Tuesday, December 27, 2011

New Year's Resolution: 12 Steps to Going Green in 2012

Sometimes I despair that enough people have the will to make the changes to prevent ruinous global warming; to change our habits so that future generations will not have to settle for pictures of wild polar bears and tigers and living coral reefs but will be able to see the real thing; and have clean drinking water and places to swim and healthy air to breathe. It is so discouraging to see our political leaders trying to push through the Keystone Pipeline, for example.

But then I remember all the people I know who have changed, or are trying to make changes, and all the organizations small and large who are doing the work that will lead to the consensus that's necessary. One of these is the Worldwatch Institute, a research organization based in Washington D.C.

Their good work includes a 12-step program for going green in 2012. Here are the steps, with their explanations and suggestions for what you can do, plus some additions from my own green tips.

1. Recycle
 In 2009, San Francisco became the first U.S. city to require all homes and businesses to use recycling and composting collection programs. As a result, more than 75 percent of all material collected is being recycled, diverting 1.6 million tons from the landfills annually----double the weight of the Golden Gate Bridge.

What you can do:
Put a separate container next to your trash can or printer, making it easier to recycle your bottles, cans, and paper. Keep a reusable shopping bag near the door and fill it with plastic bags that you can recycle at your supermarket.
(2) Turn off the lights

On the last Saturday in March----March 31 in 2012----hundreds of people, businesses, and governments around the world turn off their lights for an hour as part of Earth Hour, a movement to address climate change.

What you can do:
Earth Hour happens only once a year, but you can make an impact every day by turning off lights during bright daylight, or whenever you will be away for an extended period of time. In rooms that are too brightly lighted, remove some of the bulbs; use task lighting instead of filling a whole room with light. Install sensors that will turn off lights when you leave a room.
(3) Make the switch

In 2007, Australia became the first country to "ban the bulb," drastically reducing domestic usage of incandescent light bulbs. By late 2010, incandescent bulbs had been totally phased out, and, according to the country's environment minister, this simple move has made a big difference, cutting an estimated 4 million tons of greenhouse gas emissions by 2012. China also recently pledged to replace the 1 billion incandescent bulbs used in its government offices with more energy efficient models within five years.

What you can do:
A bill in Congress to eliminate incandescent in the United States failed in 2011, but you can still make the switch at home. Compact fluorescent lamps (CFLs) use only 20-30 percent of the energy required by incandescents to create the same amount of light, and now come in many versions for indoor, outdoor and decorative uses. LEDs use only 10 percent, helping reduce both electric bills and carbon emissions.
(4) Turn on the tap

The bottled water industry sold 8.8 billion gallons of water in 2010, generating nearly $11 billion in profits. Yet plastic water bottles create huge environmental problems. The energy required to produce and transport these bottles could fuel an estimated 1.5 million cars for a year, yet approximately 75 percent of water bottles are not recycled----they end up in landfills, litter roadsides, and pollute waterways and oceans. And while public tap water is subject to strict safety regulations, the bottled water industry is not required to report testing results for its products. According to a study, 10 of the most popular brands of bottled water contain a wide range of pollutants, including pharmaceuticals, fertilizer residue, and arsenic. 

What you can do:
This one is pretty simple: Fill up your glasses and reusable water bottles with water from the taps in your home.
(5) Turn down the heat

The U.S. Department of Energy estimates that consumers can save up to 15 percent on heating and cooling bills just by adjusting their thermostats.

What you can do:
Turn down your thermostat when you leave for work, or use a programmable thermostat to control your heating settings. Plant shade trees on the sunny side of your house, turn off the central air completely, open the windows and enjoy fresh air! Install solar panels to heat your hot water (the payback on your investment is quick) or an on-demand gas hot water heater.

(6) Support food recovery programs

Each year, roughly a third of all food produced for human consumption----approximately 1.3 billion tons----gets lost or wasted, including 34 million tons in the United States, according to the United Nations Food and Agriculture Organization (FAO). Grocery stores, bakeries, and other food providers throw away tons of food daily that is perfectly edible but is cosmetically imperfect or has passed its expiration date. In response, food recovery programs run by homeless shelters or food banks collect this food and use it to provide meals for the hungry, helping to divert food away from landfills and into the bellies of people who need it most.

