain as well as what, quite literally, shrinks the human brain.

As a society, we cannot allow any type of drugs to circulate unchecked; however, that does not mean that we cannot look to try to responsibly salvage what is, in reality, one of our own. Again, who on this list can say with surety that they themselves have not needed, nor will ever need, such grace?

Sadly, Sherry's life after hysterectomy is not all that uncommon. Not just the pain and multiple surgeries part but the unemployment and faltering at mate and motherhood. If you think about it, you probably know of someone whose life fell apart within about a year of their hysterectomy.

Ever hear the term "the pelvic brain"? Yep, it turns out that we do, indeed, have pelvic brains. Anyone want to guess how traumatic a surgery that removes portions of said pelvic brain can prove to be? Not to mention the endocrine, circulatory, sexual, and pelvic structural support deficits. The question of what happens to our brains without these supports, this stimulation, is one that, I think, the medical profession dares not look too closely at.

The HERS Foundation is an excellent source of further information on this topic. I strongly recommend the short anatomy video available at their site as it quickly explains so very much. HERS continuing exposure of medicine's complete abandonment of its' own commanding principle, "first, do no harm" unravels any shred of remaining credibility that the profession might try to cover itself with. HERS' expose is, simply, must reading. trust lost forever

 
At Thursday, January 15, 2009 3:06:00 PM, Anonymous Mattie said...

Dr. Mo, you said "What I see is the potential for a legal libel suit as a response. Remember these comments about specific doctors are not simply going over the fence like one neighbor talking to another about their doctor and experience, it is being broadcast across the nation and the world.

The cause of HERS Foundation may be valid but this method of approach to this cause is improper,unwise and maybe illegal."
Dr. Mo,
It is not illegal to tell the medical truth, it is legal for the gynecologists and their accomplices to medically lie to commit legal physical assault by deceit for profit called hysterectomy/oophorectomy: translation/sex organ amputation/castration and all that medically entails.
Every ob/gyn, gynecologist, reproductive specialist and medical doctor in the nation is responsible, by reason of silence, regarding the epidemic atrocity of sex organ amputation/castration by medical deceit for profit in America.

The medical professionals of America are making fools of themselves by protecting this inhuman, medically impossible, epidemic debauchery. The medical truth is written and the medical truth will be told. The days of whispering over the fence are gone, we are now in the age of instant reality, the internet. A day hopefully in the near future when the medical truth can no longer be obscured and hidden by greed and fear by the medical industry. A day when legal sociopath medical doctors no longer practice in plain view a hideous epidemic atrocity. The day when the medical truth will save tens of millions of American women from an inhuman suffering beyond the boundaries of inhumanity.

 
At Thursday, January 15, 2009 7:56:00 PM, Blogger Maurice Bernstein, M.D. said...

My point is that if the matter of bad practice which you and HERS Foundation have found is patently generic and systemic, the solution is not publicly naming physicians or institutions who follow the current standards of practice. You don't pick out specific individuals but you act in ways to change the entire perception and system. Picking on doctors is the same illogical behavior I have seen with the abortion issue. If the people of the United States desires to prevent further elective abortions, there should be a change in the laws regarding abortion and not the identifying and killing of doctors who practice medicine under the current law or personally intimidating their patients, as has occurred by some abortion opponents.

You have identified what may be an important problem in medicine but I hope you and the HERS foundation doesn't become an unnecessary problem yourselves. ..Maurice.

 
At Friday, January 16, 2009 9:08:00 PM, Anonymous Anonymous said...

Doctor Mo, you said, "the solution is not publicly naming physicians or institutions who follow the current standards of practice" but that only brings us to the catch 22 of those who are writing these standards also being the direct beneficiaries, along with their peers, of any so called standard.
My point being that the medical profession has no incentive-and every discouragement!- to set higher, more conservative standards of care as regards hysterectomy and ovary removal.
This same catch 22 applies when laws pertaining to the practice of medicine are written: the medical profession is always consulted. It is for this very reason that your statement on Dec. 12, "Whatever doctors do to treat gynecologic or reproductive conditions, they are not "sexually mutilating women"" is legally true. However, I would advance that the expert medical advocate who performs an unnecessary surgical procedure on a sexual organ is guilty of the sexual mutilation of another in an ethical sense.
I am afraid that I see no difference between the poor woman in the third world country who has her clitoris removed with a sharpened stone on a dirt floor and the hospitalized woman who has her clitoris' circulation and nerves severed (with hormone deprivation to follow) in a medically unnecessary operation. Truth to tell, the third world woman who keeps her uterus, cervix, and ovaries, is far better off as she remains more intact. In terms of sexuality, quadriplegic women have been shown to be able to orgasm thru uterine cervical stimulation alone. (It seems that there is a "direct connect" between the brain and the uterus: source, "Vagal afferents from the uterus and cervix provide direct connections to the brainstem" Collins JJ, Lin CE, Berthoud HR, Papka RE 1999 ISSN :0302-766X).
As to petitioning the courts, not only do courts defer to the self serving standard of care but a medical expert weighing in on your side is normally required. In other words, you have to find someone respected but someone willing to go against the vast majority of his colleagues. Any idea of how difficult that can be? Any idea of how long such a maverick is allowed to continue the practice of medicine? How long before he is no longer respected?
Not to mention the uphill financial and emotional burden that the already overwrought lay person is usually unable to shoulder.
Doctor Mo, I do appreciate your allowing this discussion. There has always been a divide between what is legal and what is ethical.
It is just such a grave injustice and sad commentary on medical ethics that the gynecological profession has chosen to hide within that divide.trust lost forever

