In my teens, I had terrible cramps that came every month with my periods. They were so painful that I was incapacitated for one week out of every four, making my life miserable.
I went to countless doctors and specialists, who either told me to “deal with it” or prescribed medication. The drugs were so powerful that, even though they took the edge off the pain, they made it difficult to function.
After years of searching for a more sustainable solution, three separate doctors told me I should have a hysterectomy to remove my uterus. I was fifteen years old.
None of the doctors I saw did any tests or conducted any investigation into why I might be having such severe cramps. When I was finally told a hysterectomy would be my only option, no one even asked if I wanted to have children.
Thankfully, I thought this was an awful solution and started looking for other options.
I was blessed to find a kind, compassionate acupuncturist—and after a few months of acupuncture and herbs (powerful tools used in Chinese medicine), the cramps that had plagued me for years went away. It was a profound experience that showed me that healing was possible—and I fell in love with this extraordinary medicine. I also decided to dedicate my life to its study and practice. I wondered how many other women were having the same experience I had, who didn’t know there were other options for healing that didn’t require drugs or surgery.
And, it made me wonder—are doctors too quick to suggest surgery to remove organs when there may be other, less drastic options available? If so, why is this their first impulse—and perhaps more importantly—why are so many women willing to comply?
Do patients have too much trust in doctors? Are doctors lazy in recommending surgery before trying to solve the problem? Or is all this surgery a fear-driven response?
Hysterectomy–Removal of the Uterus
Apparently, my story is not unique as, according to Yale Medicine, approximately 500,000 hysterectomies are performed in the United States every year, making it the second most common surgical procedure for women after cesarean section. The Centers for Disease Control and Prevention also states that approximately one-third of all women will have had a hysterectomy by age sixty. But are all these hysterectomies necessary?
Some research suggests that most hysterectomies are elective—meaning they are not performed to save a woman’s life—and that about 90 percent of hysterectomies are not necessary because they are performed for conditions like uterine fibroids, abnormal uterine bleeding, and endometriosis for which there are other, viable alternatives.
All these surgeries come with considerable risks and financial costs to patients. According to the Hysterectomy Educational Resources and Services (HERS) Foundation, some of the most common consequences of having a hysterectomy are:
- Heart disease.
- Loss of sexual desire, arousal, sensation, and uterine orgasm.
- Weight gain.
- Osteoporosis.
- Bone, joint, and muscle pain, and immobility.
- Painful intercourse and vaginal damage.
- Displacement of the bladder, bowel, and other pelvic organs.
- Urinary tract infections, frequency, and incontinence.
- Chronic constipation and digestive disorders.
- Fatigue.
- Loss of stamina
- Altered body odor.
- Loss of short-term memory.
- Blunting of emotions, personality changes, despondency, irritability, anger, reclusiveness, and suicidal thinking.
The HERS Foundation also states that women report a loss of physical sensation after hysterectomy and that a woman’s vagina is shortened, scarred, and dislocated by the procedure. They continue by saying that armed with information on the risks, 98 percent of women HERS referred to board-certified gynecologists after they were told they needed hysterectomies, discovered that in fact, they did not need the procedure after all. They state that gynecologists, hospitals, and drug companies make more than $17 billion a year from the business of hysterectomy.
The cost of a hysterectomy depends on multiple factors (such as if the ovaries, fallopian tubes, and cervix are also being removed) and can range from $10,000 to $20,000.
Mastectomy–Removal of the Breast
According to Brigham and Women’s Hospital, more than 100,000 women will undergo some form of mastectomy every year in the United States. Although many of those surgeries are to treat breast cancer, some are done to prevent breast cancer—as in the much-publicized case of Angelina Jolie (then, Angelina Jolie Pitt) in 2013.
Jolie’s op-ed in The New York Times discussed her decision to have a preventive double mastectomy because she has a mutation in the BRCA1 gene that makes her more susceptible to developing breast cancer—her doctors estimated her risk was 87 percent. Jolie later had her ovaries and fallopian tubes removed as a preventive measure against ovarian cancer (which her gene mutation made 50 percent more likely to develop.)
What is important to note is that the BRCA1 gene mutation that Jolie has is rare and, according to the CDC, mutations to either the BRCA 1 or BRCA 2 genes that increase a woman’s chance of breast and ovarian cancer only occur in approximately 1 out of every 500 women.
Jolie wrote a second op-ed in 2015 about her decision to have her ovaries and fallopian tubes removed, but she urges women to not “leap to surgery” even if they do have the BRCA gene mutation. She writes that there is more than one way to deal with any health issue, saying the most important thing is to learn about the options and choose which one is right for you.
Around 20 percent to 25 percent of all cancer diagnoses among women are ductal carcinoma in situ (DCIS), a stage 0 cancer that is considered low risk. Few websites discussing this cancer mention that of women who present with DCIS, 80 percent never advance to invasive cancer. In other words, this stage 0 cancer will only become real cancer in less than 1 in 4 diagnosed women. Yet the vast majority will pursue treatments—and many will have mastectomies.
