What you need to know about hysterectomy
In the United States, nearly 500,000 women undergo a hysterectomy each year, making it the second most common surgery after cesarean delivery. Even though the surgery is performed quite frequently, there are still misconceptions about. To address these myths, we spoke with Sandra Laveaux, MD, MPH. Laveaux provides expert care for women at all life stages and specializes in treating abnormal uterine bleeding, uterine fibroids, endometriosis and chronic pelvic pain.
What is a hysterectomy?
A hysterectomy is a surgery to remove the uterus and cervix. During the surgery, the entire uterus is removed. Afterwards, the patient will no longer have a menstrual period and cannot become pregnant.
Why do I have to have a hysterectomy?
A hysterectomy is a definitive treatment, meaning it’s the best option for a patient after all others have been tried or considered. The most common non-cancer reason for hysterectomy in the United States is uterine fibroids; however, the surgery is also used to treat:
- Heavy or unusual vaginal bleeding
- Uterine fibroids
- Uterine prolapse
- Adenomyosis, when the inner lining of the uterus breaks through the wall of the uterus and causes cramps, lower stomach pressure and bloating
- Cancer (or precancer) of the uterus, ovary, cervix or endometrium (the uterus lining)
What is a partial hysterectomy?
It can be confusing but a partial hysterectomy is when only the uterus is removed and not the cervix. This is also called a supracervical hysterectomy. If you keep your cervix, you will still need to have pap smears.
How is a hysterectomy performed?
Depending on the reason for the surgery and size of the uterus, a hysterectomy can be performed with minimally invasive laparoscopy, robotic surgery, or vaginal surgery or with open surgery through a large incision in the abdominal wall.
How long does it take to recover?
It depends on the surgery. With the minimally invasive approaches, patients can go home the same day and return to work (if it’s low impact) within two weeks, though I’ve had patients return to work sooner. With the abdominal approach, patients stay in the hospital for about two nights and recover in about four to six weeks. In both cases, it takes about four to six weeks for the vagina to heal, so it’s important to abstain from sex until cleared by a doctor.
Do I have to have my ovaries removed?
The procedure to remove the ovaries is called an oophorectomy. Generally, when a hysterectomy is performed for non-cancer reasons in a patient who hasn’t reached menopause or is younger than 60 years old, the ovaries should be left as long as they appear normal. However, every case is different.
Will I go into menopause after a hysterectomy?
If your ovaries aren’t removed, you won’t go into menopause. However, if you have a hysterectomy during perimenopause, when your reproductive hormones begin to decline, it may accelerate the onset of menopause by a few months to a year.
Will my voice get deeper? Will I get facial hair or mood swings?
Your voice, hair growth and mood aren’t affected by your uterus and cervix. If you’re perimenopausal or are experiencing mood swings prior to your hysterectomy, you shouldn’t expect much difference after the surgery.
Will sex feel different for me or my partner?
Surgeons make every effort to maintain the vaginal length to enjoy pleasurable intercourse. While you won’t have contractions in your uterus during orgasms anymore, you will still have orgasms. In fact, many feel that sex after a hysterectomy is better since the surgery oftentimes solves issues that led to sex being uncomfortable in the first place.