 
At Saturday, January 17, 2009 1:02:00 PM, Anonymous Anonymous said...

I would like to take this opportunity to again note and elaborate upon the unfair disparity of treatment that the medical profession continues to promote between the genders. When it comes to sexual, reproductive and endocrine organs, the "standard of care" applicable to men is ultra conservative whereas for women a far more radical approach is routinely taken.
Yet the biological differences and functions between male and female organs are not as far apart as is normally thought. The uterus is to a woman as the prostate is to a man, the ovary is to a woman as the teste is to a man, and the clitoris is to a woman as the penis is to a man.

Take a moment out to think about this: both the clitoris and the penis have erectile tissue. Something else, the first gynecologist, Curtis, that actually thought female anatomy revelant to gynecology, detailed the female sexual nerves as being much the same as a man's. Later, another noted gynecologist, Dickinson, did female anatomy drawings showing the clitoris as being much larger than is normally portrayed in today's medical texts. Dickinson's drawings show the clitoris as bearing an undeniable likeness to a penis with most of the organ internal. It was only later that the clitoris was widely medically illustrated as being much smaller.

Here allow me to quote from a Feb. 1993 "Self" article titled, "The C-spot" by Lynn Snowden, "The truth of the matter is that lurking beneath the tiny pea shaped organ that is visible externally is a giant network of bulbs, valves, ducts, and spongy tissues, not to mention two long clitoral "legs." What this means is that when the clitoris is viewed as a cutaway anatomical drawing, it looks as if someone had deconstructed a penis and arranged it internally. This view is only confirmed in other drawings showing how the spongy tissue of the legs becomes blood engorged and how the glans and shaft of the clitoris become erect (sound familiar yet?) and stay erect "until resolution.""

The book that Snowden was writing about is titled, "A New View of a Woman's Body" by Gage and Rothman.

How can our medical advocates value one gender's organs--and not the others'? Why is the inherent value of these organs rarely shared with their patients? To what purpose does all of this serve?

Once, I read a medical study on
the hysterectomy rate of Saudi Arabia. It was saying that the hysterectomy rate in Saudi Arabia was pretty much equal to their cancer rate. Sobering, eh? That there is place in this wide world where women are medically treated conservatively in terms of hysterectomy.

That that place should be one where we in the US generally tend to think of as being backwards in regard to their treatment of women is astonishing. I say that I would gladly walk behind my spouse and wear whatever garb chosen if I could but be intact again. My guess is that any man would make the same bargain. True equality cannot be measured by clothes or custom. No, true equality comes only in treatment.trust lost forever

 
At Saturday, January 17, 2009 1:06:00 PM, Anonymous Jeanne said...

Dr. Mo, I don't see the analogy between doctors who perform legal abortions vs. doctors who perform unnecessary hysterectomy/castration surgeries on women for profit. When a woman makes the choice to terminate her pregnancy, it is legal and the doctor is following her wishes. When a woman is deceived into an operating room, and a doctor removes her reproductive sex organs without medical justification, without her informed consent, and in many cases, against her wishes; it is at the very least unethical, but more accurately criminal. The woman who has her pregnancy terminated is still an intact woman with all her sexual and reproductive parts. The women who is deceived into unnecessary hysterectomy/castration has lost her sex organs, has an increased risk for heart disease, osteoporosis, dementia, along with a lot of other complications that present themselves then and in the future. Hysterectomy/castration is a hideous damaging mutilating act carried out for profit. The Hers Foundation has been trying to stop this for over 30 years, but it is like trying to fight a bulldozer with a kleenex. Silence has been golden for the gynecologists who are doing this to over one-third of the women in the United States. They thrive on silence. When a doctor ruins a woman's life by deceiving her and amputating her sex organs, and every institution that is supposed to protect her, fails; it just may be the time to start naming names.

