My Blog Posts

Posted by on March 8, 2013 - 4:37pm

According to a recent investigation, doctors in rural areas of India may be performing unnecessary hysterectomies (the surgical removal of the uterus) on women in an attempt to make additional money. While it is difficult to obtain exact statistics regarding hysterectomies in rural Indian villages, local reports and anecdotal information suggest that private doctors are frightening a number of women into receiving the procedure.

One woman, whose experience is similar to others who have been interviewed, recalls going to a private doctor initially for heavy bleeding during menstruation. After performing a single ultrasound, the doctor told her that she might develop cancer in the future, and needed to undergo surgery immediately. Although she wanted to wait and discuss the possible surgery with her family, the doctor pressured her into receiving the procedure a few hours later. Independent doctors have come to the consensus that a single ultrasound cannot justify a hysterectomy, and that biopsies and other tests are better indicators of cancer or pre-cancer. However, a doctor at the clinic where the woman received the operation admitted that he doesn’t always schedule biopsies prior to performing hysterectomies, so if the uterus or biopsy material is discarded afterwards, there is no way to prove whether the procedures were necessary or not.

Unfortunately, the case highlighted above is not unique in India. There are reports of large numbers of women receiving hysterectomies in some Indian states, and in one village it’s reported that around 90% of women have received a hysterectomy. As these procedures can be costly, women often have to sell some of their own assets to pay for them. Hysterectomies also lead to additional health risks inherent to any surgical procedures.

There are organizations currently working to make changes that will improve the health of women in rural India. Since health clinics are necessary and helpful, campaigners are focusing on improving oversight and regulation of the doctors working in these clinics to ensure that women are not tricked or scared into unnecessary procedures. There has been legislation passed in India to regulate private health care, but it is still in the process of implementation, and is not yet effective. For now, it’s important to raise awareness about this issue, and continue to work to improve women’s health everywhere.

Source: McGivering, Jill. "The Indian Women Pushed Into Hysterectomies." BBC News Magazine. 5 February 2013

To learn more about hysterectomy, check HERE.   If you are considering a hysterectomy you might want to read this article about decision making.

 

Posted by on February 14, 2013 - 4:18pm

In January 2013, the American College of Obstetricians and Gynecologists (ACOG), which is the nation’s leading group in the field of obstetrics and gynecology, released an opinion on a lesser known form of abuse called reproductive coercion. Reproductive coercion occurs whenever a woman’s partner tries to stop her from making her own decisions regarding pregnancy. This includes pressuring a woman to have an abortion she doesn’t want, using threats to stop a woman from having an abortion she does want, and attempting to impregnate a woman against her will. This can include a man hiding his partner’s birth control pills, removing a condom in the middle of sex, or even removing a woman’s intrauterine device (IUD) or other internal contraceptive.

Rebekah Gee, an obstetrician and gynecologist who has studied this issue, believes that for men, reproductive coercion is often, “about taking away choices, taking away freedom, control and self-esteem.” She also points out that a man may attempt to get his partner pregnant to tie her to him, and prevent her from leaving him.

Researchers believe that this form of abuse, also called “birth control sabotage,” is more common among women who are abused by their partners in other ways. One study indicates that 25% of teenage girls and 15% of women with abusive partners reported experiencing reproductive coercion. Although researchers involved in the ACOG report are unsure exactly how prevalent this form of abuse is, they believe it is common enough that physicians and other healthcare providers should screen women and check for signs of reproductive coercion during routine visits.

If physicians do not ask questions, women who undergo abuse may not realize that something can be done to improve or resolve the situation they are in. Doctors can take direct steps to help these women by providing difficult to detect birth control, such as IUDs with shortened strings, or emergency contraceptives in unmarked packaging. Additionally, they can direct women to assistance hotlines or agencies, such as the National Domestic Violence Hotline. Simply providing information can also make a difference. In one small study, women in clinics were given small cards with information and a questionnaire about reproductive coercion. Reports of coercion dropped 71% among women who received this information.

