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I first heard Stacia Alexander share her hysterectomy experience in March 2023, on a panel hosted by the group Let’s Talk Menopause. I was stunned by her candor as she recounted being plunged into surgical menopause at the age of 45.
She had chosen to get the procedure in 2015, after two decades of dealing with painful, recurrent fibroids. But her surgeon, she said, hadn’t laid out all her options. He had not clearly explained to her the function of her ovaries, nor the consequences of removing them, said Dr. Alexander, a psychotherapist. Instead, when she was already on the operating table, she recalls he asked her which of two hysterectomy types she wanted; flustered, she chose the one he said would help her avoid future surgeries.
He then removed her ovaries, uterus and fallopian tubes, according to her medical records.
Dr. Alexander soon began experiencing dramatic changes in her metabolism, moods and the mobility of her fingers. It would take three years for her to piece together the fact that these changes had been brought about by the removal of key hormone-producing glands — her ovaries — and that she would benefit from hormone therapy.
She hadn’t realized she had the choice of keeping her ovaries. Nor did she know that, by current medical standards, there was no reason for them to be removed in the first place.
Dr. Alexander’s story haunted me for months. Every patient should know their options before a surgery, and no surgery should be a puzzle that a patient needs to solve after the fact. I wondered: How many patients like her had also been left in the dark?
Many, according to six OB-GYNs who perform hysterectomies I spoke with during the three months of reporting that ensued. Often hysterectomy patients don’t understand their full range of options. Some leave the operating room without realizing they no longer have, say, fallopian tubes, or a cervix, as I reported for The New York Times’s Science section.