As I've said in the past, I am very appreciative of this forum and again would like to thank you Dr. Mo for hosting this controversial, yet important subject on your blog.

 
At Saturday, January 17, 2009 4:11:00 PM, Blogger Maurice Bernstein, M.D. said...

Virtually all the responses here on this thread strongly suggests that, women have the opinion that most GYN surgeons are not open and even deceptive in the information they provide for consent and they, without necessity, actually consistently harm the patient by their surgical procedures. If this is true for most GYN surgeons as suggested and yet the surgeons are not reprimanded or practices changed by their surgical academy or medical boards then that this may represent a system defect. If it is a system defect and if those who write here want the system to be changed, my request was not to identify and accuse individual surgeons about their practices, if they are following an accepted professional system and following the laws, just as with the doctors who are legally performing elective abortions. What needs to be done is to bring the concerns of those who write here to the attention of the authorities who define and supervise the system and demand investigation and change. It is unwarranted for individual physicians to be identified and verbally trashed (or worse) for a system failure.

Think about it. If mothers and fathers allow their children to become obese by not changing their eating habits, should the parents of these children be personally identified and individually publicly shamed for their behavior or should the system be changed by an intense and effective education program for all parents about this health issue and strongly encourage them to educate their children, eliminating the foods in schools that promote obesity in children and having required caloric information in fast food outlets as well as other approaches?

To change the wrong behavior of large populations of doctors or parents, it is the system that needs to be changed. I hope this explains my view about the naming of names of individual physicians. ..Maurice.

 
At Saturday, January 17, 2009 6:44:00 PM, Anonymous Jeanne said...

First, doctors who are performing abortions are not lying to their patients, they are performing a legal procedure with the consent of the patient. There would be no justification to target them individually. Secondly, parents with obese children are not lying to anyone either. While allowing a child to become obese is a detriment to their health, I think it's safe to say that the parents are not profiting off of it, nor do they intend the child harm, as misguided as that may be.

To say it is a problem with the system is only partially true. I am confident that no where in the "standard of care" does it suggest that a gynecologist deceive a patient into an unnecessary surgery, yet that is exactly what is being done on a massive scale. These deceptive conversations go on behind closed doors and nothing is ever in writing. If someone is lucky enough to be able to bring a lawsuit, the doctor just lies and it is viewed as "he said, she said" scenario. There is a lot of money being made off the removal of female reproductive sex organs, and not every gynecologist is lying and doing this, but the majority are because that is how they make their money and the fact that 1/3 of the women in the U.S. don't have sex organs is further proof. It would be very simple for the insurance companies to solve the problem and only pay doctors larger sums to remove cysts and tumors (or do nothing), but I imagine that since the older doctors were mostly trained to perform hysterectomy/castration, and now they've invested a lot of money in doing it with their robots, they don't intend to give it up anytime soon. As Dr. William Parker said in the ABC Video posted above on a different date, he blames both doctors and insurance companies for unnecessary hysterectomies, and that at least 50% could be avoided.

You suggested that instead of naming individual doctors, that the authorities who define and supervise the system be contacted and that we demand an investigation. Unfortunately, those who define and supervise are the very same ones who profit off of the removal of female reproductive sex organs. It would be akin to demanding Hitler to investigate why so many Jews were being killed at "his" death camps during WWII. Fat chance. If these doctors had any intention of policing themselves, they would have done it long ago. Instead, they have made surgical robots and started targeting younger women for hysterectomy/castration. They are even so bold as to advertise it on videos on the internet and brag about how easy it is to amputate a uterus, cervix and ovaries with the surgical robot.

There was a time when being a CEO and taking a private jet to Washington, D.C., would have been considered elite, but not anymore. There will also be a time when gynecologists who have removed women's sex organs for profit will be seen in the correct light; i.e., as criminals who would harm masses of women by sexually mutilating them through deceptive practices.

While you may think it unethical or unfair to target individuals, sometimes you have to fight fire with fire. Every individual woman that this has been done to has to live every day with the horror and health risks that have been thrust upon her through no fault of her own.

There is no easy answer that will guarantee change.

 
At Saturday, January 17, 2009 8:09:00 PM, Blogger Maurice Bernstein, M.D. said...

On the thread regarding patient modest,there currently has been going on discussion from my male visitors that they find gender inequality of medical care in terms of their inability to receive care by male nurses, orderlies and technicians as they desire in view of the visitors modesty and privacy concerns. They find the female healthcare providers ignoring their needs for bodily modesty and in fact may behave suggesting even forms of sexual abuse. Their observation is that women patients get care by the gender they desire (female) but male patients are ignored in their gender requests.