What you can do:
Encourage your local restaurants and grocery stores to partner with food rescue organizations, like City Harvest in New York City, Food Not Bombs on Long Island, or Second Harvest Heartland in Minnesota.
Go through your cabinets and shelves and donate any non-perishable canned and dried foods that you won't be using to your nearest food bank or shelter.
(7) Buy local

"Small Business Saturday," falling between "Black Friday" and "Cyber Monday," was established in 2010 as a way to support small businesses during the busiest shopping time of the year. Author and consumer advocate Michael Shuman argues that local small businesses are more sustainable because they are often more accountable for their actions, have smaller environmental footprints, and innovate to meet local conditions----providing models for others to learn from.

What you can do:
Instead of relying exclusively on large supermarkets, shop at farmers markets, Consumer Supported Agriculture Coops (CSAs) and local farms for your produce, eggs, dairy, and meat. Food from these sources is usually fresher and more flavorful, and your money will help support local farmers. Take the Slow Money pledge and invest 1% of your assets in food growers and processors who work locally in place of a stock fund invested in who knows what, who knows where.
(8) Get out and ride

We all know that carpooling and using public transportation helps cut down on greenhouse gas emissions, as well as our gas bills. Now, cities across the country are investing in new mobility options. Chicago, Denver, Minneapolis, and Washington, D.C. have major bike sharing programs that allow people to rent bikes for short-term use. Similar programs exist in other cities, and more are planned for places from Miami, Florida, to Madison, Wisconsin.

What you can do:
If available, use your city's bike share program to run short errands or commute to work. Memberships are generally inexpensive (only $75 for the year in Washington, D.C.), and by eliminating transportation costs, as well as a gym membership, you can save quite a bit of money!
Even if without bike share programs, many cities and towns are incorporating bike lanes and trails, making it easier and safer to use your bike for transportation and recreation.
(9) Share a car

Car sharing programs spread from Europe to the United States nearly 13 years ago and are increasingly popular, with U.S. membership jumping 117 percent between 2007 and 2009. According to the University of California Transportation Center, each shared car replaces 15 personally owned vehicles, and roughly 80 percent of more than 6,000 car-sharing households surveyed across North America got rid of their cars after joining a sharing service. In 2009, car-sharing was credited with reducing U.S. carbon emissions by more than 482,000 tons. Innovative programs such as Chicago's I-GO are even introducing solar-powered cars to their fleets, making the impact of these programs even more eco-friendly.

What you can do:
Join a car share program! As of July 2011, there were 26 such programs in the U.S., with more than 560,000 people sharing over 10,000 vehicles. Even if you don't want to get rid of your own car, using a shared car when traveling in a city can greatly reduce the challenges of finding parking (car share programs have their own designated spots), as well as your environmental impact as you run errands or commute to work.
(10) Plant a garden

Wherever you live, growing your own vegetables is a simple but revolutionary way to bring fresh and nutritious food literally to your doorstep.
What you can do:
Plant something--even just some lettuce in a window box. Lettuce seeds are cheap and easy to find, and when planted in full sun, one window box can provide enough to make several salads worth throughout a season. If you don't have a sunny spot or a lot of know-how, sign up for, or help start a community garden where growing conditions are excellent and other gardeners can provide help. One example of an organization doing this is the Long Island Community Agriculture Network that I co-founded two years ago.
(11) Compost

And what better way to fertilize your garden than using your own composted organic waste. You will not only reduce costs by buying less fertilizer, but you will also help to cut down on food and other organic waste.

What you can do:
If you are unsure about the right ways to compost, check out HowToCompost and the U.S. Composting Council.  And, stop letting landscape companies remove all the leaves from your flower and shrub beds! The leaves keep the ground warm--that's good for the plants in cold climates--and add organic matter to the soil when they decompose. The leaves taken off your lawn should go into your compost pile, not a landfill.
(12) Reduce your meat consumption

Livestock production accounts for about 18 percent of all human-caused greenhouse gas emissions and accounts for about 23 percent of all global water used in agriculture. Yet thanks to concerted PR efforts that suggest a meal isn't a meal without meat, global meat production has been going up exponentially. Another important reason to eat less meat is compassion: cows, pigs and other food animals these days endure miserable lives in factories, not on farms, and are kept from succumbing to diseases with antibiotics.

