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Women's Health

A Fresh Look at Hysterectomy

For quicker hysterectomy recovery, many women are choosing laparoscopy. Just make sure your surgeon is skilled.
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Common Reasons for Hysterectomy

The common reasons for hysterectomy are:

  • uterine fibroids
  • severe vaginal bleeding
  • uterine prolapse
  • endometriosis
  • chronic pelvic pain

Hysterectomy is also used to treat uterine and cervical cancer.

Hysterectomy: Emotions and Alternatives

Depending on a woman's age, the choice to have a hysterectomy can be an emotionally tough decision. It means that she can no longer have children. That's the crux of hysterectomy -- the uterus (or part of it) is removed.

"Hysterectomy is a very personal thing for women," explains Tse. "Some are so thankful to be done with this troublesome organ. For others, there is grief over the loss of womanliness, their ability to have children."

Today, women know they have many options, adds Katherine Hartmann, MD, PhD, vice-chairwoman of obstetrics and gynecology at Vanderbilt University School of Medicine in Nashville.

  • Medications and the IUD Marena can control heavy bleeding in some women. 
  • A surgery called myomectomy can remove troublesome fibroids while leaving the uterus intact -- a good option for women who want to have children. 
  • Uterine artery embolization -- destroying the lining of the uterus – can also reduce bleeding. So can endometrial ablation. But most women cannot get pregnant after endometrial ablation, and it’s not yet clear whether uterine artery embolization reduces chances of pregnancy.

"There is greater sense that we can work through this less aggressively ... work to alleviate the symptoms, before choosing hysterectomy," Hartmann tells WebMD. "It's not as much an automatic choice as it might have been."

Yet many opt for hysterectomy and are relieved that surgery can end difficult symptoms.

"They are just tickled,” says Hartmann. “These are women who have severe bleeding, and they just want the problem to end."

For them, hysterectomy offers better quality of life, she says. "We see improvements in anemia, fatigue, pain, missed work days. There's no more gushing bleeding that leads them to restrict their social lives. Satisfaction with sex life goes way up after hysterectomy, as they can have sex more often."

A Critical Decision: Remove the Ovaries or Not?

Women considering a hysterectomy have a big decision to make: whether to have ovaries removed (oophorectomy). Removing a woman’s ovaries triggers the biggest side effects of hysterectomy -- premature menopause. Unless a woman takes hormones, she will immediately go into menopause with all its hormonal changes and hot flashes.

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