A study published in the Journal of Clinical Oncology in 2009 found a dramatic increase in women diagnosed with ductal carcinoma in situ, or DCIS in one breast, decided to have both surgically removed. The study points out that the rate of women choosing to have a double mastectomy for DCIS increased by 188 percent between 1998 and 2005, although the study states that the reasons why women are opting for this treatment option were unclear.
One of the study’s co-authors, Dr. Todd Tuttle from the University of Minnesota said in a university-issued statement, that “the ten-year survival rate for women with DCIS is 98 percent to 99 percent, therefore, removal of the normal contralateral breast will not improve the excellent survival rates for this group of women.” The researchers concluded that more studies are “critically needed” to understand the complex decision-making process leading women to choose removal of a healthy breast.
A review published in 2016 titled “Why Are There So Many Mastectomies in the United States?” states that evidence shows that the increasing numbers of mastectomies are a patient-driven trend that is more pronounced among younger, educated, and well-insured women, which reflects a fear of recurrence—and in some cases a misunderstanding of future cancer risks.
As with any surgery, mastectomies do come with risks. According to Cancer Research UK, some of the risks associated with mastectomy are:
- Blood clots.
- Feeling tired and weak.
- Bleeding from the wound.
- Wound infection.
- Fluid collecting around the operation site (seroma).
- Blood collecting around the operation site.
- Nerve pain.
- Shoulder stiffness.
- Swollen arm or hand.
- Scar tissue in the armpit (also known as cording).
In the United States, mastectomy surgery can cost anywhere from $15,000 to $55,00, which generally does not include the price of any reconstruction that may be necessary.
Salpingectomy–Removal of the Fallopian Tubes
Salpingectomy is the surgical removal of one or both of a woman’s fallopian tubes. The fallopian tubes are the passageway that allows an egg to travel from the ovaries to the uterus. The procedure is being recommended by cancer groups, oncologists, and other medical professionals to prevent ovarian cancer and is being used as a form of permanent birth control.
The use of salpingectomy has been increasing in recent years.
A 2019 retrospective cohort study wanted to evaluate the change in the rate of the use of laparoscopic salpingectomy for sterilization after the release of a November 2013 Society of Gynecologic Oncology Clinical Practice Statement and a January 2015 American College of Obstetricians and Gynecologists Committee Opinion: Salpingectomy for Ovarian Cancer Prevention—supporting salpingectomy for ovarian cancer prevention.
The study involved all women 21 years or older who underwent interval laparoscopic permanent sterilization between April 2013 and September 2016 at four university-affiliated hospitals in Houston, Texas, and New York, N.Y. Researchers found that the number of salpingectomy procedures significantly increased between 2013 and 2014, going from 5 percent to 9 percent, but had risen to 75 percent by 2016.
The procedure is also increasingly being used to achieve permanent sterilization compared to conventional tubal ligation. Tubal ligation is also commonly referred to as “having your tubes tied” and is when the fallopian tubes are cut or blocked, disrupting the path the eggs take from the ovaries to the uterus. It is considered a permanent form of birth control.
Although there are dangers associated with any surgical procedure, salpingectomy is considered low risk. Some common risk factors of salpingectomy, according to Johns Hopkins Medicine, are:
- Bleeding.
- Hernia.
- Unintended injury to organs in the abdomen.
- Infection.
- Scar tissue.
- Chronic pain.
- Need for a longer incision (called a laparotomy).
In the United States, the average cost of a salpingectomy—which is considered major surgery and requires anesthesia—is approximately $11,000.
A Push for More Surgeries?
A series of stories came out recently about physicians and other experts calling for more women to consider removing their fallopian tubes (salpingectomy) to reduce their risk of ovarian cancer. But it begs the question: Is all this surgery really necessary?
Why is the medical establishment pushing women to remove their reproductive organs? And are there other options? If so, are women being told about them?
Is all this surgery being fueled by doctors—or patients who are terrified of possible future illnesses and willing to remove parts of their bodies to attain some peace of mind?
Another article, published in March of 2023 from Kaiser Health News, explains that for some young people on Medicare, a hysterectomy is sometimes more affordable than birth control and lists several real-world examples.
Is Surgery the Best Option?
When it comes to any medical procedure, everyone needs to decide the best option for themselves based on their personal circumstances, all available information, and an awareness of the alternatives.
But perhaps the prevalence of all this surgery points to a deeper problem.
As women, have we lost the connection to ourselves and our bodies? Instead of loving and revering the beautiful miracles that our bodies are, have we reduced them in our minds to mechanical structures—removing parts that may not be working correctly? And are doctors using fear to guide our decisions regarding diseases or their potential in the future?
Of course, sometimes surgeries are necessary and save lives. But some doctors seem to recommend them too quickly and often when other, viable alternatives can offer relief. Removing organs is permanent, and sometimes, the long-term consequences are difficult to consider in the present moment.
Doctors may not always advise their patients of other options, and sometimes it may be because they aren’t aware of them, so do your research and know that there are always many solutions to any problem—we may have to do a bit of searching to find them. When I look into my children’s eyes, I know that—in my case—the research was worth it.