What you can do:
You don't have to become a vegetarian or vegan. Simply cut down on the amount of meat you consume. As a start, consider substituting one meat meal a day with a vegetarian option.

Worldwatch points out that the most successful and lasting New Year's resolutions are those that are practiced regularly and have an important goal. With faith in each other and in the future, we can bring about the changes necessary to save our world.


Monday, December 19, 2011

Student Loans Abet High Law School tuitions

An eye-opening look at the cost of getting a law degree blames student loans for the ability of law schools to charge about $50,000 per year, when you include living and other expenses along with tuition. David Segal wrote in The New York Times yesterday that when combined with the prestige race pumped up by U.S. News & World Report's rankings, student loans have allowed law schools to disregard affordability.

The focus of the article, however, was the accreditation standards imposed by the American Bar Association. Segal writes that the standards have pretty much guaranteed that graduating lawyers have no choice but to charge high fees for their services.

If you've ever wanted to sue someone, you already know that unless you're after a minimum of $25,000, you should abandon the idea. It's just not worth it after you calculate what your lawyer will get.

The ABA's stranglehold on legal services prevents the U.S. from having categories of legal professionals who can charge less than lawyers who've passed the bar. In Britain there are other less expensive alternatives like legal executives who can appear before courts and represent clients in different sorts of matters.  Without having done any exhaustive research on the subject, it sounds like they are something like the legal version of physician assistants.

The bottom line is that although we all joke about lawyers and lament that there are too many of them, consumers could definitely benefit from access to less expensive legal help. Instead, anyone who dispenses legal advice without having gone to an ABA-accredited school (except in a few states like Tennessee) is breaking--you guessed it--the law.

Tuesday, December 13, 2011

Their stories: Slaves to Student Loans

They tell their stories with anguish, with anger, with hopelessness and with numbers. They are the victims of a student loan system designed to guarantee big profits to lenders for years to come while enslaving borrowers with outrageous terms of repayment.

You can see their pictures and read their words at a new Occupy Student Debt website. There's the 27-year old woman with $100,000 in debt who can't find a job paying more than about $12/hour. She wants to send her useless diploma to Sallie Mae.

There's the widow who went back to school at the age of 48 to get a Master's Degree and the chance at a better job as a school teacher. She's now 55. She figures that she'll be 77 before she pays off her loan.

There's the 63-year old father of 3, a physician no less, who even pre-paid tuition to lock in lower rates. But college for 2 of his children ended up costing more anyway, and he's now stuck with $42,000 in loans that carry interest rates of more than 8%, with payments in the early years going only for interest, not to pay down principle. He compares that to the terms of his home mortgage and home equity loan, both with interest rates under 4% and terms that make prepayment a smart idea.

These stories show how the banks succeeded in getting the U.S. Congress to make student loans immensely profitable for lenders and uniquely onerous for borrowers.

With interest rates so low now, refinancing a home mortgage, for example, can save a home owner lots of money, as long as they have a good enough credit rating to convince a bank to do the refinancing. You can also declare bankruptcy if you fall behind. You'll lose most of what you own, but at least you'll be able to start fresh.

But no, there are no opportunities to refinance a student loan at lower rates. Lenders have no reason to offer them. Nor can you go bankrupt. The law doesn't allow it. There is no escape.

Read their stories. 400 of them so far. Each one proof that our elected representatives care much more about banking industry campaign contributions than the plight of their constituents.

Monday, December 5, 2011

College Presidents' Pay Up Despite Economy

Thanks to the Chronicle of Higher Education, we have just learned that the pay of private college presidents continued up in 2009 despite the economy. As reported in The New York Times, 36 presidents had an average increase of 2.2 percent. Most interesting to me is the chart showing their compensation as a percentage of university expenditures, ranging from 1% to a high of 3.5% for a school I'd never heard of: Mountain State University in West Virginia.

This president, Charles H. Polk, pulled in $1, 843, 746 in 2009.

