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The Scarlet H

The sign,"!Stop! HYSTERECTOMY DAMAGES WOMEN," strapped to the side of a royal-blue Subaru parked in front of the University Medical Center, caught the attention of many Jacksonians the first week of April. Standing near the car on State Street was Nora Coffey of Philadelphia, Penn., the president of Hysterectomy Educational Resources and Services, which she refers to as HERS.

Coffey is driving through all 50 states and the District of Columbia over the next year to protest against doctors performing hysterectomies without the patients having complete knowledge of the consequences of the process. She started the organization to give women who have had a hysterectomy a place where they could be helped when physicians were not accommodating with all the information surrounding the procedure.

The crusade began for Coffey after her own bad surgical experience in 1982. Due to heavy bleeding and other symptoms, doctors examined and diagnosed her with having ovarian cancer. She went to five doctors, and all said the same thing; in fact, her last doctor was a female who said that the surgery was necessary if she wanted to see her kids grow up and play.

"That is what sent me to the surgery the next day," Coffey said in an interview in Jackson. "I feel that female gynecologists are worse than males because they know how to manipulate women in ways that men could never know."

After the surgery, when she started to experience side effects including a complete loss of sexual feeling, Coffey was told by various doctors that is was all in her head. She also discovered that the ovarian cancer she was diagnosed with was really an ovarian cyst. During research in medical libraries where she spent two years of her life post-surgery, she found fairly quickly that she was experiencing side effects normal for a hysterectomy.

Using her research, Coffey decided to educate other women. HERS has counseled 700,000 women from all over the world, mainly helping them determine if they have had a correct medical exam and if the procedures that are suggested by their doctors are needed. In some instances, HERS has found a doctor for women in their area, convincing some to waive their fee and the hospital fee for women who need attention but cannot afford it.

A hysterectomy is an operation that involves removing the uterus, the hollow organ in the female reproductive system that is the womb where the baby develops. The uterus is the target of estrogen estradiol, a hormone secreted from the ovaries that helps develop and maintain female characteristics as well as stimulating growth of the uterine lining. However, with most hysterectomy procedures, an oophorectomy—the surgical removal or one or both ovaries—is also performed.

When a woman has a hysterectomy, she may experience a loss of sexuality, pain in bones and joints, back pains, extreme dryness of the skin, eyes, and genital tissues and rapid abnormal aging of tissues affecting appearance, skin and general health. Dr. Earl Stubblefield of Jackson Healthcare for Women says that the loss of sexuality after a hysterectomy is due to the fact that most women also prefer to have their ovaries removed at the same time.

"Removing the uterus does not cause a lack of sexual feeling; removing the ovaries causes the decrease in sexuality. Most women want to have the ovaries removed so that there won't be any more problems from that area," Stubblefield said, adding that the uterus has no other function than to serve as a place to have babies.

Coffey disagrees. The uterus is a sexual, hormonal, active organ whose removal predisposes one to impairment and disease. "You need it all your life," she explained.

The National Uterine Fibroid Foundation reports that the No. 1 reason for a hysterectomy is the growth of uterine fibroids that cause abnormal bleeding, pelvic pain, frequent urination, constipation and miscarriage, if the fibroid is a part of the womb. Other reasons for hysterectomies are endometriosis, which occurs when the uterine lining grows into the abdominal area, cancer (cervical, ovarian, etc.), chronic pelvic pain and prolapse, caused by the "sagging" of the uterus into the vagina due to stress. More than 12 million women have undergone hysterectomies in the last 20 years.

Stubblefield says that though he is aware of the high rate of hysterectomies, especially in the South, he does not know the reason for the excessive surgery. "I do know that there are ethnic differences in why women have hysterectomies. For example, black women are more likely to have uterine fibroids. We think it is genetic."

To prepare for her tour, Coffey contacted women from each state—whom she had previously counseled—to join her in the fight. The biggest problem she said she encountered in Mississippi is that women have said that they would participate in the protest, but, as it came closer to the time, started to pull out. The woman who was to be the Jackson contact backed out, saying, "her husband would not allow her to do it."

Coffey says women are afraid to be identified as hysterectomized. "They don't want anyone in their community to know when they have had the procedure. They feel as if they may as well as have a scarlet H on their foreheads," she said.

Billed on Coffey's Web site (http://www.hersfoundation.com) as a march against unwarranted, unconsented, unwanted hysterectomies, The HERS protest continues until March 12-15, 2005, where it will end on the National Mall in Washington, D.C.

Index: Under the Knife

• Twice as many women in their 20s and 30s are hysterectomized than women in their 50s and 60s.
• At least one in four American women will have a hysterectomy by the time she is 60 years old.
• The United States has one of the highest hysterectomy rates in the world. Rates vary geographically
with the highest rates occurring in the South and Midwest. Hysterectomy rates are higher for African-American women.
• Nearly three-quarters of all hysterectomies are done when women are between 10 and 54 years of age.
• Annual hospital costs for hysterectomy exceed $5 billion per year.
• Outpatient surgery and overnight "observation" stays are common for hysterectomies. A woman may not be fully recover for four to six weeks or longer following her surgery, depending on the surgical approach used.
-Source: National Women's Health Resource Center

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