Commentary
Zonta Pelvic Pain GYN health seminar
Its great to see Zonta doing this work. Well done. I won their award in 2005 so it is very rewarding to see this progress for women.
New look – Kath Mazzella Gynaecological Awareness Consultancy
GYN quilt at Cottesloe Beach
Just happened to have the GYN Quilt on hand whilst passing Cottesloe Surf Life Saving Club thought I would get a shot on the beachfront.
Hail Carolyn Deweginer – standing up for her rights – mutilated
Power to Carolyn for all she has done, changed legislation in NSW so this cannot happening to another woman or whatever happened to the other 500 women without a voice. All this done without a computer. How did she do it??????. BRAVO
Read here about the recent article in Sydney Morning Herald.
Outraged by SMH article – Designer Vagina’s
I have written to the SMH and am hoping that you will join me in expressing your outrage at a doctor dumbing down their explanation instead of using the right terminology for the vulva and the trend for our young women to be ordering ‘designer vaginas’.
Here is my response to this article, http://www.smh.com.au/national/rise-in-women-seeking-designer-vagina-20121120-29o3h.html#ixzz2D5xpBb4
Dear Editor
I refer to the article, ‘Rise in Women Seeking Designer Vagina’, where Dr Sonia Grover said young girls were concerned with looking different and often requested labiaplasties, a procedure to change the size and shape of the external coverings of the vagina.
Firstly, let me say that it is a sad sign of the times that our young women would want to go under the knife voluntarily and one has to ask the question, ‘Why?’ What is it in our society that has our young women concerned about the attractiveness of their genitalia? Is it that we do not have enough education about all aspects of our body and that they do not realise that every woman’s sexual anatomy is going to be different looking? Is it that there is an over-emphasis on sex in our communities that is causing an abnormal concentration of energies on perfecting the body for sex? Or is it that they have seen too many pictures that have been altered by photographic technologies, so that they are comparing themselves to an unrealistic model? I am reasonably confident to say that they have not all been lining up to show one another what their vulva looks like so they can know that they are all different!
I had major life-saving surgery due to vulval cancer 17 years ago involving the removal and remodelling of my vulva and the pain and suffering I have endured during and after surgery still haunts me. The thought that our young women would actively choose this procedure terrifies me because I know the emotional scars that accompany the physical ones.
I was recently awarded the WA Senior of the Year for my GYN and Sexual Health Awareness work, however, the one issue that I really feel I have failed to get a satisfactory outcome for is the attitude of educators and doctors/GYNs that seem too afraid to call a vulva what it really is. Schools continue to incorrectly label it the vagina. To describe it as the ‘external coverings of the vagina’ by someone who knows the difference is to misinform those very young women who are seeking surgery. To me it is the same as describing the penis as the external coverings of the testicle.
Dr Sonia, I implore you to call it a vulva so we are all clear what part of the anatomy it really is and so that when it is altered for life, these young women will know what they have lost.
I agree with Dr Sonia that, “These requests come from a lack of understanding of what is considered normal…” Surely, we can start to normalise the use of the word vulva and open the conversation with our young people so they can know that they also are normal and can appreciate their uniqueness instead of desiring to conform to an unrealistic image of what is normal.
Kathleen Mazzella OAM
Leading World Expert on Women’s Sexual and GYN Health Experiences
Join with me in insisting that they get it right, break down the barriers and stigmas associated with the use of the word ‘vulva’ and start to educate our young women that vulvas come in all shapes and sizes and what you’ve got should be treasured and valued just the way it is. Unless we speak out ladies, we will continue to be kept in the dark on these issues.
More Women Can Avoid Hysterectomy for Common Problem CYPRESS
Federally-Funded Study Shows More Women Can Avoid Hysterectomy for Common Problem CYPRESS, Calif., Dec. 27 /PRNewswire/ —
A minimally invasive procedure called endometrial ablation is as effective as hysterectomy in solving a common female complaint called “dysfunctional uterine bleeding” or DUB, according to a new federally-funded study published in the Journal of Obstetrics and Gynecology. DUB (dysfunctional uterine bleeding) can be described as abnormal bleeding which cannot be attributed to abnormalities of the female reproductive system, pharmacological interaction, intrauterine contraception, or bleeding disorders. It is also referred to menometrorrhagia. The condition affects up to a third of all women at some point during their reproductive years, usually women over age 30. It is characterized by extremely heavy, erratic menstrual bleeding and is often accompanied by fatigue, pelvic pain and decreased quality of life. The excessive blood loss in DUB can provoke iron deficiency anemia.
“This is a very important study, proving that a minimally invasive procedure — endometrial ablation — can solve the problem of excessive bleeding as well as hysterectomy,” commented Franklin D. Loffer, M.D., Executive Vice President/Medical Director of AAGL, the professional organization dedicated to the advancement of minimally-invasive gynecologic surgery.