In defense of his and other million dollar plus pay packages, David L. Warren, president of the National Association of Independent Colleges and Universities, told The Times: "There is just a small pool of candidates who possess the skill set that is required and are willing to take on the stressful 24/7 nature of the position."

The Times reporter didn't bother to quote anyone critical of these pay scales, much less anyone from the Occupy movement.

So Mountain State must be an excellent school, right? Wrong. Instead, the school may lose its accreditation early in 2012. A show-cause order by the Higher Learning Commission cited problems of monitoring of student progress, governance, and--get ready for it-- availability of resources. Seems to me that with a performance like that, everybody at Mountain State should be questioning his "skill set."

The other interesting chart shows the presidents' compensation as a multiple of average pay for professors--not adjuncts, of course, but the full-time profs. That ranges from a high of 16.1 for Stevenson University in Maryland to a low of about twice for the president of Wabash College in Indiana. Five other presidents earned at least 10 times as much as their full professors.

Stevenson has been undergoing rapid expansion in the last several years so that may be why its board of trustees thinks president Kevin J. Manning deserves to be paid so much more than the professors, a rich package worth $1,493,655. If I were a student there with student loans, I'd sure want to ask them.

Wednesday, November 30, 2011

The Equalizer/Frances Cerra Whittelsey: Student Loans Enable Sky-High Tuitions

The Equalizer/Frances Cerra Whittelsey: Student Loans Enable Sky-High Tuitions

Student Loans Enable Sky-High Tuitions

A few years ago, the chiropractor who was working on my back confided in me that she'd never be able to own a home because she had racked up a massive amount of student debt. She explained that she had taken out student loans to pay for chiropractic school expecting a big payoff, but then health insurance companies had essentially stopped paying for chiropractic visits. So she had gone back to school to become a licensed acupuncturist. That additional skill had not paid off either.

Now she had debt approaching $100,000 and saw no possibility of ever paying it off.

So I naively suggested that she declare bankruptcy to get out from under. I was incredulous when she told me that bankruptcy was not allowed under the laws regulating student loans.

But I quickly learned she was right.

Now, as Occupy Wall Street has morphed on campuses into the Occupy Student Debt Campaign, students facing a bleak job future are demanding relief from tuition increases. Meanwhile, an on-line effort to start a boycott of making debt payments has begun, and everyone involved in higher education is talking about ways to contain costs and give graduates some measure of relief from their debts--although not through bankruptcy.

Left out of this discussion is the elephant in the room: the role that the student loan program itself has played as colleges and universities ratcheted up the price of tuition by 50 percent in the past decade. Patrick M. Callan, president of the Higher Education Policy Institute, indirectly pointed it out recently when he said that huge federal funding increases in Pell grants under Presidents Clinton, Bush and Obama had "been absorbed by tuition increases."

He went on: "And with all that we've invested, we have a less affordable system than we had a decade ago. We're on a national treadmill."

Imagine how different the situation would have been if prospective college students and their parents had had to pay tuition out of current income or from loans whose repayment was not deferred until after graduation. Top administrators at colleges and universities wouldn't have been able to raise their salaries to astronomic heights. They couldn't have engaged in a luxuries arms race with other institutions, building campuses gilded with state-of-the art fitness centers, elaborate theaters and stadiums, ski areas, golf courses, arboretums and dorms that, in the case of Princeton, have been described as "a billionaire's mansion in the form of a dorm."

They were able to raise their prices knowing that students would simply borrow more to compensate. No one questioned whether the pay the students should expect after graduation had gone up enough to cover the added amounts. It's not substantially different from giving new home buyers mortgages that could never be supported by their income, except that with student loans the banks don't even have to repossess anything. In fact, they face virtually no risks.  Thanks to laws passed by Congress, student debtors become indentured servants, obligated to a lifetime of payments--or maybe 20 years of them under new proposals--since they can't relieve themselves of the debt by going bankrupt.  Worse still, students who miss payments can easily end up in a cycle of punitive fees that makes their debt balloon even bigger. 

The high pay of university administrators and the luxury facilities, of course, have little or nothing to do with education. Most colleges and universities save on the actual cost of teaching by making heavy use of adjunct professors instead of hiring more full-time. As one myself, I can tell you that they haven't invested those tuition increases in higher adjunct pay although adjuncts teach so many of the required courses at the core of a college education. In fact, anyone who wants to live on the pay of an adjunct becomes an itinerant, driving from one campus to another trying to cobble together a big enough load to make a meager income.

Seen from this perspective, student loans have enabled spending sprees by the administrators of our colleges and universities who didn't have to worry--until very recently--about making their schools unaffordable.

Now, with so much money sunk into facilities, administrations have little room to maneuver. Perhaps it's time to take a hard look at cutting those top salaries, as some have done, at eliminating top-heavy staffs, and pulling back to a focus on the core mission of education. In 2008, 23 university presidents earned more than $1 million. The NY Times reported that the median pay for presidents of the 419 private colleges and universities surveyed by the Chronicle of Higher Education was $358,746, a 6.5 percent increase over 2007. Over the five years previous years, the median presidential pay grew by 14 percent, and that is adjusted for inflation.

And lest you think this applies only to private institutions, consider that the median total compensation for public college presidents in 2009-10 was $375,442, according to the Chronicle of Higher Education.  E. Gordon Gee, the president of football power house, Ohio State, topped the list, earning more than $1.3-million in total compensation. 

Not incidentally, sports programs at public and private schools more often lose money than make it. Overall, only 12% of college athletic programs are profitable, according to the NCAA. Even most football programs--57%--lose money. 

Funneling more money into loan programs won't help stop spiraling tuition prices. Unfortunately, that will just continue to enable the spending sprees that have created the crisis we're in. NYU professor Andrew Ross, who has started the campaign for a boycott of loan payments, is, among other things, calling for private and for-profit colleges to open their books so the public can see just where all that tuition is going. The books of public colleges should be open, and citizens should demand to know which aspects of spending have priority.

Ross has also recognized, as he told the NYU student newspaper blog, "that my own salary is debt-financed. … There’s an element of complicity. It’s an incredible burden for faculty to bear.”

Now we need to hear that same sentiment coming from university presidents, along with some serious rethinking of spending priorities. When we do, we might begin getting back to a realistic balance between the cost of a higher education and the income students can expect after graduation.

Wednesday, October 12, 2011

Love Your Body/Love Your Uterus

Say what?  Love your uterus? You'd better. We need to love our bodies, inside and out.

This post is part of the 2011 Love Your Body Day Blog Carnival sponsored by the NOW Foundation.  The focus of this campaign is fighting self-hatred because we’re too fat, too old, too flat, too wrinkled, too unfashionable. But we need to look inside our bodies as well and love the "sacred" organs, as one enlightened doctor described them, that make us female.

The fact is that there is an ongoing epidemic of unnecessary hysterectomies in the U.S. In no other country in the world, developed or otherwise, do one out of three women end up without their uterus by the time they are 60, a toll of about 600,000 women a year. And about half lose their healthy ovaries at the same time.

The unnecessary loss of one's sexual/reproductive organs can cause a profound loss of self-esteem tied to real physical and sexual changes that can't be fixed with a diet, cosmetic surgery, a change in attitude or replacement hormones.
For far too long, American women, including myself,  have been agreeing to let doctors cut out our organs because we didn't know the consequences and because the doctors told us we really didn't need them any more if we'd already had our babies. This attitude by doctors was born of ignorance but reinforced by sexism. Why would women past 40 need to worry about sex anyway? With replacement estrogen, after all, they could still have intercourse!

Sadly, this attitude is still prevalent, even among women gynecologists trained by a male-dominated medical establishment. Women with bleeding or pain problems too seldom learn about alternatives to hysterectomy, and even less often about the importance of our organ to our lifelong health and our view of ourselves.
I first realized this when I heard a gynecologist speaking reverently about the uterus and ovaries. He actually called them “sacred!” I had never understood that the uterus is a powerful muscle even though it has to be. That’s how women push their babies out. Nor did I understand that the uterus is central to the structural integrity of a woman’s body, like the keystone in an arch that keeps everything together.  Here’s a structural description, taken from the text of an informative video on the HERS Foundation website:
     The uterus is attached to broad bands of ligaments, bundles of nerves, and networks of arteries and veins…The severing of the ligaments (done for hysterectomy) permits the pelvic bones to move and widen, affecting the hips, lower back, and skeletal structure.
    The displacement of the pelvic bones results in compression of the spine. 
Women report that as the spine compresses, the rib cage gradually drifts down until it sits directly on the hip bones.  This compression is the reason why hysterectomized women have protruding bellies and little or no waist.
   The bladder sits in front of the uterus, and the bowel sits behind it.  The uterus separates them and helps keep the bladder in its natural position above the pubic bone and the bowel in its natural configuration behind the uterus.