Perhaps some of the visitors to this thread might go to the patient modesty thread and read the comments there and write to the men on that thread your opinions about their concerns. ..Maurice.

 
At Sunday, January 18, 2009 10:01:00 AM, Anonymous Anonymous said...

It seems to boil down to informed consent... the need for the surgery, the consequences of the surgery, the risks of the surgey need to be explained in lay language in detail....It must surely be based on the facts of each case individually..and the wishes of each patient individually..
To perform any needless surgery would be a violation of the Hippocratic Oath in my book..
The standard of care mentioned here leaves me wondering if this principle is akin to "what would the prudent person do" except it is for the doctor.
leemac

 
At Sunday, January 18, 2009 5:21:00 PM, Anonymous Anonymous said...

There have been ases of a male having part or much of his genetalia removed..without realising when he had authorised surgery that after the fact the cancer turned out to be benig.. or without realsing the extent that the surgeon would cut out or off tissue.There are also a few cases where a guy lost a testicle by mistake...I think those are really rare though.
Although it is falling out of favor, removal of the prostate seemed to be a very common surgery.. kinda like what I have read here and other places about hysterectomies.
Among the issues at the modesty blog are also the feeling men have that because they are male...they do not care how much of them are exposed nor to whom, by many in the medical field... Something that the ladies have made great strides in eliminating for themselves...So perhaps you will make unecessary hysterectomies history as well.
leemac

 
At Sunday, January 18, 2009 6:47:00 PM, Blogger Maurice Bernstein, M.D. said...

I think leemac has brought up a good analogy between surgical practices comparing those on men with women. Prostatectomy for enlarged prostate or cancer of the prostate has been encouraged as a method of treatment for years. The procedure may end up with the man having sexual impotence. It is becoming clearer, by studies, that not all diagnosed prostate cancers need surgical removal of the prostate or perhaps any specific treatment. So what has been a standard of practice for years with unnecessary prostate surgery may be changing with these findings. Perhaps the same will occur with hysterectomies as a standared response by surgeons to the gynecologic condition. I can't believe that all hysterectomies have been performed out of the surgeon's greed. If unnecessary hysterectomies are performed it may be from inadequate scientific studies regarding the benefits vs risks. ..Maurice.

 
At Tuesday, January 20, 2009 5:08:00 PM, Anonymous Mattie said...

"If unnecessary hysterectomies are performed it may be from inadequate scientific studies regarding the benefits vs risks. ..Maurice."
Dr. Mo...Surely you jest...ha ha ha!. Please stop acting like you don't know the truth. The hystererectomy/castration epidemic by deceit for profit by American medical doctors, gynecologists, is blatant. The medical facts are clearly written and the deceit is clearly written. The numbers don't lie regarding the non-cancer found in almost all hysterectomy/castration biopsies.
Here, I'll help you...Dr. Mo.
1. Why don't the medical doctors just start calling hysterectomy and oophorectomy: Sex Organ Removal and Castration; Tell the woman her whole body will go into hormone chaos, never to return to full balance...never. Which will in turn and systematically morph her body into someone she won't recognize or know mentally and physically.
(The medical industry does not have a remedy for what they are doing to these tens of millions of women, medical fact. The doctors don't even understand all of the hormones and substances of the female sexual/reproductive organs and their impact on the woman's physical and mental well-being and health yet. Some unknown uterine substances have been found as recently as 1999 and are not not understood medically or replicated pharmacologically. The medical doctors just legally lie and act like they do know to make lots of money using false facts, cancer scare tactics and acting out their sociopath behavior legally in a perfect legal crime.)
2. And then tell the women she will no longer achieve a uterine orgasm after she has her sex organ amputated. (See how fast she and her husband will run out of the office..lol...and then you won't need to do a scientific study and spend all of that useless money because so few women would ever consent to the medical truth.

The plain truth is a gynecologist surgeon and his accomplices ruined my body and much of my mind...I feel brain damaged and am physically and mentally in pain since they assaulted me physically and the doctors know it.
This surgery has ruined my body...my life...my happiness...and turned me into someone I am still trying to figure out almost two and a half years later. I was a very sensuous woman, I was very happy, kind, thoughtful, etc. I am now a zombie compared to what I was and I scare myself. I have to fake many emotions because they don't flow freely from me as they did. One emotion that does come easily to me now is anger. Just as a man would be if a doctor cut his penis and testicles off by deceit for profit would be. And not to mention that the doctors insulted and humiliated the man afterward with a bunch of nonsense and practiced contrived confusion and reckless human disregard.

