People may have a hysterectomy due to health conditions like fibroids, endometriosis, or cancer. It may also be part of gender-affirming care.
A hysterectomy is a surgery to remove your uterus. Sometimes, doctors will also remove your fallopian tubes and ovaries during a hysterectomy. After a hysterectomy, you won’t have periods and won’t be able to get pregnant.
A hysterectomy is the second most common surgery performed on women in the United States after cesarean delivery. Each year, nearly
Uterine fibroids are noncancerous growths that form in the uterus. They’re one of the most common reasons for a hysterectomy.
Fibroids can cause heavy bleeding, pain, or stomach distention. They may also affect fertility.
Your doctor may first recommend medications, such as oral birth control pills, or other less-invasive procedures, such as a myomectomy, to treat fibroids. A myomectomy removes only the fibroids and leaves the uterus intact.
If other measures aren’t effective or fibroids continue to regrow and produce symptoms, a hysterectomy may be an option.
Cancer is the reason for about 10 percent of all hysterectomies.
Your doctor may recommend a hysterectomy if you have cancer of the:
Your treatment approach will depend on the type of cancer you have, how advanced it is, and your overall health. Other options may include chemotherapy and radiation.
Sometimes, doctors recommend surgery if you have precancerous conditions or if they suspect cancer. In some cases, removing the uterus may be a safer way to diagnose cancer than through a biopsy on an intact uterus.
You may also opt to have a hysterectomy to reduce your risk of developing cancer in the future if you have Lynch syndrome. This is an inherited condition that can increase your risk of colon, uterine, and other cancers.
If you test positive for the BRCA gene, you don’t necessarily need a hysterectomy. People with this gene may have an increased risk for ovarian and breast cancers, so doctors may just recommend the removal of ovaries and fallopian tubes.
Endometriosis is a condition where tissue that normally lines the uterus grows outside of it. Endometriosis can cause extreme pain and irregular periods. It can also lead to infertility.
Doctors usually recommend hormone therapy or medical procedures to remove endometrial tissue before a hysterectomy.
A hysterectomy can often reduce or eliminate symptoms from endometriosis, but it’s still possible for endometriosis to recur following hysterectomy. It’s important to discuss the pros and cons of this treatment option with your doctor before having surgery.
Adenomyosis happens when the lining of the uterus grows into the muscle of the uterus. This causes the uterine wall to thicken, which leads to pain and heavy bleeding.
This condition often goes away after menopause, but if your symptoms are severe, you may require treatment sooner.
Hormone therapies and pain medication are usually tried first. If they don’t work, a hysterectomy may be an option.
Pelvic Inflammatory disease (PID) is a bacterial infection that can lead to severe pelvic pain.
When found early, PID can usually be treated with antibiotics. But it can damage the uterus if it spreads.
Your doctor may recommend a hysterectomy if you have severe PID.
Hyperplasia means the lining of your uterus is too thick. This condition may be caused by having too much estrogen.
In some cases, hyperplasia can lead to uterine cancer.
Hyperplasia can cause heavy, irregular menstrual bleeding.
Typically, treatment options include different types of hormone therapies. If your hyperplasia is severe or your doctor suspects it may develop into cancer, they may recommend a hysterectomy.
You might benefit from a hysterectomy if you regularly experience heavy or irregular menstrual bleeding.
Irregular bleeding can be caused by:
- hormone changes
- other conditions
It can be accompanied by stomach cramps and pain.
Removing the uterus is sometimes the only way to find relief from heavy bleeding. Other treatments, such as hormone therapy, are usually tried first.
Uterine prolapse happens when your uterus slips from its usual place and falls into the vagina. This condition is more common in those who’ve had multiple vaginal births. It can also affect people with obesity or who have gone through menopause.
Common symptoms with uterine prolapse are:
- pelvic pressure
- urinary issues
- bowel problems
Treatment options often depend on how severe the prolapse is. Certain exercises and devices can be used at home. In some cases, doctors can repair the weakened pelvic tissues with minimally invasive surgery.
If these measures don’t work or aren’t good options, a hysterectomy may be the treatment of choice.
Sometimes, a hysterectomy is performed within 24 hours after vaginal or cesarean delivery. Certain complications, such as severe bleeding, may mean your doctor has to take out your uterus.
