When I was in 10th grade my English teacher went into the hospital with some kind of abdominal complain and came back out with a full hysterectomy. Which didn’t sit very well with her, her being newly married, still childless, and still only in her mid 20s. She’d let it pop up in conversation every now and then and each time she’d cut it off with a remark along the lines of “well, I guess I’m supposed to feel lucky I’m alive.”
Hmm. Another interesting article from ScienceDaily.com, this time about sexual problems for long-term cancer survivors from the University of Chicago Medical Center. (I used to read ScienceDaily for work, well, daily. I’ll probably start dialing it back into my regular rotation again.)
“Discussions with a physician about sexual consequences of cancer and cancer treatment matter a great deal to many of these patients,” Lindau said. “But survivors report that such conversations infrequently occurred. If such discussions are not happening in this context,” she said, “we suspect that they are even less likely to occur when the connections between disease or treatment and sexual function are less apparent.”
“It seems unbelievable to me,” added one cancer survivor who responded to the survey, “that a surgeon would remove one’s sexual organs and never talk about sex.”
Two points worth mentioning about the study. First, it focused on 20 year survivors and a lot (a lot!) has changed since then when it comes not only to quality of sex but general quality of life issues in medicine. The attitude back then was much more “you’re lucky to be alive, quit complaining.” Or at least a lot less than there used to be.
Second point being that only women survivors were studied but I’m pretty sure the findings and recommendations would benefit all survivors.
The first study to look at sexual function in very long-term female survivors of genital-tract cancer found that these women were pleased with the quality of their cancer care but less satisfied with the emotional support and information they received about dealing with the effects of the disease and treatment on sexuality.
While 74 percent of the women in this study believed that physicians should initiate a discussion about sex, 62 percent of women who had undergone “severe compromise to their reproductive and sexual organs” said their physicians had never brought up the effects of their treatment on sexuality.
Women who had not had such a discussion were three times as likely to suffer from multiple sexual problems at the time of the survey, the researchers report in the August 2007 issue of Gynecologic Oncology.
And of course a disconnect between treatment of non-sexual vs. sexual side effects isn’t limited to cancer survivors. Any number of other medical procedures, and all kinds of prescription drugs also affect sexuality in all kinds of ways from instant menopause after hysterectomy to instant impotence from major nerves severed during prostate surgery to a simple inability to reach orgasm on some antidepressants or loss of interest on others. Oh yeah, and some people wind up with frequent, spontaneous, uncontrollable-and-therefore-unwelcome orgasms.
I know some of my readers are in school to become sex therapists. If I was looking into careers in sexology, medicine, and/or sex and relationship counseling I think I might do worse than specialize in the study and treatment of medically-induced problems with sex. Unless I’m terribly behind the times I think it would be a wonderful area to go into where I think you could help a lot of people.
Submitted by 1519 (not verified) on Tue, 2007-07-31 13:52.
Good call on prostate surgeries. This is sort of embarrassing (because I hate to admit my addiction to that show), but they made a good point about that during an episode of Grey's Anatomy when a patient came in for prostate removal and the surgeon doing it was notorious for cutting the nerves around there rather haphazardly. He wanted to get to a golf game or something, and another surgeon reminded him that he might not like it if he were in the same position. I think we'd like our doctors to treat us, if not like themselves, like a member of their family, whose health they really care about and whose wishes they would take into consideration. Unfortunately, it seems to be too much to ask sometimes. Which is, really, a shame.
[Oh yeah, that Grey's Anatomy episode was, um, gripping! But to be... um... fair to the old dick-cutter guy, cutting all the nerves to your patients penis really will produce a (ok, fractionally) better outcome... even if he and his partner question whether it's worth it afterwards. (That's the tricky part about *not* removing the testicles -- you have all the hormones and almost none of the nerves to needed to do anything about it!!!!) Thanks, WG, you're a total peach. Also I know you've said winding up with a long-term partner who turns out to be a sexual non-performer freaks you out big time. --fl]
Submitted by 1519 (not verified) on Tue, 2007-07-31 11:07.
I've had a hysterectomy. I had it when I was 41 and I have never looked back. I feel GREAT, and sex is great. You don't necessarily have to have your ovaries removed at the same time - I didn't. The comment above stating such things as *facts* is almost as misleading as some of the myths.
A balanced view is needed. Sometimes these campaigns, well meaning though they may be, tend go far out in the opposite direction until everyone who contemplates or has had surgery is made to feel some sort of outcast. Believe me you can feel damnably awful without it being life-threatening. It does do some people a great deal of good and I have no regrets whatsoever.
As it happens, my mother-in-law had her uterus removed during gall-bladder surgery. I was pretty horrified, informed consent and all that, but she was delighted. She was well past the menopause so whether they left her ovaries or not is probably academic.
Final point, coincidentally Papillon has written a post about thinking about going to a sexologist because of the difficulties she has had since her operation to repair her circumcision. I haven't translated it yet because I'm just home and it'll take me an hour or two. It's quite interesting to read about the psychological impact of the circumcision being explored.