“Women should always be offered the least invasive, effective approach to solving her medical problems.”
While hysterectomy (the removal of the uterus and in some cases the ovaries and cervix) has a long history of use to cure DUB, newer, less invasive procedures have become available in recent years. These have stirred controversy over whether hysterectomy is overused, particularly for conditions such as DUB for which more conservative approaches may be just as effective and cause fewer complications.
The new study, bearing the acronym of StopDUB for “Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding,” was a multi-center, randomized, controlled trial in the U.S. and Canada involving 237 women at 25 treatment centers. The primary complaint causing women to seek surgery was excessive bleeding that had not been mitigated by medical therapy. These women were randomly assigned to receive either hysterectomy or endometrial ablation, a minimally invasive technique that removes only the lining of the uterus (the lining cells are responsible for the bleeding), not the entire organ. The primary measure of success in the study was women’s satisfaction with their treatment, rather than just a clinical endpoint.
After three years of follow-up, the vast majority of patients in both groups (93-95%) reported that their problem was solved.
The secondary endpoints of pain and fatigue were also similar between the hysterectomy group and the endometrial ablation group.
“Using women’s satisfaction as the study goal, rather than clinical endpoints alone, was very astute from our perspective, because the most important outcome is the woman’s opinion, not the doctor’s,” said Dr. Loffer. “Our view at AAGL is always patient-focused: how much pain will there be, how much trauma, how much time lost, what impact on the quality of life? These are the measures that count.”
Advantages of the less invasive procedure include shorter hospital stays (hours instead of days), less blood loss, fewer complications and quicker recovery.
In many cases endometrial ablation causes menstrual periods to become much lighter and more regular, rather than eliminating them altogether. Many women consider this to be a satisfactory outcome and would prefer to have normal periods rather than lose their uterus.
“Both endometrial ablation and hysterectomy are effective treatments in women with dysfunctional uterine bleeding. However, hysterectomy was associated with about four times more adverse events and six times as many postoperative infections,” said Malcolm Munro, MD, an investigator in the StopDUB Research Group at the David Geffen School of Medicine, University of California Los Angeles. Dr. Munro is also an advisor to the AAGL.
The American College of Obstetricians and Gynecologists (ACOG) recommends that treatment for menorrhagia begin with the least invasive therapy. But, for some women, endometrial ablation may not solve their problem.
“In this study about two thirds of women were able to avoid hysterectomy by having an endometrial ablation procedure while about a third of the patients who had received endometrial ablation ended up having a hysterectomy several years later. This rate is comparable to that seen in other studies,” said Munro.
About 600,000 hysterectomies are performed annually in the U.S., making it the second most common major surgery performed on women of reproductive age. There is controversy about how many of these hysterectomies are really necessary.
Clearly, 120,000 hysterectomies performed each year for DUB (without uterine pathology) are amenable to endometrial ablation. Moreover, many patients with uterine fibroids and abnormal bleeding can be treated via endometrial ablation.
Fibroids account for 40% of hysterectomies each year. While some doctors may look for anemia as a diagnostic indicator for DUB, in the StopDUB study women’s perception of their problem was the main criterion, supported by clinical measures of excess duration, amount, or unpredictability of flow.
“We felt that women should not have to be anemic in order to seek help and have their problem taken seriously,” said Munro. “Based on our results, it is reasonable to recommend that women should select the type of surgery they want for DUB, based on their preferences and situations,” concluded Munro.
About AAGL The AAGL is the first and largest organization in the world dedicated to gynecologic endoscopic surgery. Founded in 1971, AAGL works to advance the safest and most efficacious diagnostic and therapeutic techniques that afford less invasive treatments for gynecologic conditions through the integration of clinical practice, research, innovation, and dialogue.
For the past 36 years, the organization has educated the world’s finest surgeons while improving the lives of women everywhere. This global commitment to women’s health care is embodied in their continuing medical education of physicians and professionals to further promote the well-documented high standards of minimally invasive gynecologic surgery.
For more information visit http://www.aagl.org. http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/12-27-2007/0004728173&EDATE=
Vulva is to vagina, as penis is to testicles
I presented at Vulval Awareness Day on Saturday. Em from 92.9 hosted and said she’s realised she’s been telling her daughters the incorrect terminology; vagina instead of vulva for the external genitalia. She said she was blown away by the information. (If only there were a thousand women there!)
Following that she went on air and spoke about the issue so that women can know the difference between the two.
Em told me the radio station had complaints about the use of the world ‘vulva’. Note: they use the word ‘penis’ all the time. Still a long way to go…