Is your tiptoeing around this subject really necessary, Dr. Mo? I believe you know how horrible this epidemic sex organ removal/castration by gynecologists by deceit for profit is and medically why.
Why are you afraid to speak frankly, Why?
Or
What do you think would happen if a medical doctor told the truth very publicly about the current Hysterectomy/Castration Epidemic? And what might that medical doctor say if they were to tell the truth?

 
At Tuesday, January 20, 2009 8:12:00 PM, Blogger Maurice Bernstein, M.D. said...

Mattie, I can't speak frankly the words you want me to speak since I don't believe that the generalization that the performance of most gynecologic procedures such as hysterectomy, oophorectomy or others represent, in fact, "deceit for profit". In fact, I refuse to accept such a generalization. Again, if you find this behavior widespread throughout the gynecologic specialty, "deceit for profit" in medicine is unprofessional and therefore you should hopefully bring it to the attention to the medical boards, the press and the government and put an end to these practices. But I can't agree with you on this issue. ..Maurice.

 
At Wednesday, January 21, 2009 4:43:00 PM, Anonymous Nora W. Coffey, HERS Foundation said...

Maurice,

Two Congressional subcommittees investigated why it is that one out of three American women is hysterectomized and castrated by the age of 60, while the rate of penectomy and male castration remains statistically insignificant. The first, in 1978, found that hysterectomies for cancer prevention or sterilization were unjustified. The second, in 1993, concluded, "90 percent are performed more out of folklore and tradition than proven effectiveness."

The testimony at these hearings did not bring about change. The hysterectomy rate remains status quo. Unrestricted, doctors continue to remove the female organs from another woman every minute of every hour of every day. 621,000 women each year. And doctors are enabled by hospitals and their staffs, as well as other doctors who keep a code of silence.

The Congressional hearings were important because they shed light on a serious, hidden problem. But they were expensive and unproductive, because they did not bring about a solution, or even meaningful action. Neither ACOG, the surgical academy, nor the medical boards you refer to took any action.

Although there is a large body of research that documents the damage caused by hysterectomy and female castration, most of the damage is self-evident and does not require more research. The uterus is a hormone-responsive, reproductive sex organ that provides structural support to the bladder, bowel, and pelvis. Women who experience uterine orgasm will not experience it without a uterus. The vagina is shortened, sutured shut at the top, and made into a closed pocket. These are the most basic of the far-reaching facts that reveal the damage caused by the surgery.

How many studies do you believe are warranted to study the benefits vs. the risks of the removal of male sex organs? It is no less ludicrous to suggest that women’s sex organs continue to be removed so scientists can study the benefits vs. the risks.

Gynecologists develop an expertise in their field by studying female anatomy and the functions of the female organs. So if they don’t know that the uterus is a sex organ and that removal of the ovaries is castration, either they didn’t pay attention in medical school or they’re lying when they tell women sex will be the same or better after hysterectomy. In fact, when women ask if sex will be changed, many doctors tell them, “No, I’m just taking out the crib, but I’m leaving the playpen.” When doctors deny women basic information about the adverse effects of the surgery, they choose not to provide them with the information required for informed consent.

It is unacceptable. It is beyond belief that an expert in female anatomy does not know that women have sex organs and that if they remove them the functions of those organs will be permanently lost. One could argue that all women should take responsibility for informing themselves, but most women do not have time to learn what doctors learn in medical school, nor do many women understand medical terminology.

The reason doctors are able to do this to women and not men is because the female organs are inside the body. The functions aren’t visible. Most women are unaware that they experienced uterine orgasm, until their uterus is removed.

When women go back to the gynecologist after the surgery to tell them they no longer have sexual feeling and now experience debilitating back, hip, and leg pain, profound fatigue, and personality change they’re often dismissed with, “I’ve never heard that before, you’re the only one.”

HERS has directly addressed “the authorities who define and supervise the system and demand investigation and change”. In fact, HERS formally notified the chairman and department faculty of Obstetrics & Gynecology at 10 of the top-ranked medical schools in America that failure to provide the 12-minute video 
“Female Anatomy: the Functions of the Female Organs” is a breach of their professional duty. Their complete lack of response to that letter speaks volumes. Although it did not surprise me, I wanted to make certain HERS had made every possible attempt to convey the magnitude of the problem to the appropriate “authorities.”

The only thing that’s going to stop them from damaging women is a law mandating that the information requisite to informed consent is provided to every women before she is told to sign a hysterectomy consent form.

As you rightly point out, “To change the wrong behavior of large populations of doctors...it is the system that needs to be changed.” Since they will never give it up voluntarily, there must be a law to compel them to provide the requisite information for informed consent.

