It’s time to retire “Hysterectomy”

New Delhi:  Language changes as our knowledge and understanding evolve, in medicine and in social movements. Language matters in medicine and health care too!
Language in medicine impacts patient care and health. It needs to be accurate and clear, not include words associated with bias or discrimination, and not disempower a person.
Research studies have pointed that ambiguous  terminology such as “hysterectomy” is associated with low patient understanding of the procedure and the female anatomy involved.
Each time health care professionals talk about a hysterectomy,   they remind themselves, and those seeking care from them, that women are  hysterical and therefore cannot be trusted to make the right decisions for themselves. That they need cisgender men to tell them how to dress, how to behave, and, yes, how to use and not use their bodies, especially their reproductive organs.                                                                                                                                                     Hysterectomy is the term given to the procedure where a woman’s uterus is removed. The first documented abdominal hysterectomy procedure was done in 1843 , the outcome, unfortunately, was death due to wrong diagnosis. At that time the death rates due to this procedure was 70%, which is not surprising due to the lack of antibiotics or anesthesia. Women often died of hemorrhage, infections and exhaustion .

The name hysterectomy is rooted in a mental health condition, called “hysteria” that was once believed to affect women. But now the medical world knows that this condition doesn’t exist. Continuing to call this significant operation a hysterectomy both perpetuates misogyny and hampers people’s understanding of what it is.
The word “hysteria” originally came from the ancient Greek word for uterus, “hystera”. But the modern Greek word for uterus is “mitra”, which is where words such as “endometrium” come from.
It may be recalled that hysteria was only removed as an official medical diagnosis in1980. Hysteria was once believed to be a mental disorder solely attributable to women characterized by extreme excitability and emotional overflow. Consequently, doctors at the time ‘cured’ the disease by removing the source, which was, at the time, believed to be the uterus. Thus the word for Hysterectomy came about around 1879, with ‘Hyster’ referring to the womb.

It is a recognised fact that hysteria does not exist and therefore “Hysterectomy” should also be removed from medical terminology because it continues to link the uterus to hysteria.
Instead uterectomy should be used for removal of the uterus, in combination with the medical terms for removal of the cervix, uterine tubes and ovaries as needed. For example, a uterectomy plus cervicectomy would refer to the removal of the uterus and the cervix.
This could help patients understand what is (and isn’t) being removed from their bodies and increase clarity for the wider public.
However, there are many eponyms, something named after a person, in anatomy and medicine, such as the Achilles tendon and Parkinson’s disease. They are almost exclusively the names of white men.
Eponyms for female anatomy and procedures include the Fallopian tubes, Pouch of Douglas, and Pap Smear.
The anatomical term for fallopian tubes is uterine tubes. “Uterine” indicates these are attached to the uterus, which reinforces their important role in fertility.
The Pouch of Douglas is the space between the rectum and uterus. Using the anatomical name (rectouterine pouch) is important, because this is a common site for endometriosis and can explain any associated bowel symptoms.

It is understood that changing medical vocabulary is an arduous process, nevertheless it is a necessary and inevitable step that must be taken better sooner than later.
Furthermore, history has demonstrated that the changing of nomenclature is possible, such as Wegener’s disease being changed to granulomatosis with polyangiitis. This was due to Dr. Wegener’s history as a follower of the Nazi regime and his experiments performed on the imprisoned Jewish population . Terms like these only aid in the remembering  of past mistakes or false assumptions and the related suffering of millions. The hidden meaning between Hysterectomy supports the prehistoric notion that females let their emotion take the better of themselves and that they are anatomically predisposed to it.​
Hysterectomy is an emotional procedure with not only physical but also psychological effects. Not directly referring to the uterus perpetuates the historical disregard of female reproductive anatomy and functions. Removing the link to hysteria and renaming hysterectomy to uterectomy would be a simple but symbolic change.
For these reasons, the International Federation of Associations of Anatomists recommends removing eponyms from scientific and medical communication.

Of course, changing medical vocabulary won’t erase sexism and patriarchy. However, as feminists have been saying for decades, if men bore children, abortions would be as freely available as flu shots. And of course, if men had uteruses, the surgical removal of this organ would be called by its anatomically correct name, a uterectomy.

It’s high time to rename the hysterectomy to uterectomy.
Medical experts and science communicators will certainly play an important role in using the term uterectomy instead of hysterectomy.
Responding to the need of the hour the World Health Organization should make official changes in the International Classification of Health Interventions.
In line with increasing awareness and discussions around female reproductive health and medical misogyny, now is the time to improve terminology. Healthcare professionals must ensure the names of body parts and medical procedures that reflect the relevant anatomy.

*Dr. Narresh Purohit-MD, DNB, DIH, MHA, MRCP(UK), is an Epidemiologist, and Advisor-National Communicable Disease Control Program of Govt. of India, Madhya Pradesh and several state Health organizations.    He’s  the Principle Investigator – Association of Studies In Behavioural Science),                 Dr. Purohit is also Advisor-National Mental Health Program .