NEWS2U Health & Wellness
Living Healthy in an Unhealthy World

Friday, June 20, 2008

Baby Boom Women Confronting Pelvic Health Conditions

...many aren't aware of newer treatments for problems such as uterine fibroids, heavy bleeding, report says

By Carolyn Colwell

Baby boomer women still have hysterectomies at nearly the same rate that women did 25 years ago, despite the development of less drastic medical and surgical alternatives, a new report finds.

In 2005, more than 181,000 hysterectomies done in the United States were on Baby Boomers with two common uterine problems -- fibroid tumors and heavy bleeding. But both conditions can often be treated with newer, less-invasive approaches, according to the report commissioned by the National Women's Health Resource Center.

The center describes the report as a first-of-its kind study on the prevalence of pelvic health disorders among American women.

Baby Boomer women, born between 1946 and 1964, are now in the age group where other pelvic disorders, such as stress urinary incontinence and pelvic prolapse, are common. Both stress urinary incontinence and pelvic prolapse, when the pelvic organs shift downward, may be significantly under-diagnosed in American women. That lack of diagnosis may be due to several factors, including lack of awareness or the perceived stigma associated with the conditions, according to the report released Tuesday.

The National Women's Health Resource Center (NWHRC) commissioned the report because there "are so many new treatment options for pelvic disorders available," said Elizabeth Battaglino Cahill, the organization's executive vice president. "What we're finding out is that so many women don't know about" those options, she added.

Cahill said the report found that many women don't report the symptoms of fibroids, heavy bleeding, stress urinary incontinence or pelvic prolapse out of embarrassment or the belief that they are part of the normal course of aging.

She added that the NWHRC wants to make pelvic health the subject of the kind of discussion that's now commonplace for menopause. That way women will become more aware and ask their doctors about newer treatments, she said.

With that in mind, the group is launching a campaign called "What's Going on Down There?" It seeks to educate women how to maintain pelvic health throughout their lives and to provide information about common pelvic conditions and available treatments.
The number of women 40 to 49 years old who are having hysterectomies is a "secret in plain view," added Henrick Harwood, a vice president of the Lewin Group, which prepared the report for the NWHRC. "It's estimated that at least 25 percent of boomers will have a hysterectomy by the age of 60," he said.

What makes Baby Boom women turn to hysterectomies, the same treatment their mothers and grandmothers underwent, when better, newer options are available?

"That's the real question," said Dr. William H. Parker, an obstetrician and gynecologist and clinical professor at the University of California, Los Angeles School of Medicine.

"The numbers still haven't changed," Parker said, despite such surgical advances as myomectomy, which removes the fibroid rather than the entire uterus, and endometrial ablation, which destroys a thin layer of the uterine lining. "It's shocking," he added.

Parker said some women may not turn to the newer treatments, which have a quicker recovery time and preserve the uterus and ovaries, because the doctor who delivered their children and whom they've seen for 20 years recommended a hysterectomy.

Many doctors, Parker added, aren't trained to do the newer surgeries, insurance companies may not reimburse for them, or women may simply not be aware of them.

"A major part of my practice is giving second and third opinions because women are not getting the information they want," Parker said.

There are other factors that may compel women to continue to have unnecessary hysterectomies.

Dr. David Archer, a reproductive endocrinologist at Eastern Virginia Medical School in Norfolk, said endometrial ablation may not always be the cure for heavy bleeding, called menorrhagia. "The improvement in blood loss may not mean no blood loss at all," he explained. He added that, with a hysterectomy, the bleeding stops, so some women may choose that option to get it over with.

The report said an estimated 33 percent of Baby Boom women have stress urinary incontinence, but only about 47 percent of all women have ever asked their doctor about it. Many women don't realize that treatment may be as simple as floor exercises or biofeedback, or that surgical interventions are also available, the report said.

Some statistics show that as many as 40 percent of women between the ages of 50 and 79 have some form of pelvic prolapse, the report added. But only about 10 percent to 20 percent of women seek medical care, which includes surgical and non-surgical treatments, the report added.

More information:
To learn more about the report, visit the National Women's Health Resource Center.

SOURCES: Elizabeth Battaglino Cahill, RN, National Women's Health Resource Center, Red Bank, N.J.; William H. Parker, M.D., obstetrician and gynecologist and clinical professor at the University of California, Los Angeles David Geffen School of Medicine; David Archer, M.D., reproductive endocrinologist, Eastern Virginia Medical School; Norfolk