While increasing awareness about reproductive coercion and providing immediate help to women experiencing this type of abuse is critical, implementing education and prevention programs will be an important step in stopping reproductive coercion in the future.

Source: Painter, Kim. “Abusive Partners can Sabotage Contraception.” USA Today. 23 January 2013.

Posted by on February 3, 2013 - 9:20am

According to recent studies, many women are receiving unnecessary Pap tests, or smears, to screen for cervical cancer, while others are not receiving the appropriate tests. The guidelines for how often women should receive Pap tests were recently changed. Previously, physicians typically administered Pap tests to women 3 years after they became sexually active, or when they turned 21. After that, women were advised to receive a Pap test once every one or two years.

In March 2012, physicians’ groups released new Pap test guidelines. These recommend that most women do not need a Pap test before age 21, and that between ages 21 and 65, women should typically be tested once every 3 years. However, some women ages 30 to 65 may receive a Pap test in intervals of 5 years, as long as they are being tested for the human papillomavirus (HPV) as well. After age 65, women do not need to receive a Pap test unless they are at a high risk of cervical cancer. Additionally, testing is not recommended for women who have received a hysterectomy and have no history of cervical cancer or abnormal test results. These changes were made because cervical cancer is rare for young women, and grows at such a slow rate, that longer intervals between tests is not harmful.

Recent data shows that although some of these guidelines are being followed, others are not. Looking at positive trends first, the percentage of women aged 18 to 21 who have not received a Pap test has increased from 26% in 2000 to 48% in 2010. Additionally, the percentage of women over age 65 (who have not had a hysterectomy) that have recieved a Pap test has gone down slightly, from about three-quarters in 2000 to two-thirds in 2010.

However, there are also several negative trends visible. The percentage of women between ages 21 and 30 who have never received a Pap test has increased from 7% in 2000 to 10% in 2010. Another shocking statistic indicates that about 60% of women who have had a total hysterectomy, which means they no longer have a cervix, are still receiving Pap tests. While unnecessary tests cost money, they can also produce false results, anxiety, and additional tests and procedures. With increased dissemination and awareness of Pap test guidelines, physicians can work with their patients to provide appropriate care.

Sources:

 

Posted by on January 22, 2013 - 10:50am

On January 7, the U by Kotex brand, with the help of Ogilvy and Mather, launched a new campaign titled “Generation Know” aimed at addressing vaginal health myths. The campaign consists of short TV spots, longer more candid online videos, and a website providing a forum for frank and honest vaginal health discussion. A representative of the brand has stated that the campaign is meant to inform and empower young girls and women by allowing them to feel comfortable having conversations about their vaginas.

One video in the campaign tackles myths that women have heard about their vaginas and periods. Some of these myths are more common and serious, such as women losing their virginity from a tampon, and the possibility of losing tampons inside the body. Others, including the risk of a bear attack while camping with your period, are more humorous. The video takes these and other myths into consideration, and dispels them while encouraging women to seek out answers to questions they may have.

Another video focuses on how vaginal health is viewed as a taboo subject, and that many women have difficulty finding answers to questions they have about their vaginas. By approaching women in the street and beginning discussions about vaginal health, video blogger Kat Lazo finds that many women feel uncomfortable discussing their vaginas. In fact, one woman likened getting her first period to joining a secret society that every woman is a member of, but no one talks about. Lazo states that this culture of silence, “affects young girls’ self esteem, because if you fear talking about it, then you actually fear your vagina itself.”

These videos, along with other aspects of the “Generation Know” campaign highlight the fact that there is a significant amount of misinformation regarding vaginal health being spread around, and that many women are not comfortable discussing this topic. By encouraging women to ask questions and talk to one another, U by Kotex hopes to change the way our society feels about vaginal health. For more information on this campaign, visit the website at www.ubykotex.com.

 

Source: Neff, Jack. "Kimberly-Clark: Can We Talk...About Vaginal Myths?" Advertising Age. 4 January 2013. 

