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Should I Have a Hysterectomy?

By Christina Frank
WebMD Feature

“If I just got a hysterectomy…”

Maybe that’s what you’re thinking would stop you from having such heavy, painful periods. You’ve tried medications, but they haven’t taken care of the problem. Is having your uterus surgically removed the answer?

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The surgery can completely relieve many painful pelvic conditions, but it's not the answer for everyone. If you’re thinking of having a hysterectomy, consider some important issues first.

When a Hysterectomy Can Help

Before you decide to remove your uterus, you need to be sure it’s the cause of your pelvic problems. A lot of different conditions can affect that organ and cause pain, bleeding, and other symptoms. In these cases,a hysterectomy can provide a long-term solution," says Sondra Summers, MD. She's a gynecologist at Loyola University Health Systems in Chicago.

The surgery might help if you have:

  • Fibroids. These tumors that grow in or around the uterus aren’t cancer, but they can cause heavy or painful periods, the need to pee often, constipation, and pain during sex.
  • Adenomyosis. The tissue that normally lines your uterus grows into its muscular wall, making your periods agonizing.
  • Endometriosis. The tissue lining your uterus grows on the outside of it instead, which can cause severe period pain, ongoing back aches, uncomfortable sex, and bleeding between periods.
  • Scar tissue that forms after a C-section or other surgery can cause pain and bleeding.
  • A prolapsed uterus. When the tissues that support your uterus are weakened (often because of childbirth), it can drop down into your vagina and cause back aches, loss of bladder control, and painful sex.
  • Bleeding in your vagina (not part of your period) that doesn't stop after other treatments.
  • Cancer of the cervix, ovaries, or uterus. If you have any of these types of cancer, your doctor will almost certainly call for a hysterectomy.

 

When a Hysterectomy Won't Help

Sometimes, pelvic pain isn't caused by a problem in the uterus.

"In the past 5 years or so, we've begun to understand that there may be causes of pelvic pain that aren't related to the pelvic organs, but may instead be caused by problems with the muscles and ligaments in the pelvis," Summers says. "In this case, a hysterectomy would not solve the problem." 

Removing your uterus also won't stop bleeding that happens because of a hormone imbalance.

Your doctor should give you a thorough pelvic exam as well as an ultrasound and an MRI, if necessary, to pinpoint what's causing your pain and to help you decide if surgery is an option.

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