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Fibroids—noncancerous growths in the uterus—are very common, occurring in as many as 40 percent of women as they approach menopause. The discomfort, pain, and bleeding they cause have led many women to have a hysterectomy—removal of the uterus. Excluding cancer, however, hysterectomy is usually unnecessary, and there is a tremendous need for educating women and their doctors about fibroids and the alternative, less invasive ways of treating this condition.

Sophie Bartsich, a Weill Cornell Medical College student, and her father, Dr. Ernst Bartsich, Clinical Associate Professor of Obstetrics and Gynecology at New York Weill Cornell Medical Center of NewYork-Presbyterian Hospital, have produced a tidy, neat, and illustrated little book, The Other Choice: A Comprehensive Guide for Women with Fibroids, and also a Web site, www.fibroid-choice.com. Both book and Web site summarize in clear, simple terms what a woman needs to know if she has been diagnosed with fibroids.

"The discovery of uterine fibroids is usually sudden and upsetting," the authors write. "Most women do not know that they are a common problem, and as a result, are not prepared to deal with the situation. They know little about how fibroids behave, and even less about their treatment options. Most of the time, the doctors they consult will tell them that removal of the fibroids will only result in their growing back and further health complications. A hysterectomy seems at first to be the only choice for completely resolving the problem and avoiding repetitious treatment."

However, of all the hysterectomies performed in this country—it is second in frequency only to the Cesarean section—only about 15 percent are medically necessary. Among the drawbacks of hysterectomy, the authors write that it "impacts the patient's sense of self as a woman and a childbearer," and that it often has secondary side effects in "the loss of pelvic support, the dropping of the bladder or the rectum, and problems with sexual function."

By "The Other Choice," the Bartsiches mean the choice of whether or not to have a hysterectomy. Each alternative, as well as hysterectomy itself, is fully described and discussed: supra-cervical hysterectomy, myomectomy, myolysis, laparoscopy (laparoscopically assisted fibroid removal), embolization (uterine artery embolization), hysteroscopy (hysteroscope-assisted fibroid removal), hormone therapy, and the decision to do nothing at all.

The Other Choice discusses how to make a decision, including "Myths and Misconceptions" and "The Big Picture"; how to find and choose a doctor; and five case studies—on women who had mixed results with treatment of their fibroids before consulting Dr. Bartsich. The book also includes the issue of informed consent (since full informed consent is often lacking with hysterectomy), and the opinions of four distinguished doctors.

The authors say they wrote the book "because thousands of women—and even their doctors—do not know the many legitimate and available alternatives to treating fibroids," and, they note, "700,000 hysterectomies performed every year in the United States is simply too high a number in this day and age of modern and compassionate medicine."

Copies of the book are available through the Xlibris Corporation at 1-888-7-XLIBRIS or www.xlibris.com or [email protected].

Visitors to Dr. Bartsich's Web site, www.fibroid-choice.com, will find invaluable information on fibroids and treatment options, as well as advice on dealing with a doctor and getting further information.