Medical experts generally recommend that
hysterectomy should not be used to treat
dysfunctional uterine bleeding until medical therapy
has failed.1, 2 The cause of
the bleeding should be thoroughly evaluated with tests such as an endometrial
biopsy before hysterectomy is considered. Hysterectomy is used as surgical
treatment for dysfunctional uterine bleeding when:
Dysfunctional uterine bleeding does not respond
to medicine or other treatment. These options include taking a
nonsteroidal anti-inflammatory drug (NSAID) or
progestin, using a progestin IUD (Mirena), or
completed and you do not wish to try treatment with
Symptoms of dysfunctional uterine bleeding outweigh the
risks and discomforts of surgery.
The size, location, and involvement of other abdominal organs
type of hysterectomy is most appropriate.
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Removal of the ovaries (oophorectomy) may be required, for example, when
ovarian hormones are making other conditions worse, such as
ovarian cysts. When the ovaries are removed,
estrogen replacement therapy (ERT) is usually
prescribed to take the place of the hormone cycle and protect against
osteoporosis risk, at least until
How effective is it?
Hysterectomy is a successful
technique for the treatment of dysfunctional uterine bleeding.3 But it is usually reserved for women who have tried other
What else should I know?
An accurate diagnosis is
essential to the successful outcome of a hysterectomy. If your symptoms are not
accurately diagnosed, a hysterectomy may not relieve your symptoms.
Loba RA (2007). Abnormal uterine bleeding. In VL Katz
et al., eds., Comprehensive Gynecology, 5th ed., pp.
915-931. Philadelphia: Mosby Elsevier.
Speroff L, Fritz MA (2005). Dysfunctional uterine
bleeding. In L Speroff, MA Fritz, eds., Clinical Gynecologic Endocrinology and Infertility, 7th ed., pp. 548-571. Philadelphia:
Lippincott Williams and Wilkins.
Kuppermann M, et al. (2004). Effect of hysterectomy vs medical treatment on health-related quality of life and sexual functioning: The medicine or surgery (Ms) randomized trial. JAMA, 291(12): 1447-1455.
Primary Medical Reviewer
Sarah Anne Marshall, MD - Family Medicine
Specialist Medical Reviewer
Kirtly Jones, MD - Obstetrics and Gynecology
July 15, 2010
WebMD Medical Reference from Healthwise
July 15, 2010
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