Here are a few of the thousands of available citations:

1. Alsever JD. Lumbosacral plexopathy after gynecologic surgery: case report and review of the literature. American Journal of Obstetrics & Gynecology 1996;174:1769-1777.
2. Adler LM, Loughlin JS, Morin CJ, Haning RVJ. Bilateral compartment syndrome after a long gynecologic operation in the lithotomy position. American Journal of Obstetrics & Gynecology 162:1271-1272.
3. Richards DH. A post-hysterectomy syndrome. Lancet 1974;2:983-985.
4. Borg EJ, Gerards-Rociu E, Haanen HC, Westers P. High frequency of hysterectomies and appendectomies in fibromyalgia compared with rheumatoid arthritis: a pilot study. Clinical Rheumatology 1999;18:1-3.
5. Spector TD, Hart DJ, Brown P et al. Frequency of osteoarthritis in hysterectomized women. J Rheumatol 1991;18:1877-1883.
6. Rocca WA. Increased risk of cognitive impairment or dementia in women who
underwent oophorectomy before menopause. Neurology 2007;69:1074-1083.
7. Thakar R, Manyonda I, Stanton SL, Clarkson P, Robinson G. Bladder, bowel and sexual function after hysterectomy for benign conditions. Br J Urol 1997;104:983-987.
8. Varma JS. Autonomic influences on colorectal motility and pelvic surgery. World Journal of Surgery 1992;16:811-819.
9. van Dam JH, MJ G, Drogendijk AC, Hop WC, Schouten WR. Changes in bowel function after hysterectomy. Scandinavian Journal of Gastroenterology Supplemental 1997;40:1342-1347.
10. Prior A, Stanley KM, Smith AR, Read NW. Effect of hysterectomy on anorectal and urethrovesical physiology. Gut 1992;33:264-267.
11. Rosenberg L, Hennekens CH, Rosner B, Belanger C, Rothman KJ, Speizer FE. Early menopause and the risk of myocardial infarction. Am J Obstet Gynecol 1981;139:47-51.
12. Centerwall BS. Premenopausal hysterectomy and cardiovascular disease. Am J Obstet Gynecol 1981;139:58-61.
13. Shelton JD. Postacyclin from the uterus and woman's cardiovascular advantage. Prostaglandins, Leukotrienes, and Medicine 1982;8:459-466.
14. Parrish HM, Carr CA, Hall DG, King TM. Time interval from castration in premenopausal women to development of excessive coronary atherosclerosis. Am J Obstet Gynecol 1967;99:155-162.
15. Reyes M, Dobbins JG, Mawle AC et al. Risk factors for chronic fatigue syndrome: A case-control study. Journal of Chronic Fatigue Syndrome 1996;2:17-33.

 
At Wednesday, January 21, 2009 9:29:00 PM, Anonymous Nora W. Coffey, HERS Foundation said...

Correction to my last comment: Of the 371 gynecologists who received HERS letter (see my last comment), there was one response. It was from Dr. Sherman Elias, chair of the Department of Obstetrics & Gynecology at Northwestern. He requested 11 copies of HERS Female Anatomy DVD for the doctors in his practice.

The loss of uterine orgasm and sexual feeling after hysterectomy is one of the most frequently reported adverse effects of hysterectomy. These are a few of the available citations:

1. Levin RJ. The physiology of sexual arousal in the human female: a recreational and procreational synthesis. Archives of Sexual Behavior 2002;31:405-411.
2. Wagner G. Aspects of genital physiology and pathology. Semin Neurol 1992;12:87-97.
3. Masters WH, Johnson VE. The uterus: physiologic and clinical considerations. eds. Human Sexual Response. Little, Brown and Company, 1966:111-126.
4. Masters WH, Johnson VE. The Female Orgasm. eds. Human Sexual Response. Little, Brown and Company, 1966:127-140.
5. Utian WH. Effect of hysterectomy, oophorectomy and estrogen therapy on libido. International Journal of Gynaecology and Obstetrics 1975;13:97-100.
6. Zussman L, Zussman S, Sunley R, Bjornson E. Sexual response after hysterectomy-oophorectomy: recent studies and reconsideration of psychogenesis. American Journal of Obstetrics & Gynecology 1981;140:725-729.

 
At Thursday, January 22, 2009 3:20:00 PM, Anonymous Mattie said...

