Hysterectomy: Why did Lena Dunham talk about removal of the uterus
Olga Lukinskaya
Yesterday the whole world spread the news that Lena Dunham suffered hysterectomy — an operation to remove the uterus — after many years of excruciating pain due to endometriosis. In her column for American Vogue, the director tells how difficult it was to make this decision, given that she always wanted and wants to have children. We understand why it is important to talk about such interventions.
The fact that someone removed the uterus, we hear quite rarely - in our country it is not the most common operation, but, probably, an important role is played by the taboo of the topic: women who have lost reproductive organs can be condemned (as if it was their fault) or called "inferior." Our heroine, who had ovarian cancer, told how her neighbors in the ward discussed whether they should talk about the operation “on the female part” of their husbands - unfortunately, families often break up after women are diagnosed with oncological diagnoses (six times more often than in cases when a man fell ill).
At the same time, in the same USA, hysterectomy is the second most common surgical procedure for women of reproductive age (cesarean section is in the first place). Of course, this operation is carried out according to strict indications, including malignant tumors or severe bleeding; The uterus can be removed if serious complications develop during childbirth, when it comes to saving lives. At the same time, the general attitude towards intervention is still positive: if we have women intimidate them with future “inferiority,” then in America they are told that although the uterus must be removed because of a particular disease and this is sad, the contraceptive issue will be resolved forever .
Due to the low awareness, the removal of the uterus has become overwhelmed with a huge number of myths: after it, it is supposed that a menopause immediately occurs, and the abdominal organs (probably the intestines) can fall out through the vagina. In fact, the onset of menopause is associated with hormonal background, and the ovaries, if they are preserved, continue to work after hysterectomy - instead of the uterus, the eggs get into the abdominal cavity or pelvic cavity, where they simply dissolve. In one study, ovarian failure after removal of the uterus was somewhat more common than in women with intact organs, but only four out of 406 women had menopause for four years after the operation; Considering their age (up to forty-seven years at the beginning of the study), it is possible that the effect of hysterectomy was even weaker than it seems.
Since the hormonal background after the operation does not change (and if necessary, the doctor may prescribe hormone replacement therapy), another frequent fear, masculinization, is not justified. A woman’s mustache will not grow from the removal of the uterus and the voice will not change, just as a woman will not become a man from the biology point of view of biology — however, with the understanding of these facts even the judicial bodies have problems, let alone people who do not have professional knowledge.
Libido and the ability to enjoy sex also should not change after such an intervention - another thing is that they can be seriously affected if a woman's self-esteem decreases or depression develops. If in other countries in this situation you can apply for psychological support, we have no problems with sexual desire to discuss - and having turned to a doctor, there is a risk of running into a conviction in the spirit of “what did you want, your uterus was removed!”.
Due to low awareness, uterine removal has become overwhelmed with a huge number of myths: after it, it is supposed that menopause immediately occurs, and abdominal organs can fall through the vagina
In addition, there is a certain need for suffering in our culture - and for supporters of the ostentatious "we are not looking for easy ways" a healing operation may seem too simple a solution. As women who applied for the services of a surrogate mother, are accused of "unwillingness to spoil the figure," not realizing that the number of hormonal injections can lead to excess weight, and many other unpleasant consequences, the removal of the uterus is regarded as the most direct way to get rid of pain instead of continuing to tolerate her. It is worth thinking that any operation is a risk associated with anesthesia and proper intervention, and then rehabilitation, which can be long and difficult.
Dunham says that she had to stay in the hospital for two weeks (an unprecedented period of hospitalization for a country where a day in the hospital costs the health care system a lot of money). At this time, not only were the procedures for preparing for the operation, but also a multiple discussion of the situation: the doctors had to make sure that she understood what was going on. Of course, this is done in order to protect the clinic and doctors from lawsuits in the future - but still the most important thing here is the awareness of the patient herself, so that she can make a decision, weighing all the pros and cons.
What is worse - endless excruciating pain or infertility? What is more important - to get rid of endometriosis and enjoy life without pain or be able to potentially endure the child in the future (potentially, because endometriosis itself may not allow it)? The decision must be made by the patient herself, having received the most honest and objective, without intimidation or pressure, information about possible options and their consequences.
In an ideal world, this would have happened - or rather, in an ideal world, no one would be sick, but in an almost ideal world, people would receive the most objective data to make an informed choice. Even in such a world, women would feel the unconditional support of their medical choice - from doctors, partners and society, and the state would provide psychological help services, not considering that a person without any authority becomes the worst parent. While this is not so, we can support each other on our own, recalling that each person has the right to decide what to do with his own body without being subjected to condemnation. In the end, for people who have lost a kidney or lung, the labels of "inferiority" are not hung with such ease as for women who have undergone removal of the mammary glands, ovaries or uterus.
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