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A Fresh Look at Hysterectomy

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

Hysterectomy: Emotions and Alternatives continued...

"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.

This is another opportunity to make an informed decision, Hartmann tells WebMD. If a woman is "seven to 10 years from natural menopause, she may choose not to do oophorectomy. We're very much moving away from the 'clean sweep' approach ... the thought that while we're there, we'll just take out the ovaries, too."

However, women with inherited types of breast or ovarian cancer may decide to have their ovaries removed as preventive (prophylactic) procedure -- to reduce cancer risk.

Because removing ovaries brings on sudden symptoms of menopause, including the possible loss of sexual desire, Tse usually advises women to keep their ovaries.

"Loss of libido can be very difficult to treat, because a woman's libido is very complex -- tied with hormones, self-image, her bond with her partner," Tse says. "Unless there is a medical reason for it, we should not take the ovaries."

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Reviewed on July 13, 2009

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