Should I Have a Hysterectomy?

From the WebMD Archives

"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?

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.

Pelvic inflammatory disease (PID). This bacterial infection can permanently damage your uterus and fallopian tubes. It can leave you in pain all the time.

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.

Weigh the Pros and Cons

If your doctor finds that your uterus is the source of your pain or bleeding, ask yourself these questions before scheduling a hysterectomy:

Are my symptoms seriously affecting my quality of life? If not, any benefits you might see may not be worth the risks that come with surgery.

Are there other treatment options? Depending on your particular problem, you may find relief from pain medications, hormone therapies, or other less-invasive treatments. "I encourage women to explore all nonsurgical options before deciding to have a hysterectomy," Summers says.

Do I want to have a baby? Since a hysterectomy permanently removes the uterus, you won't be able to have children after this operation.

Will my health insurance cover it? Hysterectomies are sometimes considered "elective" rather than necessary surgeries, so it's important to check with your insurance company before scheduling one.

Who can help me while I recover? Depending on the way your doctor does the surgery, you may need anywhere from 2 weeks to 2 months to recover completely. During that time, you probably won't be able to lift things, shop, care for your kids, or go to work, so you'll need to have people who can help with your usual tasks until you're back on your feet.

WebMD Feature Reviewed by Kecia Gaither, MD, MPH on July 01, 2014



CDC: "Women's Reproductive Health."

Sondra Summers, MD, division director of Minimally Invasive Gynecology Surgery, Loyola University Health System.

Scott Chudnoff, MD, associate professor of obstetrics and gynecology, Montefiore Medical Center

U.S. Department of Health and Human Services, Office on Women’s Health: "Hysterectomy Fact Sheet."

NHS Choices: "Hysterectomy - Why it is Necessary."

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