Here's the lowdown on what may be involved before, during and after a hysterectomy.
A hysterectomy (removal of reproductive organs) is an operation in which the uterus (womb) is removed. Most commonly, the cervix (neck of the uterus) is also removed, but this is not always necessary. In some cases, the operation may involve removing the ovaries and fallopian tubes, particularly if there is endometriosis. The operation can be carried out through a cut in either the vagina or the abdomen; or via keyhole surgery.
Why might a woman need a hysterectomy?A hysterectomy may be necessary to treat health problems including: fibroids; endometriosis; prolapse of the uterus; chronic pelvic pain; painful periods; and cancer of the reproductive organs.
After a hysterectomy:• A woman will no longer have a monthly period or be able to become pregnant.
• Removing the ovaries reduces the risk of ovarian cancer. However, it may increase the risk of certain heart conditions, such as angina.
• Removal of the ovaries causes the body to go suddenly into the menopause (the end of menstruation), which results in a loss of hormone production. This may cause menopausal symptoms such as hot flushes, mood swings, insomnia and vaginal dryness. Some women may also feel emotionally bereft as they come to terms with the loss of their fertility.
What is HRT?Going through the menopause causes the level of hormones (oestrogen and progesterone) in a woman’s body to drop. Hormone replacement therapy (HRT) involves taking replacement hormones to artificially boost hormone levels and reduce menopausal symptoms.
HRT may be offered either following a hysterectomy with oophorectomy (removal of ovaries) or after a woman has gone through the menopause naturally. Some women find they can manage menopausal symptoms by making certain changes in their lifestyle, such as improving their diet and taking regular exercise. For others, HRT may be helpful.
There has been lots of research on the positive and negative effects of taking HRT, so it’s important to think through your options carefully.
If your doctor suggests a hysterectomyGabby Miles* endured painful periods and other gynaecological problems for many years before having a hysterectomy. Here's her advice:
Do your research Before you make the decision to go ahead with a hysterectomy, spend some time finding out what’s involved to make sure it’s the right decision for you. Weigh up the pros and cons. Ask lots of questions and make sure you understand the potential benefits and downsides of the operation. Make sure you’ve discussed all possible alternative treatments with your doctor.
Talk to other people who’ve had a hysterectomy. Ask them to tell you honestly how it affected them. My friends were realistic about the operation. They didn’t say it made them feel like new women. In fact, one of them had problems afterwards with HRT, although the other said the absence of periods made it all worthwhile.
Be aware that your body will change As far as I can remember, no-one mentioned the fact that I might put on weight after the operation. I think if they had, I’d have thought longer about it. Or maybe they did mention it and I just thought, oh, I’ll be fine, I’ll exercise more. But I haven’t.
Remember that HRT may not be a permanent solution There are various health risks – including cancer – associated with taking HRT so most women are advised to come off it after between five and 10 years. Because I started taking HRT quite young, I’ll have to come off it at some point. I don’t know how that will affect me.
*Name has been changed.
Read our logart about what Gabby went through before her hysterectomy.
Read about Gabby’s hysterectomy and what happened next.
Find out more about hysterectomy.
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