Why not get a hysterectomy? Why do I need my uterus and ovaries after my child-bearing years? I believe that Mother Nature created our bodies quite perfectly and that it's best to keep all of our organs as long as we can. The long-term consequences of a hysterectomy can include osteoporosis, bone and joint problems, increased incidence of heart disease, urinary problems, loss or decrease of sexual desire, and depression.

Some of these problems can be averted by taking estrogen replacement therapy following the hysterectomy, however ERT carries with it other possible side effects such as liver cancer, gall bladder disease, fatigue, vaginal dryness, and, possibly, breast cancer and circulatory prob- lems. Most of these symptoms result from the withdrawal of estrogen. It is important to remember that it is ovaries, not the uterus, which produce estrogen. Therefore, I suggest that, even if a hysterectomy is necessary, a woman try to keep one or both ovaries. Sometimes, due to the trauma of surgery, these remaining ovaries will not function optimally. However generally the estrogen production will continue, even in the absence of a uterus, until the natural time of menopause. If retaining one or both ovaries is not possible, the woman, regardless of age, will experience premature, surgically-induced menopause and will need to make some decisions immediately about whether or not to take hormones.

If I do need a hysterectomy, is it dangerous? No. The surgery is usually quite straightforward and extremely safe. The mortality rate from hysterectomies dropped from close to 90% in l830 to 10% in 1890. By l985, with the use of antibiotics and transfusions, the mortality rate is only one in a thousand. It is very important that you choose a surgeon who you really trust. I have found that, by preparing women through nutrition, homeopathy, and hypnosis, they recover much more quickly from a hysterectomy.

If I've been told I need a hysterectomy, how can I find out if it's really necessary? First, consult at least two physicians specializing in women's health care to get their opinions. If you feel inclined to naturopathic or other forms of alternative medicine, seek out such a physician, again one specializing in women, to hear the natural side of your story.

Don't panic. No matter what the diagnosis and prognosis, it is essential that you take the time to gather all of the information you need, outer and inner, to make the right decisions. Anyone, professional or lay, can order a Medline search on a particular health topic. This will provide

you with the data on the effectiveness of a given therapy for your condition. You may be able to interpret the medical research for yourself or may need one of your doctors to help you sort it out. There is also quite a bit of popular literature on hysterectomy. I recommend Women on Menopause: A Practical Guide to a Positive Transition by Dickson and Henriques (the only book on menopause to mention homeopathy and other natural alternatives besides diet), The Menopause Self-Help Book by Lark, The No-Hysterectomy Option by Goldfarb (includes no natural therapies but discusses clearly diagnosis and orthodox treatment options), and No More Hysterectomies by Hufnagel.

Make sure that you are really comfortable with and trust any doctor that you're working with. Deciding to go ahead with a hysterectomy is a big step with life-long repercussions. Talk to other women who have been in a similar situation and find out how they feel, in retrospect, about the choices they made. If you wish to contact HERS, the support organization mentioned above, call (215) 667-7757. Use meditation, creative visualization, or hypnosis to journey within and find out what you inner self has to say about your particular situation. Imagine yourself at a crossroads. One path leads to a hysterectomy; the other path does not. See or feel yourself traversing one path, then the other. How do you feel? What is the outcome? What are the lessons for you?