THE HYSTERECTOMY HOAX

A gynecologist's emphatic appeal to women to refuse to have hysterectomies unless their lives are at stake—for besides being almost always unnecessary, hysterectomies are fraught with risks that women need to understand. West (chief of reproductive endocrinology at Manhattan's St. Vincent's Hospital), assisted here by medical-writer Dranov, combines his warning with clear advice on how to get proper gynecological care. In his experience, doctors are too ready to perform hysterectomies—a readiness that's fostered by both economics and their medical training. West carefully explains the various conditions for which American doctors often recommend hysterectomies—troublesome fibroids, endometriosis, prolapse of the uterus, ovarian cysts, pelvic inflammatory disease—and, in considerable detail, describes alternative treatments for each. Since fibroids are the most common condition for which hysterectomy is urged, he devotes the most coverage to them. West describes and illustrates just what fibroids are; what tests and procedures can be performed to examine and assess them; what treatment options are available; and how they can be removed through a surgical procedure called ``myomectomy,'' which preserves an intact uterus. Noting the communication gap between doctors and patients, the author offers specific questions that a woman should ask her gynecologist when seeking treatment for any of the listed conditions, and he includes some cautionary notes about finding the right doctor and getting second (or third) opinions. (An appendix covers sources of further information, and—though West's writing is always clear—there's also a handy glossary of medical terms with understandable definitions.) Medical guidance that educates and empowers. (Twenty-five line drawings)