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medpundit |
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Thursday, March 25, 2004About 90% of hysterectomies are performed before menopause for abnormal uterine bleeding and other non-life-threatening reasons, according to one of two studies on the subject in today's Journal of the American Medical Association. That study enrolled 63 U.S. women, ages 30 to 50, who on average had been experiencing abnormal uterine bleeding for four years. They all had tried at least one hormonal treatment, called medroxyprogesterone, without success. The women were randomly assigned to have a hysterectomy or go on other hormonal medications, such as birth control pills, for bleeding. Six months into the study, the hysterectomy group reported greater improvement in quality of life than the medical treatment group. By the end of two years, half of the women randomly assigned to take pills had opted for a hysterectomy, so most differences between the treatment groups disappeared. "Perhaps these data show that physicians don't need to be so afraid of raising hysterectomy as an option early on," says lead author Miriam Kuppermann of the University of California-San Francisco. Or, perhaps this study shows that women who are unhappy with medical therapy want surgery. Not only was the sample size very small, but it was a very small sample of a very select group: A multicenter, randomized controlled trial (August 1997–December 2000) of 63 premenopausal women, aged 30 to 50 years, with abnormal uterine bleeding for a median of 4 years who were dissatisfied with medical treatments (emphasis mine) It really isn't surprising that these women felt better after having a hysterectomy. They have already said they don't care for medical therapy. Treating them with hormones when they've already expressed their dissatisfaction with that approach isn't likely to make them like it more. It's only going to increase their dissatisfaction. A better study would have been to look at a diverse patient population rather than focusing on those who are already predisposed to want surgery. posted by Sydney on 3/25/2004 10:07:00 AM 0 comments 0 Comments: |
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