Recent research shows that significant numbers of women are alarmingly ignorant about their reproductive/sex organs. A survey of 1,273 adult women this year found that 30% didn’t even know that removing the uterus would stop menstrual activity, and 13% didn’t know they couldn’t get pregnant without a uterus.

Dr. Oz Harmanli, the Springfield, Massachusetts urogynecologist who led the study, said in an interview that “younger women are almost clueless” about the functions of the uterus, cervix and ovaries. The purpose of the study, he said, was to highlight the need to give women more information so that they can make a well-informed choice about having a hysterectomy. 

Dr. Harmanli, who is director of urogynecology and pelvic surgery at Baystate Medical Center and an Associate Professor of Obstetrics and Gynecology at Tufts University School of Medicine, is refreshingly candid about the penchant of American gynecologists to cut out women’s organs. 

“I come from Turkey, been here over 20 years, trained here, started practicing here,” he told me. “When I go back to Turkey (for meetings), when I suggest hysterectomy for certain conditions, they look at me like I came from Mars.”

He continued: “The climate here created by practitioners, and by tradition in families (successive generations having hysterectomies) is that loss of the uterus has not been considered such a major loss compared to other cultures and countries.” He added that there are many complex factors behind the uniquely high rate of hysterectomies in the U.S. I believe that money is one of them: hysterectomies bring in enormous income to both doctors and hospitals; hysterectomies are the second most common women's surgery, behind only Caesarians.

Elsewhere on this blog I have described the serious health problems, shortened life span and sexual problems that result from hysterectomy and removal of the ovaries. There is simply no good medical reason why one-third of American women end up without a uterus compared to, for example, one-fifth of British women. The situation is outrageous, full of long-term implications for the general health of American women and the price women pay for health care via insurance premiums and out-of-pocket.

We’ve allowed gynecologists to define our organs as reproductive and therefore unnecessary once we’ve had all the children we want. But our organs are as central to our identity, our energy, our joy in life,  as surely as men’s testicles are to theirs.

So learn more about these vital organs. Love your uterus and your ovaries even though you can’t see them in the mirror!

Wednesday, September 21, 2011

Doctors' Group Ignores Hysterectomy as a Cause of Incontinence; Urinary Problems Cost U.S. Women $13 Billion/Year

They call themselves Urogynecologists, women's doctors who do not deal with pregnancies or infertility or  hysterectomies, only what they refer to as "pelvic floor disorders" including urinary incontinence. So you'd like to think they'd be upfront about the fact that hysterectomy is one of the major reasons why 40% of all U.S. women find themselves leaking urine by the time they hit the age of 60. (Interesting coincidence: that's the same percentage of women who undergo a hysterectomy by the time they are 60.)

In fact,  a very large and long study of Swedish women found that a woman's chance of incontinence at least doubled after a hysterectomy.

This group of doctors has even put a price tag on what it costs women to deal with incontinence: an average of $15 a week for pads, laundry and dry cleaning. If you multiply that by the 17 million women--a low estimate--who have this embarrassing problem, and then by 52 weeks, you find out that incontinence is costing American women at least $13 billion a year. This calculation does not include the cost of the various prescription medications now being promoted by drug companies to relieve incontinence.

Yet, you can search the website of the American Urogynecologic Society (AUG) or their new information website, Voices for PFD, and you won't find a mention of hysterectomy. The closest you get is this statement with its vague reference to surgery: "Sometimes, very clear-cut events such as pregnancy, vaginal delivery, surgery, radiation or accidental injury can lead to these kinds of problems..." Notice that all of these causes of incontinence are essentially unavoidable--except surgery for hysterectomy, which is avoidable with other treatments in 70 to 90% of cases.

