Julia Pascal
For the Guardian3/2002

I collected medical books and journals on women's health care since college. These were rare. I would study a subject and collect every article and book I could fine.

The attitude of the male physician to women and their uteri was incredible. There has been this need to destroy it.
Its actually a small compact organ. Its strong and somewhat like the human heart in the tissue density.

I saw several treatments in the turn of the century that have been revived it seems. The treatments were to control bleeding of the uterus. The concept here is to do anything and everything to stop bleeding. One popular treatment was to use battery acid. Yes, battery acid . A rubber catheter was placed up inside the uterus. Then a funnel attached to the end and battery acid was poured into the uterus.
The image of this was totally horrific. Many academic papers were published on this wonderful treatment for women.

Another one in history was the use of electrodes placed
into the uterine cavity then "sparks", as the uterus was electrocuted.

When I read today about the "new" treatments they do not seem so knew.

The basic concept in developing Female Reconstructive Surgery was to separate this work from traditional approaches which are so destructive. The foundation is based on preserving and healing tissue, not tissue death.

The endometrium is the lining of the uterus that is shed every month. The monthly bleed is a sign of health. The sign that the reproductive system is in tact. Abnormal bleeding is not caused by the normal endometrium.
Bleeding comes from abnormal conditions. If the uterine lining is abnormal then this can be a precancerous condition ( Hyperplasia) and this must be treated and not with ablation.

The selling of procedures is easy. You tell the public how great it is and how there are no problems. Of course this is intentional fraud but that has become acceptable in medicine. Ablation is the heat destruction of the uterine lining. A device is placed on the lining and heat is used to destroy the lining, The depth of tissue destruction goes beyond what one can see. The result is the lining dies and scar tissue replaces it. You are actually burning the entire lining off. You are destroying it. Sometimes some may regrow but in general the endometerium is now gone.

This is not a rational approach to the treatment of a bleeding condition. A fibroid that has grown will not be gone. Adenomyosis of the uterus will not be gone. Removing the lining does not remove these conditions.
If the bleeding was caused by hormonal imbalance still remains.

The reality is this is not a rational concept at all.
Yet, it is sold to the public as a great advancement in medicine. The press and media seem to take every new idea and make it the perfect . I have never seen a balanced article on uterine ablation.

As an academic I believe the only condition this procedure should be used in, is when a woman has severe cardiac disease and a bleeding disorder so that any other procedure would be life threatening.

The complications are not listed routinely so let me go over them: