Reasons for Hysterectomy
A hysterectomy is an operation to remove your uterus. It treats many women’s health conditions and is one of the most common gynecologic surgeries. In the U.S., more than 500,000 women have a hysterectomy each year.
Learn more about the reasons for a hysterectomy, plus the benefits and potential side effects.
What Is a Hysterectomy?
With a hysterectomy, a surgeon removes some or all of your cervicx, uterus (womb) and, if necessary, other reproductive organs. Your uterus is the hollow, pear-shaped organ in your pelvis where a baby grows during pregnancy.
The top of your uterus connects to the fallopian tubes and ovaries. At the bottom of your uterus is your cervix, which opens into your vagina.
There are different types of hysterectomies.
- A partial (also called supracervical) hysterectomy removes only the uterus, leaving the cervix intact.
- A total hysterectomy removes your entire uterus and cervix.
- A radical hysterectomy removes your uterus, cervix, tissue on both sides of your uterus, and the upper part of your vagina.
With any of these procedures, you doctor may also remove your ovaries and fallopian tubes. Whether or not they do this will depend on the reason for the surgery and your specific medical situation.
There are also various ways of doing a hysterectomy. Your surgeon will decide which of these methods is best for you:
- With a vaginal hysterectomy, your doctor removes your uterus and your cervix — and any other organs — through a small cut in your vagina. They don’t cut into your abdomen.
- A laparoscopic or robotic hysterectomy is a minimally invasive surgery in which your doctor makes tiny cuts in your abdomen. They use small instruments to remove your uterus and other organs through those cuts or your vagina.
- With open abdominal hysterectomy, your doctor makes a large incision in your lower abdomen. They’ll remove your uterus and any other organs through your abdomen.
Reasons for a Hysterectomy
Sometimes a hysterectomy is a medically necessary treatment. Other times, it helps improve your quality of life if medications or other treatments aren’t effective in managing certain health conditions.
Common reasons for having a hysterectomy include:
Cancer treatment or prevention
A hysterectomy is often a treatment for cancer (or precancer) of your reproductive organs. Doctors may recommend a hysterectomy to treat or prevent cancer of the:
- Uterus.
- Endometrium (the lining of the uterus).
- Cervix.
- Ovaries.
- Fallopian tubes.
Depending on the type and extent of cancer, you may also have chemotherapy and radiation as part of your treatment.
Some people have a hysterectomy to prevent or reduce the risk of heredity cancers, like breast, ovarian, or endometrial cancer. With this surgery, doctors often remove your ovaries and fallopian tubes too.
Uterine fibroids
Uterine fibroids are one of the most common reasons for a hysterectomy. These noncancerous growths in the muscle of your uterus can cause:
- Abdominal pain or pressure.
- Painful menstrual cramps.
- Heavy bleeding during your period.
- Irregular periods.
- Swelling in your abdomen.
- Fertility problems.
Doctors usually try to treat uterine fibroids with medications or a procedure to remove the fibroid, leaving your uterus in place. If these don’t work — or if new fibroids grow — your doctor might recommend a hysterectomy as a permanent treatment.
Endometriosis
This condition causes tissue that normally lines the inside of your uterus (endometrial tissue) to grow outside of your uterus. It might grow on your ovaries, fallopian tubes, or other areas in your pelvis.
- Painful periods.
- Heavy bleeding during your period.
- Bleeding in between your periods.
- Pain during sex.
- Pain when you urinate or during bowel movements.
- Infertility.
A hysterectomy can eliminate or reduce endometriosis pain, but it’s not a permanent cure. Doctors often recommend medicine or surgery to remove the endometrial tissue, but sometimes a hysterectomy is the best treatment.
Adenomyosis
With this condition, endometrial tissue grows into the wall of your uterus. It causes heavy and painful menstrual bleeding. Some medicines can help manage symptoms, but severe cases might benefit from a hysterectomy. There are less common cases of heavy bleeding and/or pelvic pain that may also be treated with a hysterectomy.
Uterine prolapse
Uterine prolapse happens when your uterus slips down into your vagina. It’s more common if you:
- Have delivered many babies vaginally.
- Are obese.
- Have gone through menopause.
Uterine prolapse can cause pelvic pain. It may also cause bladder or bowel troubles. Doing pelvic floor exercises to strengthen your pelvic muscles can help, but sometimes a hysterectomy is the best treatment.
Placenta accreta
In this rare pregnancy complication, the placenta attaches too deeply to the wall of the uterus. It can cause life-threatening bleeding when you deliver your baby. There is no way to prevent or treat placenta accreta.
If you develop this condition, your doctor will deliver your baby by cesarean section. Most people need a hysterectomy after delivery to prevent excessive bleeding and save the mother’s life.
There are other conditions that cause severe bleeding after delivery that may also require hysterectomy as a life-saving measure.
Hysterectomy Benefits and Potential Side Effects
A hysterectomy is often necessary, as in the case of treating cancer or placenta accreta. Having one can save your life.
And if you have a health condition that isn’t managed well with other, less invasive treatments, a hysterectomy can provide relief. For many women, it significantly improves their quality of life, eliminating chronic pain and heavy bleeding.
But having a hysterectomy is a big decision because it permanently changes your body. Having your uterus removed means you won’t have periods and can no longer get pregnant. If you want to have children in the future, discuss your treatment options with your doctor.
A hysterectomy might also cause early menopause. If your doctor also has to remove both your ovaries during a hysterectomy, you won’t produce estrogen or other female hormones. As a result, you’ll experience menopause symptoms and side effects like:
- Hot flashes.
- Night sweats.
- Vaginal dryness.
- Less interest in sex.
- Sleep problems.
- Increased risk of bone thinning (osteoporosis) and heart disease.
Your doctor may recommend hormone therapy to manage these symptoms.
Even if you keep your ovaries, a hysterectomy might cause you to go into menopause earlier than the average age of 52.
Although hysterectomies are safe, like any surgery, they carry certain risks, including:
- Infection.
- Bleeding during or after surgery.
- Anesthesia-related breathing or heart problems.
- Blood clots in your legs that can travel to your lungs after surgery.
- Injury to nearby organs during the surgery.
Recovering From a Hysterectomy
Hysterectomy recovery depends on the type of procedure you had and your overall health. It usually takes three to four weeks to recover from minimally invasive surgeries like a vaginal, laparoscopic, or robotic hysterectomy. Recovering from open abdominal surgery takes longer, at least six weeks.
Your doctor will give you medicine to manage any pain right after the surgery. Getting plenty of rest after a hysterectomy is essential to help your body heal.
You should avoid lifting anything heavy, strenuous activities, and sexual intercourse for the first six weeks. Your doctor will tell you when you can resume normal activities and drive.
A hysterectomy is a common and safe treatment for many women’s health conditions, but it can have life-long effects. Talk to your doctor about your treatment options and the pros and cons of this surgery.