Roughly one in nine women in the United States will have a hysterectomy, or surgery to remove the uterus, at some point in their lifetime. A healthcare provider (HCP) might recommend the procedure to treat various different gynecologic conditions or to relieve chronic pelvic pain.
While they’re considered to be very safe, hysterectomies are still major surgeries and it’s important to understand the risks vs. benefits when deciding to have one. Here are three facts to consider.
1. You may not need one.
Hysterectomies are a common surgery in people with a uterus, with more than 400,000 performed annually in the U.S., according to a 2013 study published in Obstetrics & Gynecology. The procedure can be lifesaving in some people with gynecological cancers, such as uterine, ovarian, or cervical cancer. But HCPs may also recommend them for non-life-threatening conditions including fibroids, endometriosis, pelvic organ prolapse, and even abnormal bleeding.
A hysterectomy might be warranted if these problems affect a person’s lifestyle, says Stephen K. Montoya, MD, an OBGYN at Sunrise Hospital & Medical Center in Las Vegas. But it’s important to talk to your HCP. Ask about all your options and whether a hysterectomy is medically necessary for you. In some cases, medication or different procedures may be enough to appropriately treat your condition.
2. There are different types you should know about.
When you're deciding about a hysterctomy, you should speak to your HCP about the different kinds of hysterectomies and the way in which yours might be done, according to Edmond Pack, MD, an OBGYN at Southern Hills Hospital in Las Vegas. Common procedures include:
- Partial: The upper portion of the uterus is removed.
- Total: The uterus and the cervix are removed.
- Radical: The uterus, cervix, neighboring lymph nodes, upper one-third to one-half of the vagina, and some tissue surrounding the area are all removed. Radical hysterectomies often involve a diagnosis or suspicion of cervical or uterine cancer.
Surgical techniques may be traditional and performed through a large incision in the lower abdomen, or minimally invasive and conducted through small incisions. Laparoscopic hysterectomy is minimally invasive, and the most common hysterectomy procedure in the U.S. Vaginal hysterectomy is also minimally invasive; it’s done via a small incision in the vagina.
No matter which surgery your HCP recommends, make sure to learn the details and whether you have other options. Ask questions about what the hysterectomy entails, your expected recovery time, the post-surgery care, and any potential complications. Keep an open line of communication throughout the process in case you have additional questions or concerns.
3. You may not need your ovaries removed.
Sometimes during a total or radical hysterectomy, the ovaries and fallopian tubes are removed. Your HCP may be less likely to recommend this if you are young, or aren’t at high risk of ovarian cancer. While removing the ovaries may be associated with lower risk of ovarian cancer for some people, this reduced risk may be outweighed by other health risks related to removing the ovaries. These risks include higher odds of developing coronary heart disease, osteoporosis, and cognitive decline, among other issues. Everyone is different—ask your HCP about your risk profile, and whether or not removing the ovaries is medically necessary. Sometimes just the fallopian tubes can be removed to lower the risk of ovarian cancer, so that the ovaries can be preserved.
For people who have not yet gone through menopause, sudden removal of the ovaries can lead to symptoms of menopause following surgery. Hormone replacement therapy can help with these symptoms and may reduce some long-term health effects. Be sure to discuss the risks and benefits with your HCP so that you can make a fully informed decision.
