Our bodies go through many changes throughout our lifetime. From puberty, pregnancy (if that’s what you choose), to menopause, to the myriad symptoms and conditions that come along with a lifetime of reproductive health. From chronic pelvic pain to gynecological cancers, some people can find immense suffering from the part of their body that is the center of some of life’s most pivotal moments. And for some, removing this part of the body is an option. For better or of worse, this is why we have hysterectomies.
Hysterectomies are a fairly common procedure for people with uteruses. In fact, it’s the second most common surgery for people with uteruses in the United States, with ~500,000 people receiving hysterectomies each year. So if they are so common, why are they not openly talked about? Well we (unfortunately) live in a society that places value of people with uteruses around their ability to reproduce, which is an INCREDIBLY harmful narrative that needs to be broken down. Because not only do hysterectomies save lives, but they give many people the freedom to live their lives unencumbered by constant pain and fear.
So let’s break down what hysterectomies are, why they are performed, and life after a hysterectomy is truly like.
What is a Hysterectomy:
A hysterectomy, to put it simply, is the removal of the uterus and potentially the cervix, fallopian tubes, and ovaries (depending on the hysterectomy type). The hysterectomy type you receive depends on each patients unique needs There are four types of hysterectomies that can be performed:
Total hysterectomy (the most common): The complete removal of the uterus and cervix.
Supracervical hysterectomy: The removal of the upper part of the uterus while leaving the cervix. The benefits and risks of leaving the cervix are still being studied.
Total hysterectomy with bilateral salpingo-oophorectomy: The removal of the uterus, cervix, PLUS the fallopian tubes (salpingectomy), and ovaries (oophorectomy).
Radical hysterectomy with bilateral salpingo-oophorectomy: the removal of the uterus, cervix, fallopian tubes, and ovaries, as well as part of the vagina, lymph glands, and fatty tissue. This is usually reserved for cancer treatment.
Procedure Types:
Hysterectomies can be done through the vagina, abdomen, or via a laparoscope. The method a surgeon chooses depends on the type of hysterectomy that is being performed and each patient's unique needs. The four methods are:
Vaginal Hysterectomy: The uterus (and possibly cervix) is removed through an incision in the vagina. This option requires no abdominal incisions and has a generally lower risk for complications but may not be possible for patients with larger uteruses or scarring from previous surgeries.
Abdominal Hysterectomy: The uterus (and possibly cervix, fallopian tubes, and ovaries) is removed through a roughly 6-8 inch incision in the abdomen. This technique has the longest recovery time and is considered the most invasive. A provider may choose this option if a patient has a larger uterus or if the hysterectomy is a form of gynecological cancer treatment.
Laparoscopic Hysterectomy: A small video camera attached to a telescope ( laparoscope) and other thin surgical tools are inserted through multiple small incisions in the abdomen. The surgeon can then remove the uterus in small pieces through the incisions, through the vagina, or through an abdominal incision. This method is generally considered lower invasive and has a shorter recovery time than an abdominal hysterectomy.
Robot-Assisted Laparoscopic Hysterectomy: A type of Laparoscopic hysterectomy that involves a small robotic arm controlled by a surgeon and is performed through tiny incisions in the abdomen. The results are comparable to those from a Laparoscopic hysterectomy.
Reasons for a Hysterectomy:
People with uteruses many undergo hysterectomies for a myriad of reasons including:
- Chronic pelvic pain conditions such as: uterine fibroids, endometriosis, and adenomyosis
- Severe pain during menstruation (Dysmenorrhea)
- Abnormally heavy menstrual bleeding (Menorrhagia)
- Uterine prolapse (when the uterus drops down into the vagina due to weakened pelvic muscles and surrounding tissue)
- Gynecological cancer of the uterus, cervix, ovaries, or endometrium (the lining of the uterus).
- Gender affirming surgery for Trans and non-binary individuals. Learn more about hysterectomies as a form of gender affirming care here
Read More: 6 Common Pelvic Pain Conditions
Recovery and Potential Side Effects:
The amount of time it takes to recover from a Hysterectomy depends on the type of Hysterectomy that was performed and the procedure method used (vaginal, abdominal, laparoscopic, or robotic-assisted laparoscopic). But hysterectomy patients can commonly expect to recover within 4 to 8 weeks. Similar to many medical procedures, you will want to avoid strenuous activity, lifting heavy objects, or have sexual intercorse within this timeframe.
Some of the short-term side effects that are common post-hysterectomy are: tenderness around the abdomen, bleeding and vaginal discharge (alert your medical provider if there is an access of bleeding from the vagina or procedure site), bloating, constipation and general gastrointestinal discomfort. Make sure to develop a pain-management plan before going home to ensure you are as comfortable during the healing process as possible.
*Always speak with your doctor if you experience severe symptoms or feel you are developing an infection.
Life Post-Hysterectomy:
There are some longer term-side effects and potential lifestyle changes that can happen after a hysterectomy. One of the most notable is that patients will not be able to become pregnant after a hysterectomy: this is because the uterus (womb) is where fetuses gestate. So make sure to speak with your doctors about potential family planning steps (such as egg freezing) you may want to take before the procedure. Hysterectomies also end your menstrual cycle.
Read More: How Your Hormones Change From Puberty to Post Menopause
Also, if you have a hysterectomy that removes both ovaries (oophorectomy), you'll enter menopause immediately after your operation. This is referred to as “surgical menopause” and will happen regardless of age or lifestyle. Some providers offer HRT (hormone replacement therapy) if both ovaries are removed. HRT can replace the key hormones the ovaries would produce and helps to relieve any severe menopausal symptoms.
Hysterectomies have changed (and saved) the lives of so many people.
And no matter what your reason for having or wanting to get a hysterectomy is, you’re taking control of your body and health, and you are valid. So let’s talk openly about hysterectomies, learn about them, and normalize them.
Further Reading:
Pelvic Health Priorities, It's more than Kegels.
Understanding Uterine Fibroids
My Experience With Lichen Sclerosus
Momotaro Apotheca and its materials are not intended to treat, diagnose, cure or prevent any disease. All material on Momotaro Apotheca is provided for educational purposes only. Always seek the advice of your physician or another qualified healthcare provider for any questions you have regarding a medical condition.