Posted by on January 8, 2013 - 11:05am

A recent study published in the Obstetrics and Gynecology edition of the online journal BMJ Open has shown a disturbing amount of inaccurate and misleading information regarding the growing trend of “designer vaginas.” This term refers to female genital cosmetic surgery (FGCS) procedures, such as altering the shape of the labia, for women who wish to change the way their genitals look. In this study, researchers searched online for private providers of FGCS services and examined the top 5 UK and U.S. websites found. Their goal was to determine the breadth, depth, and quality of information provided by examining 16 information categories, including the types of procedures offered, success rates, and risks involved. In studying these websites, researchers identified 72 different procedures offered, although a lack of standard terminology made it difficult to determine an exact number.

The websites studied seemed to prey on women’s unfounded fears about the appearance or cleanliness of the vagina. Three of the websites claimed that labial surgery prevents infection and reduces odor, while other sites suggested that labial reduction makes the vagina “sleeker” and “more appealing.” Several of the websites even promised an increase in sexual pleasure following cosmetic surgery. However, the researchers dismiss these claims, stating that they are unsubstantiated and that there are no well-planned long-term studies on the outcomes of FGCS procedures. Only two of the websites included success rates, which ranged from 95% to 100%, although there was no information about what defined success. While all ten of the websites included information about risks, they were significantly downplayed, and four of the websites failed to specifically list any. Another disturbing finding was the failure of all the websites studied to include a lower age limit for these types of procedures (Science Blog).

Although this a small study, it demonstrates the shortcomings of the information currently being offered by private providers of FGCS procedures. The authors highlight the importance of creating a set of guidelines regarding FGCS procedures, and improving the standards of providing information so that women can make fully informed and safe decisions.

Source: Bryner, Jeanna. “‘Designer Vagina’ Websites Need Makeover, Study Suggests.” Live Science. 21 November 2012. 

Posted by on December 22, 2012 - 10:57am

On November 28, the United Nations’ (U.N.) human rights committee approved a resolution calling for a ban of female genital mutilation (FGM) throughout the world. The human rights committee condemned the practice as “a harmful and serious threat to the psychological, sexual, and reproductive health of women and girls.” This is the first resolution regarding this topic passed in the U.N., and its Secretary-General Ban Ki-moon believes it is a major step forward in protecting millions of women and girls (UN News Centre).

FGM is a procedure in which a girl’s clitoris, and sometimes other genital parts, are removed during early childhood or adolescence. In 2010, the U.N. estimated that about 70 million women and girls had received the procedure and the World Health Organization reported that about 6,000 girls undergo FGM every day. Some who practice FGM believe that it is required by their religion, or that by completing the procedure they can control women’s sexuality, and perhaps increase fertility. However, it has been proven that there are no health benefits to FGM, and that it leads to painful sexual intercourse, childbirth complications, and other health issues. Despite the prevalence of FGM, reconstructive procedures are not widely available. A group of French researchers and doctors have studied the effects of a type of surgery to reconstruct the clitorises of a group of women, and found that in the long term, most of the women reported either an improvement, or no change, in the amount of pain and clitoral pleasure experienced. Beatrice Cuzin, a urologist who participated in this study states that most women who undergo FGM do not have access to reconstructive surgery, and even if they do, cost is often prohibitive (Barclay, NPR).

FGM is prevalent in many African countries, but is also common in some Middle Eastern and South American communities. However, FGM education and reform should not just be limited to these regions because it is often practiced in diaspora communities all over the world, including the United States. For more detailed information on its prevalence and on efforts to prevent it, the United Nations Population Fund offers additional resources.

It is likely that the full U.N. General Assembly, which consists of 193 member states, will take up this issue in the second half of December, and it is nearly certain that it will be passed. While an approval wouldn’t result in any legal ramifications, U.N. resolutions carry significant moral and political weight, and it would send a strong message to the international community. The resolution condemns the practice and calls for states to create and promote educational campaigns for both men and women to teach them about the negative effects of the practice in an effort to eliminate it. It also encourages countries to enact legislation that prohibits FGM and ends leniency for those who practice it (Lederer, The Associated Press).

 

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