All of me

Would I be as much of a woman without my womb? Unlike every other organ, the womb has no anatomical counterpart in the male body. Inevitably, it defines our femininity and our fertility. Although it makes no difference whatsoever to my sex appeal, without my womb, I'd feel less sexy.

My attachment to my uterus is deeply rooted. This foetal tent is credited as the source of not only my menses, but also my madness. The remarkably dynamic organ - it can expand from the size of a small fist to the giant belly of pregnancy, then shrink right back down again within weeks - has long been seen as the reason for a woman's instability. Until the 19th century, it was commonly believed that the uterus competed directly with the brain for blood supply. Any effort a woman made to nourish her mind through education or a career could only come at the expense of her fertility.

In theory, there is something attractive - liberating, even - about withdrawing from this ancient battle and becoming womb-free. But for many women, like me, this isn't an academic exercise. One in three of us aged over 30 has fibroids - benign tumours, formed by overgrowths of muscle - in the womb. (When the gynaecologist told me this was what was causing my severe pain and heavy periods, I had never heard of the condition; if one in three men were affected by something that could cause incredible discomfort, we would all know about it.)

My uterus should be shaped like an upside-down pear, and be about the size of a grapefruit. But it is extended and misshapen due to an orange-sized fibroid. Such fibroids, varying from pea- to melon-size, account for one in every three hysterectomies performed in Britain.

Although the operation can be partial, leaving the ovaries intact so that menopause isn't triggered, you will inevitably lose your womb. Some believe that, as with caesareans, there's an overeagerness on the part of a surgically obsessed male medical profession to remove an organ that we would be better off retaining, however flawed. The Campaign Against Hysterectomy and Unnecessary Operations on Women estimates that around 30,000 hysterectomies a year are carried out due to fibroids, and that most of them are unnecessary. Hysterectomies, it is argued, are a very primitive solution to a very simple problem. It's like a dentist who only does extractions.

Indeed, there are other ways to remove fibroids without removing the womb: myomectomy (surgical removal of the fibroid from the uterus); drug therapy (using hormone-suppressant medication, temporarily blocking production of oestrogen, which feeds fibroid growth); and embolisation (blocking the blood supply to the fibroid, causing it to die). But all of these methods can be temporary, cause pain, or have side effects.

In America, where one woman has her womb removed every minute, the hysterectomy issue has been debated long enough for there to be a pro-hysterectomy backlash. According to the womb-removal lobby, American women now suffer from "anti-hysterectomy fever", which needs to be treated. Rather than America having too many hysterectomies, they argue, Britain has too few. Why should women put up with pain? An uncomfortable condition such as fibroids shouldn't somehow be seen as a natural part of the female lot. Hysterectomies may be drastic, but at least they work.

A diseased and difficult womb cannot be better than no womb at all. But only by removing the womb from our canon of womanhood can we make a proper, informed decision whether we need it or not.

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