This outcome is very rare, but it can be lifesaving.
Placenta accreta happens during pregnancy when the placenta grows too deeply into the uterine wall. This condition can be very serious, but it often doesn’t cause symptoms.
In almost all cases of placenta accreta, the doctor will perform a cesarean delivery followed by a hysterectomy to prevent blood loss that happens when the placenta separates.
A transgender person may choose to have a hysterectomy. They may decide to only remove the uterus or to remove the uterus and ovaries.
Your doctor can help walk you through the different procedures and possible complications.
Some insurance providers will cover gender affirming hysterectomies. If you have insurance, it’s a good idea to review your policy and confirm your coverage with your provider. They can help you understand if and when hysterectomies are covered.
There are several types of hysterectomy. The type your doctor recommends will depend a lot on the reason you’re having a hysterectomy.
Types of hysterectomy include:
- Partial hysterectomy. With this type, a portion of your uterus is removed, and your cervix, ovaries, and fallopian tubes are left intact.
- Total hysterectomy. Your doctor will remove your entire uterus and your cervix. They may also remove your fallopian tube while leaving your ovaries intact. Removing your fallopian tubes and cervix may reduce your risk for certain cancers.
- Hysterectomy and salpingo-oophorectomy. With this procedure, your doctor will remove your uterus and one or both ovaries along with your fallopian tubes. You may require hormone treatment following this type of hysterectomy.
In addition to different types of hysterectomy, there are also different surgical procedures or methods to remove the uterus. The actual procedure your doctor recommends will depend on your reason for having a hysterectomy.
Your doctor might go through your abdomen or your vagina to get to your uterus. The procedure can be done as a laparoscopic, robotic, or open surgery. If you have open surgery, your doctor may do either a vertical or a horizontal incision.
Discuss all of your surgical options with your doctor ahead of time. Depending on the type of surgery, you may have an increased risk of some side effects or complications.
While a hysterectomy is considered one of the safest surgeries, there are risks involved with any procedure.
Potential side effects or complications may include:
- heavy bleeding during or after the procedure
- injury to other organs
- blood clots
- breathing or heart complications from anesthesia
- bowel blockage
- trouble urinating
Serious complications are more common in abdominal hysterectomies compared to other, less invasive types. Remember, after a hysterectomy, you won’t get your period again.
If you have your ovaries removed as part of the procedure and you haven’t gone through menopause yet, the surgery could cause you to experience menopause symptoms, such as:
- hot flashes
- vaginal dryness
- mood swings
Ovary removal also puts you at risk for developing other medical conditions like bone loss, heart disease, and urinary incontinence.
A hysterectomy can improve your quality of life.
For people living with fibroids, adenomyosis, endometriosis, or abnormal periods, a hysterectomy can help reduce or eliminate chronic pain. It can also help avoid unexpected and heavy bleeding.
For people having the surgery due to cancer, hysterectomy can be an important part of your treatment plan.
Talk with your doctor about how a hysterectomy might improve your symptoms or quality of life.
Having a hysterectomy is a big decision. It’s a major surgery that can change your body forever. You cannot become pregnant following a hysterectomy. You may also go into early menopause.
You might want to ask your doctor the following questions before considering a hysterectomy:
- Do I need a hysterectomy? Why?
- What are the benefits and downsides of having a hysterectomy for my particular condition?
- What other options are available?
- If I don’t have a hysterectomy, what will happen?
- How can a hysterectomy relieve my symptoms?
- What kind of hysterectomy will I have?
- What are the symptoms of menopause?
- Will I need medications after surgery?
- What changes to my mood will it have?
- What will my recovery be like?
If you need a hysterectomy but still want to have children, make sure you discuss your options with a healthcare professional. Adoption and surrogacy are two potential options you may consider.
A hysterectomy is a common procedure that can improve symptoms caused by many different medical conditions. In some cases, the surgery can be lifesaving.
You won’t be able to get pregnant following the surgery and you may go into early menopause. But, the procedure can relieve heavy or irregular bleeding and pelvic pain.
Talk with your doctor if you think you might benefit from having a hysterectomy. There are lots of factors to consider before deciding to have this surgery.