[I'm old enough to have friends who've loved theirs too -- endometriosis and fibroids are *harsh!* But that doesn't mean folks should just go popping them out of their patients without a little consideration. The good news? Surgeons these days, especially younger ones, really are being a lot more considerate -- the survey, after all, was of 20-year survivors and I think a lot has changed. (For instance MRIs before abdominal surgery has to be helping limit some of those mid-surgery suprises. Thanks, A. --fl]
Submitted by 1519 (not verified) on Tue, 2007-07-31 03:50.
Fig,
I think your suggestion that more new sex therapists consider work with women (and men, too) recovering from medically-induced sex problems is great. Sounds like it's been a neglected area for a long time.
Re: Rick Schweikert's observation on the disparity between the rates of female and male sex organ removal (as well as the low rate of life-saving hysterectomies) was shocking, so much so as to cause me to think, whoa, why such a large difference?
But then I thought, aren't prostate removals considered removal of a sex organ? I don't follow these things closely, mind you (certainly not like you, Fig!) but reading msm stuff, I have the impression that prostate cancer results in quite a few removals (I'll let you supply the figures; I have not a clue, perhaps not as many as hysterectomies, but probably lots).
In any event, it occurs to me that Rick Schweikert might want to include prostate procedures in his stats. Otherwise (to me, anyway) I'd wonder seriously about that huge disparity between female and male sex organ procedures...
[After reading Eherenreich and English's For Her Own Good: 150 Years of the Experts' Advice to Women I have a pretty good idea why women have gotten such extraordinarily short shrift when it comes to hysterectomies. And since I've been close friends or neighbors with a couple of urologists I'm acutely aware just how often, and just how radically, prostate cancer kills men and prostate surgery destroys sexual capability. And there are just too many medications that affect anybody or everybody's sexuality. So for that reason I couldn't just advocate specializing in therapy for just one or the other gender since historically sexual capability for either has been totally last on the list. Thanks, Tambopaxi. --fl]
Submitted by 1519 (not verified) on Mon, 2007-07-30 18:00.
Female Anatomy Exposed:
If the female sex organs were visible like the male sex organs, would they still be removed from 622,000 women each year?
Myth: “Only men have gonads.â€
FACT: A woman’s gonads are her ovaries. Removal of the ovaries is castration, and the aftereffects are to women what the aftereffects of removal of the testicles are to men.
Myth: “Sex will be better than ever after hysterectomy.â€
FACT: Removal of the uterus causes the loss of uterine orgasm, one of the many irreversible consequences of hysterectomy.
Myth: “After the surgery you’ll feel like a million bucks!â€
FACT: The most common problems women report after hysterectomy include loss of sexual feeling, loss of vitality, bone/joint/muscle pain, fatigue, and personality change.
Myth: “Doctors don’t perform as many hysterectomies as they used to.â€
FACT: Less than 2% of all hysterectomies are life-saving. Most hysterectomies are performed for benign conditions, not medical problems. The rate of cancer in the female sex organs and the male sex organs is almost identical. The rate of male sex organ removal is statistically insignificant, and yet in the last decade an average of 622,000 hysterectomies and 454,000 female castrations were performed each year in the U.S. That’s more than one every minute of every hour of every day. There are 22 million women alive today in America whose sex organs have been removed.
Myth: Doctors don’t have enough time to provide information about female anatomy and the functions of the female organs before they tell women to sign hysterectomy consent forms.
FACT: It takes just a few seconds for doctors to hand women HERS’ 12-minute “Female Anatomy: the Functions of the Female Organs†DVD, available at www.hersfoundation.org/anatomy.
And that’s good news. HERS’ 12-minute female anatomy video makes the female organs visible. It fills the information gap and can prevent about 610,000 unnecessary hysterectomies each year and save more than $17B+/year in rising healthcare costs.
Contact:
HERS Foundation
610-667-7757
www.hersfoundation.org
[I agree with each of your points, Rick. Not least because they correspond with everything my long-ago (but not old) English teacher felt comfortable sharing with her students after her abrupt separation from her ovaries. And yes, I agree that if they were external they might not be yanked so willy-nilly. Thanks. --fl]
Submitted by 1519 (not verified) on Tue, 2007-07-31 07:09.
Ugh. Do you think they'd ever randomly remove, say, the testes of a 20 year old man? God, but they were loose with hysterectomies back then. Both of my grandmothers were given them, along with both my mom's sisters and a couple of her friends. I don't know; it just seems a little weird that they were so fast to throw away this whole organ with so little thought.
You'd have to convince me pretty good to get one, basically it'd have to be life-threatening. And if they just took it out along with everything else as they seemed to do to your teacher, I'd sue their fucking pants off.
[Eh. No such luck suing back then. If you read the old Ms. magazines and such back then they used to have horror stories about hysterectomies. I remember one pull quote where a woman went in for something entirely different... appendicitis or gall bladder surgery or something and the surgeon casually mentioned "oh, her uterus didn't look so hot so I took it out too." Yeeeikes! Anyway, yeah, while they rarely take out men's testicles the way they did women's ovaries they've sure as hell wreaked havoc during prostate surgery which, while not removing the testicles still render them effectively meaningless. (Please note that while I say "prostate surgery's awful" I'm not belittling the often more barbaric or presumptuous procedures women have been put through -- two wrongs absolutely don't make a right.) Thanks, WG. --fl]