Dr. Mo,
I will say it again.
It is frightening to listen to doctors talk about women's sex organs like they don't know what they are. It is frightening to learn that the ovaries are part of the endocrine system and then be told "I have never heard of that before" by many gynecologists. I have learned more in the past two years about my sex organs, amputated by deceit, and my endocrine system, than it seems many medical doctors claim to know or will publicly admit.
This is not "The Emperors New Clothes". Hysterectomy/Castration by deceit is the most important, critical and urgent woman's health issue concerning the female population in America today. I personally feel hysterectomy/castration by deceit is a national emergency. Hysterectomy/Castration effects every member of the hysterectomized woman's family in a negative and destructive way. It has been so life altering physically, mentally, sexually, psychologically, creatively and spiritually to me. I did not believe it was possible for a doctor to take advantage of my poor endocrine health (hyperthyroid storm) and strip me of my sexual organs by legally lying profusely, but in reality that is what was done to me and 22 Million Women Alive Today In America.
Sorry you can't see the truth in front of you, Dr. Mo. Or should I say? Sorry you (as a medical doctor) can't admit it?
American President Obama, please end the legal torture of tens of millions of American women by deceit for profit by the medical industry.

 
At Thursday, January 22, 2009 3:53:00 PM, Blogger Maurice Bernstein, M.D. said...

If this is such a universal and yet unattended problem, why don't you and the HERS foundation and others write to President Obama's Department of Health and Human Services Secretary Tom Daschle explaining the issue and let's see what can be done. Another suggestion is to write to whitehouse.gov. If Obama and his staff are truly monitoring public input as they claim they will, you got there a direct link to the White House. I am sure that suggestions to reduce the cost of medical "care" by eliminating unneeded gynecologic surgery would be perfectly in keeping with the new administration's plans for revision of the healthcare system. ..Maurice.

 
At Saturday, January 24, 2009 9:04:00 PM, Anonymous Mattie said...

Dr. Mo,
Here is another good idea concerning the "unattended problem":
All medical doctors and medical industry professionals in America concerned about human life and the debilitating legal gynecologic surgical attack of the female population by deceit for profit epidemic:
"write to President Obama's Department of Health and Human Services Secretary Tom Daschle explaining the issue and let's see what can be done. Another suggestion is to write to whitehouse.gov. If Obama and his staff are truly monitoring public input as they claim they will, you got there a direct link to the White House. I am sure that suggestions to reduce the cost of medical "care" by eliminating unneeded gynecologic surgery would be perfectly in keeping with the new administration's plans for revision of the healthcare system."

 
At Saturday, January 24, 2009 11:00:00 PM, Blogger Maurice Bernstein, M.D. said...

Mattie, it's you and your group who are the one's aware of the system problem. You agree that the doctors and others in the medical system are ignoring what is actually happening to women. You can't then expect the doctors to be activists for change. If you want to change the doctors education, thinking, behaviors, standards and medical practice, it is for you and your group to take the activism lead and notify the governmental resources I suggested.
Don't expect the ignorant to take the lead. ..Maurice.

 
At Sunday, January 25, 2009 1:50:00 PM, Blogger HERS Foundation said...

Maurice,

HERS is a non-profit, non-membership international women's health education organization. Our mandate is to educate the public about the functions of the female organs, and the consequences of hysterectomy and female castration. HERS is leading the way to stop the unacceptable status quo of removing the female organs from women who have not been provided with the information requisite to informed consent.

Although only HERS staff represents the organization's position and policy, we encourage and respect diverse perspectives and opinions. HERS welcomes everyone to join the movement to change the law. These issues cross all gender, age, racial, ethnic and socio-economic boundaries. The very fabric of society has been weakened by a surgery that disables more than half a million women every year. The direct physical damage and far-reaching consequences for millions of women are irreparable.

The remedy of a law that compels doctors to provide HERS video, “Female Anatomy: the Functions of the Female Organs”, to every woman before she is told to sign a hysterectomy consent form will cure this problem for the next generation. Most importantly women, and families too, will benefit when women go from cradle to grave with their powerful female organs inside their bodies, not on a shelf in a pathology laboratory.

 
At Sunday, January 25, 2009 9:39:00 PM, Blogger Maurice Bernstein, M.D. said...

Shouldn't the discussion here on this thread ("Use vs Abuse of Hysterectomy") be whether hysterectomy and oophorectomy are procedures which should be discouraged (certainly suggested by the negative impression of virtually all the comments here and HERS video on the consequences) or or are safe and effective therapy for appropriate medical conditions?

What seems to be missing in this blog discussion is data related risk vs benefit analysis for the procedures themselves in terms of the various underlying pathologic process that requires a therapy.
Another question is whether all the negative studies on outcomes, based on the quality of the research, trump those studies which show beneficial outcomes.

