In Honor of Ovarian Cancer Month: Hold On To Your Ovaries!

Shame on The New York Times for printing a one-sided article touting the benefits of female castration as a way of preventing ovarian cancer. The article reported on a study of women who had inherited the BRCA1 or BRCA2 mutations that increase the risk for breast and ovarian cancer. Of the women who kept their ovaries, 6 percent developed ovarian cancer, compared with 1 percent of those who gave permission to remove their ovaries.

Ovarian cancer is deadly serious: 15,000 women a year die from it, and the Ovarian Cancer Alliance has marked September for observance of Ovarian Cancer Awareness Month. Fear of ovarian cancer is the major reason why about 300,000 women a year permit doctors to remove their ovaries, usually at the same time as a hysterectomy. However, only a small percentage of those women have the BRCA mutations; they face a lifetime risk of only 1.39% of developing ovarian cancer (or 1 in 72), while the risk of breast cancer over her lifetime is 12.15% (or 1 in 8), according to the National Cancer Institute. So using fear of ovarian cancer to convince a woman who does not have the mutations to have a hysterectomy, is clearly unwarranted.

Now the question is, how warranted is such a recommendation for women who do have the mutation? Well, if all we were talking about was removing some non-essential or at least less-essential body part--even a breast--then trading a 5% risk for a 1% risk of a deadly cancer, for which there is no good treatment, might indeed be a sensible option.

But no woman should make that choice until she understands all that she will be sacrificing along with her ovaries, and the added health risks that accompany this drastic decision.

As I've blogged about before, losing your ovaries is literally castration and brings on not only a sudden, intense menopause, with severe hot flashes, mood swings, loss of energy, etc., but also drastically raises the odds that a women will suffer other serious problems as a result. A study published in the journal The Lancet in October, 2006, found that women castrated before the age of 45 double their risk of death from heart attack. Some previous studies put the increased risk of heart disease at 5.5 times, regardless of age at time of operation.

And then there are the increased risks for osteoporosis and bone fractures and Parkinson's disease and other forms of dementia.

As for women who have enjoyed sex--well, they can say good-bye to their former selves. Our ovaries continue to function long after menopause, still producing some estrogen and other hormones. Without them, welcome to the world of dry. Libido--gone or dramatically reduced. Ability to feel and enjoy--women can't even remember what it felt like. Impact on your relationships--depends on how understanding and tolerant is your partner.

The Ovarian Cancer National Alliance is pushing for an increase in funding for research for a test that would detect ovarian cancer at an early stage, and for a cure. Amen to that.

But the next time The New York Times or anyone else publishes an article about ovarian cancer prevention through castration, they ought to be sure to tell women about the increased risks and poor quality of life that they will be endure as a result.

1 in 3 American Women Castrated

Castration is an ugly word, but it's the right word to use when talking about the 600,000 American women who have their uteruses removed every year! And of them, 438,000 simultaneously have their ovaries cut out also. One out of three American women over 60 lives on without her uterus or ovaries, and is never the same for their loss.

Never the same sexually: a woman who always had uterine contractions during orgasm can't have them ever again after a hysterectomy. Furthermore, even if her ovaries are not removed, sexual sensation is diminished because of the severing of nerves and lowered flow of blood to the vagina, labia and clitoris. If a woman consents to removal of her ovaries also, she is thrown into an immediate and crushing menopause.

As someone who underwent uterine removal in her 40s, I am speaking from personal experience, but to get a sense of how bad it is for women take a look at both the website of the HERS Foundation and its associated blog and comments. The foundation's mission is to stop this continuing assault on women by the medical profession. In their comments on the blog, young women, one only 16, others in their 30's and older describe not only devastated sex lives, but loss of energy, depression, memory loss, bone and joint pain.

Nora Coffey, president of the HERS Foundation, is campaigning for a law that would require that women receive complete information about hysterectomy before they consent. They aren't getting that now, with so-called patient education information limited primarily to talking about the uterus's function as a baby incubator. (You don't need it anymore, dear, do you? goes the spiel.) HERS has developed an 11-minute video that makes clear the uterus's other functions as a sexual organ and a muscle that supplies support to the bladder and bowel. The video should be required viewing before a woman gives her consent. In fact, there's a petition to sign to make that happen.

In no other country do so many women undergo hysterectomies, and the procedure is less necessary today than ever because there are now alternatives for treating bleeding from fibroids, for example, the single largest reason for hysterectomy. It's a scandal of which America's oby-gyns should be ashamed.