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One size doesn't fit all in reproductive health

On July 8, 2013

  • Many women undergo hysterectomy surgery when there are other alternatives.

(BPT) Every woman knows that in the world of fashion, there's no such thing as "one size fits all." Yet for decades, American women have seemingly accepted the "one size fits all" approach when it comes to dealing with reproductive health issues. This one-size approach has meant that each year, thousands of women undergo hysterectomies that they may not need.
 About 600,000 women have hysterectomies each year, according to the Centers for Disease Control and Prevention. Yet many of these highly invasive surgeries are medically unnecessary. And as more women realize they have options besides a hysterectomy, more women are seeking alternative solutions by consulting with their own doctors, tapping online medical resources, and discussing their experiences and options on websites like
 In 2003, the most recent year for which statistics are available, more than 90 percent of hysterectomies were performed for benign conditions; just 10 percent were done to treat cancer of the ovaries, uterus or cervix, according to a study published in the journal Obstetrics and Gynecology. Among the most common benign conditions treated were fibroids (35 percent), heavy periods (30 percent), endometriosis and pelvic pain. The CDC notes that from 2000 to 2004, fibroid tumors, endometriosis and uterine prolapse were the three most common conditions associated with hysterectomy.
 "If a patient does not feel comfortable with a recommendation for surgery, they should seek a second opinion," said Dr. Jessica Shepherd, assistant professor of clinical obstetrics and gynecology and director of minimally invasive gynecology at the University of Illinois College of Medicine. "As a woman, I feel it is imperative that we feel we have options. Today, women dealing with reproductive health issues such as heavy periods or fibroids, have non-surgical treatment options available, too. These options come in medical and surgical forms and I always want my patients to know all of them."
 For example, fibroids or polyps in the uterus can be removed with a procedure called MyoSure, which requires no cutting into or removal of any part of the uterus. The procedure can help patients reduce heavy bleeding caused by polyps or fibroids while retaining a fully functional uterus. Heavy periods, which affect more than 10 million women, can be treated with the NovaSure procedure, a five-minute, non-surgical procedure that can be performed in your doctor's office. For more than 90 percent of women, the procedure can dramatically reduce menstrual bleeding or even stop it altogether.
 "This procedure works very well and can also be done in the office setting," said Shepherd. "For every procedure, there are those patients that may not be a candidate for them and that is why a detailed conversation with your doctor is important. Feel comfortable asking questions and getting all the information you need."
 Some serious conditions may only be treatable by hysterectomy. According to the National Women's Health Network (NWHN), these include: invasive cancer, unmanageable infection or bleeding, and serious complications during childbirth, such as rupture of the uterus.
"Fibroids do cause heavy bleeding and sometimes the size of the fibroid can be very large and they may require a more invasive surgery. Therefore it is important to talk to your gynecologist about your fibroids and all the options that can treat them," added Shepherd.
However, NWHN "believes that unnecessary hysterectomies have put women at risk needlessly, and that health care providers should recognize the value of a woman's reproductive organs beyond their reproductive capacity and search for hysterectomy alternatives before resorting to life-changing operations," according to the organization's website.
"In the end, we as women should celebrate our bodies and having engaging dialogue with your gynecologist and other women only encourages healthy lifestyles," said Shepherd. "In my forum for women's health care we discuss all the topics that you may not want to or feel embarrassed about. We want you to open up about these topics and feel empowered." To learn more about non-surgical treatment for heavy periods, polyps or fibroids, visit
Visit Viewpoint with Dr. Shepherd at and

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