About one-third of American women will have a hysterectomy by the time they’re 65 years old. So if you’re thinking about having a hysterectomy, you’re not alone. More than 600,000 hysterectomies are performed each year in the United States, the majority of which are to improve quality of life for perimenopausal women. Although hysterectomy is a common surgery, it’s a serious one. Despite the high rates of hysterectomy in the United States, little is known about how women make decisions regarding this surgery and, in particular, how ethnic and cultural factors may influence these decisions.

The 4 centers participating, in the ENDOW study were sponsored by the Women’s Health Initiative of the National Institutes of Health and The Centers for Disease Control and Prevention to focus on women’s attitudes, experiences, and decisions regarding hysterectomy/surgical menopause and those questions about menopause and the use of hormone replacement therapy (HRT) that exist in and across racial/cultural groups. ENDOW centers include the University of Alabama at Birmingham (Birmingham, AL), the University of New Mexico (Albuquerque, NM), the University of South Carolina (Columbia, SC), and the University of Texas at Houston (Houston, TX). 

The study assessed the attitudes of more than 4,000 American women from 4 ethnic groups: African-American, Hispanic, Navajo, and non-Hispanic white. Findings from this study indicated that all groups wanted to be more educated on menopausal issues and expressed interest in discussing these issues with their families and health care providers. Based on their findings from extensive focus groups and surveys, ENDOW investigators developed Hysterectomy: The Decision is Yours, a video and a brochure (available in English and Spanish) that provides information on the procedure, identifies proper communication techniques with health care providers, and offers effective decision-making skills. The video was the recipient of the prestigious Telly and Cindy awards. Additional intervention materials include The Wise Woman's Guide to Making Decisions and The Decision is Yours: Talking to Your Doctor. Materials may be obtained from ENDOW at the cost of reproduction