I may have missed something (and maybe I did) but I just haven't seen any risk-benefit analysis here especially dealing with severely symptomatic disorders including life-threatening ones like uterine or ovarian cancer. And risk-benefit is what patient informed consent is all about. So, in conclusion, relative to the title of this thread is hysterectomy simply an abusive procedure or can it be useful? ..Maurice.

 
At Monday, January 26, 2009 4:33:00 PM, Anonymous Mattie said...

About 2 percent of the sex organ amputations in America are due to medically confirmed cancer. The remaining female sex organ amputations appear to be useful to the bank accounts of extremely warped sociopath medical doctors with legal clearance and medical doctors and their accomplices playing along with the medical charade.
I don't work for Hers Foundation, Dr. Mo. Hers saved my life after I was legally assaulted legally by the gynecological medical profession. I am concerned that this legal medical assault will continue if it isn't stopped by law though, very concerned.

 
At Monday, January 26, 2009 7:33:00 PM, Blogger Maurice Bernstein, M.D. said...

Mattie, your words illustrate the irrational and uncivil approach to expressing concerns by you and some of the others who wrote to this thread. It is clear that if patients were truly the victims of a "medical assaults" such assaults would be illegal and the police should be notified and the cases go to court. In any sense, having an examination or a procedure done on you without your permission, except in a life emergency where you or your surrogate are unable to give informed consent is a potential assault or battery on your person and belongs in the justice system and not simply reported to HERS.

A procedure in medicine which is not standard is considered experimental and not a criminal act unless performed without the patient having been been given informed consent to the procedure. Experimental procedures must however be subject to professional as well as established regulatory review. Procedures which are standard in the medical profession such as hysterectomy and oophorectomy are accepted as such for established indications but can be changed by new guidelines based on facts and set by established medical societies and institutions. Physicians themselves or patients can provide facts to these organizations which should be considered for changes in standards.

There is no benefit for other patients or to encourage acceptance of ones point of view by using terms like "extremely warped sociopath medical doctors" for those surgeons who perform hysterctomies since it is being applied to every one of the gynecologists who perform their responsible patient duties. Are they all sociopaths? Is any person who follows standards applied to their work which is unwelcome by others actually behaving as a psychiatric defined sociopath?

Yes, Mattie, you feel you were injured and still live with the scars and none of us will ever fully know under what terrible burdens you now carry. You have decided there are others suffering from the same injury and such injuries should be prevented in the future. Yes, an organization such as HERS Foundation may be one means for providing the professional organization with facts to encourage review and changes in standards. But painting virtually all gynecologists with a brush of uncivil and inappropriate words for what they are doing does not encourage review and change by the organizations but encourages disregard. ..Maurice.

 
At Monday, January 26, 2009 8:51:00 PM, Blogger HERS Foundation said...

I think an important issue for bioethicists to consider about hysterectomy and castration is "Why doctors are permitted to not inform women about the adverse effects of the surgery. And why their colleagues don't speak out against the harm they are doing by putting pressure on them and their licensing board. Doctors are in a position where they can influence medical practice, policy and standards.

The primary issue for a woman who is told she needs a hysterectomy is to be informed, by the doctor who recommends the surgery, about the consequences of removing her female organs.

Consent without the information necessary for informed consent is considered unconsented. It is framed in the law as a "battery". However, informed consent cases rarely have their day in court because it's not possible to prove what was said. And many women are "consented", that is told to sign a consent form they have not had an opportunity to read or question, while already sedated and in or on the way to the OR.

Women are systematically given false or misleading information about hysterectomy and castration and their adverse effects.

Because women who watch HERS anatomy video invariably choose not to have the surgery, we know it is an effective educational tool. When doctors will not embrace the solution to the problem, it must be made law with an effective legal remedy for those who fail to comply. HERS is working with a small group of lawyers, one of whom is a bioethicist who has published extensively about informed consent, to create a legal remedy.

Not wanting to dominate the discussion of this post on your blog, I've made few comments until last week. I'm most appreciative of the open discussion here, and in particular your willingness to engage in discussion of these critically important issues.

You've responded with sensitivity to some of the comments that seem to stem from extreme anger and hurt. Such acts of kindness take time and thought, which we all should strive to do more often.

 
At Tuesday, January 27, 2009 10:21:00 AM, Blogger Maurice Bernstein, M.D. said...

AS OF JANUARY 27 2009 THIS THREAD WILL BE CLOSED FOR ALL COMMENTS. DO NOT ATTEMPT TO WRITE ANY FURTHER COMMENTS HERE. PLEASE GO TO "USE VS ABUSE OF HYSTERECTOMY: SECTION 2" TO CONTINUE COMMENTS. ..Maurice.

 

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