But wait, these doctors have a solution to incontinence, once you've got it:  More surgery! Last year, the AUG released results of a study showing that two years after women had surgery to try to cure stress urinary incontinence, their cost per week had dropped to $4 from $15 while their episodes of incontinence dropped from 23 per week to 3. Hooray.

The final irony is that just a few days ago, the AUG released its own study of information about incontinence on various web sites and found them "inadequate." Two physician reviewers evaluated more than 50 websites and found them "not comprehensive, relevant or accurate."

I tried to reach Dr. Steven Minaglia, a Hawaii-based physician whose team reviewed the websites, but he had left for a trip to China. Perhaps when he gets back he can ask them to review why AUG's own website doesn't bother to tell women about the connection between hysterectomy and incontinence.

Perhaps he could start by having them review the Swedish study.

Tuesday, September 13, 2011

Hysterectomy is a Feminist Issue: 1 in 3

The Ms. Magazine Blog now features an article I wrote that gives some of the shocking information about the epidemic of hysterectomy. I have been amazed for a long time that this most feminist of issues is not on the radar of feminist organizations despite the huge impact of these surgeries on women's health, well-being and relationships.  I've struggled to understand why. Partly, I think, it's because the surgery is simply so common. Breast cancer advocates have made women very aware that their life-time risk is 1 in 8. But consider: 1 in 3 women 60 and older no longer has a uterus!

That's right, 1 in 3. It's just about a right of passage for older women.

But as I say in the Ms. blog, we who are the 1 in 3 have got to speak up. We can't let this continue. Keeping our condition a secret because we're embarrassed, afraid of being regarded as less of a woman, or as being too unaware to prevent our doctors from doing this to us--well, we've just got to get over that the same way women who've lost a breast have done so bravely.

Tuesday, September 6, 2011

Summarizing the Risks of Hysterectomy

When a women has surgery to remove her uterus, and way too often her healthy ovaries at the same time, she increases her risk of dying prematurely, diminishing her sex life, and suffering from a host of other health problems.

Here's a quick summary of the Risk Increase shown by some of the research, with sources:

Hysterectomy Alone
  • Incontinence: 60% greater risk by age 60 than an intact woman ("Vital Signs: Consequences; Hysterectomy and Risk of Incontinence." The New York Times, Aug. 22, 2000. By Eric Nagourney
  • Coronary Heart Disease: 3 times grater risk if hysterectomy done before menopause (American Journal of Obstetrics & Gynecology, Jan. 1981; 139 (1):58-61)
Oophorectomy (removal of ovaries)
  • Early Death: twice the risk if ovaries removed before age 45 and no estrogen replacement given ("Survival patterns after oophorectomy in premenopausal women: a population-based cohort study." Lancet Oncology Volume 7, Issue 10, 2006, pp.821-828; by W.A. Rocca, MD, and others.)
  • Dementia: 33% higher over all than women who keep their ovaries through menopause; 74% higher if her ovaries are removed on or before age 43 ("Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause." Neurology 2007; 69:1074-1083; by W.A. Rocca, MD, and others)
  • Heart Attack: double the risk if a woman loses her ovaries between the ages of 40 and 44; 40% higher if ovaries removed after age 50 ("Ovarian Conservation at the Time of Hysterectomy for Benign Disease." Obstetrics & Gynecology, Vol. 106, No.2, Aug. 2005
  • Bone fractures from osteoporosis: 54% more fractures when ovaries removed after menopause (same study, Ovarian Conservation, etc., cited above)
This is not a list you will find in any of the literature given out by gynecologists. Nor, when they try to talk women into letting them take out their ovaries while doing the hysterectomy, will they reveal that the average woman's risk of ovarian cancer is 1 in 72 (or 1.39% over her lifetime). By comparison, the lifetime risk of breast cancer is 1 in 8 (or 12.15% over her lifetime).

Of course, some women have genetic and family risk factors for ovarian cancer that make their decision much more difficult. I feel for them. But for other women, a gynecologist who uses the fear of ovarian cancer to convince her to consent to ovary removal is nothing less than unethical. Such a doctor should do women the favor of finding some other line of work.