When men get a vasectomy as a form of birth control, one common question they ask is: Are vasectomies reversible? The answer, in most cases, is yes.
But can you reverse a hysterectomy? The answer to that question, in all cases, is no.
When women undergo a hysterectomy — surgery to remove their uterus or womb — it’s irreversible. If you need or want a hysterectomy, here’s what you should know about it and why it’s impossible to reverse one.
What Is a Hysterectomy?
A hysterectomy is surgery to remove all or part of a woman’s uterus or womb. Each year, nearly 500,000 women in the U.S. get a hysterectomy, according to the U.S. Department of Health and Human Services Office on Women’s Health. It’s the second most common surgery women get (cesarean section to deliver a baby — or C-section — takes the top spot.)
What is a uterus?
The uterus is a hollow, pear-shaped organ in a woman’s pelvis. The top connects to the fallopian tubes and ovaries. At the bottom of your uterus is your cervix, which opens into your vagina.
To understand why you might need or want a hysterectomy, you should know about the role of the uterus in women’s health. The uterus serves three main functions:
- For menstruation, or your monthly period. Your uterine arteries supply blood for menstruation and during pregnancy. During this period, your body gets rid of the monthly buildup of blood in your uterus.
- For gestation or pregnancy. When you’re pregnant, the fertilized egg implants in the endometrium (the uterus lining). The placenta then forms, supplying the embryo with food and oxygen through the umbilical cord. As the embryo grows and matures, your uterus expands to fit the growing fetus.
- For labor and delivery. During normal labor, your uterus contracts as your cervix dilates or gets wider to help push the baby out of your womb.
What Happens During a Hysterectomy?
What happens during a hysterectomy depends on two things:
- The type of hysterectomy you will get.
- The type of surgery your doctor will perform.
Types of hysterectomy
Surgeons perform five types of hysterectomy surgeries, all under general anesthesia.
- A total, complete, or simple hysterectomy. This removes your entire uterus, including the cervix. This is the most common type of hysterectomy.
- A partial hysterectomy — also called a subtotal or supracervical hysterectomy. This type only removes the uterus, leaving the cervix in place. You may or may not have your ovaries removed.
- A hysterectomy with oophorectomy. This removes your uterus and one or both of your ovaries.
- A hysterectomy with salpingo-oophorectomy. This removes your uterus, one or both ovaries, and your fallopian tubes.
- A radical hysterectomy. This removes your uterus, cervix, the top of your vagina, and tissue around your uterus. Surgeons may or may not remove your fallopian tubes. This type of surgery is less common and can serve as treatment for certain types of cancer.
Types of surgery
Vaginal surgery is the preferred surgical method for hysterectomy, according to the National Library of Medicine. But it may not work for all women.
With vaginal surgery, the surgeon can remove your uterus, cervix, ovaries, and fallopian tubes through a small cut in your vagina. The surgeon doesn’t need to cut into your abdomen or belly. It’s the least invasive type of surgery and often has better outcomes and fewer complications than other types of hysterectomy surgery.
Surgeons can choose vaginal surgery for benign or noncancerous conditions if you are deemed a good candidate.
Other types of surgery for hysterectomy, including minimally invasive gynecologic surgeries, include:
- Abdominal, also called open abdominal surgery. The surgeon removes your uterus through an incision across your lower abdomen or belly. This type of surgery often applies when there’s abnormal bleeding, significant endometriosis, and uterine fibroids or prolapse.
- Laparoscopic. A surgeon makes small cuts, like keyholes, in your abdomen. They then insert a laparoscope (a flexible tube with a tiny camera) to see your pelvic organs. They use small instruments to remove your uterus through the cuts in your abdomen or vagina — called a laparoscopic-assisted vaginal hysterectomy.
- Robot-assisted laparoscopic hysterectomy. Your surgeon makes small incisions in your abdomen but uses a robotic arm to help move the instruments.
Why Do Women Have Hysterectomies?
You may need or want a hysterectomy for several reasons:
- Adenomyosis, or heavy or abnormal uterine bleeding.
- Cancer prevention or treatment of certain gynecologic cancers.
- Endometriosis.
- Gender-affirming surgery and transgender care.
- Pelvic infection or chronic pelvic pain.
- Placenta accreta, a rare pregnancy-related complication.
- Uterine prolapse.
- Uterine fibroids.
What Happens After a Hysterectomy?
After you have a hysterectomy and the surgeon removes your uterus, you can’t reverse the procedure. The surgeon can’t ever put your uterus back in your body.
When you get a hysterectomy, you’ll no longer have monthly menstruation. You also can’t get pregnant. Many women worry that a hysterectomy will cause early menopause, but that’s only true if the surgeon removes both ovaries.
What is a reverse hysterectomy?
You may have heard the term “reverse hysterectomy.” However, that doesn’t mean your hysterectomy is reversible.
Reverse hysterectomy refers to a type of laparoscopic hysterectomy that’s usually for women with a prior history of C-sections.
These women often have scar tissue that makes it difficult for surgeons to mobilize the bladder as they normally would to take out the uterus. With a reverse hysterectomy, they can mobilize the scarred bladder by using a “reverse vesicouterine fold dissection.”
Talk to Your Doctor
Hysterectomies offer many benefits. But because you can’t reverse the procedure, talking about the decision to get one with your doctor and loved ones is crucial. And if you’re younger and premenopausal, a hysterectomy can affect how you age.
Some women can also struggle with the idea that they can no longer have children after a hysterectomy. Your doctor may recommend you talk to a mental health professional before and after having a hysterectomy.
Your doctor can help answer any questions and figure out whether or when you should get one and which kind is right for you.