Is Preventive Hysterectomy a Good Idea?

Hysterectomy surgeries are the second most performed surgery for women in the US (the first being cesarean section). About 600,000 hysterectomies are performed each year, with 20 million US women having had the surgery. The question is: Were they all necessary?

The National Women’s Health Network (NWHN) doesn’t think so. They say that any unnecessary hysterectomies put women at risk, and many should try alternatives before resorting to surgery that removes important organs. NWHN Executive Director Cindy Pearson told the L.A. Times, “I advise any woman who is not in a life-threatening situation to see someone else besides a surgeon to explore nonsurgical options first.”

When is a hysterectomy a necessary procedure?

  • When life-threatening cancer is present in the uterus, cervix, vagina, ovaries or fallopian tubes
  • Unmanageable infections or bleeding
  • Life-threatening complications from childbirth
  • You’ve tested positive for a genetic mutation that has high chance of cancer risk
  • Severe endometriosis or fibroids that impede your quality of life

The premature removal of the uterus and/or ovaries has been linked to increased risk of heart attack, stroke, earlier menopause and other health problems like urinary incontinence and urinary tract infections. One study found that removing the ovaries prematurely caused cognitive impairment, dementia, Parkinson’s, osteoporosis and even premature death.

If your primary care physician or gynecologist recommends a hysterectomy for you, you are free and encouraged to get a second or third opinion from a specialist, like a gynecological oncologist. Your healthcare provider should explain clearly the type of hysterectomy you are recommended for (if any) as well as answer any of your questions regarding the surgery.

Reasons NOT to have a hysterectomy

Avoid pregnancy

Not wanting to get pregnant is not an appropriate reason to get a hysterectomy. There are a plethora of other options for birth control, such as the pill, IUD, vaginal ring, etc., that should be used first.

Eliminate monthly periods

A desire to stop having menstruation does not merit a hysterectomy. If you’re unsure whether your PMS symptoms are abnormal and disruptive to your lifestyle, speak with your doctor.

Fibroids

Asymptomatic fibroids, or those that do not cause extreme symptoms, should be first treated in other ways before a hysterectomy.

Prolapses

For minor prolapses in the pelvic area, a hysterectomy may not help the situation. There’s a variety of minimally-invasive options for helping bladders and bowels such as strengthening the pelvic floor muscles with Kegel exercises. Your doctor can recommend a treatment plan.

If you are interested in having a hysterectomy (without a doctor first recommending one), think long and hard on if the risks and uncomfortable symptoms that may accompany it are worth the trouble. If you’re concerned about your health and think a hysterectomy may be the correct option, speak up to your doctor and most likely they’ll be able to provide you with an alternative, less-invasive options if they don’t see you as a candidate for surgery.

Content provided by Dr. Lynn Kowalski of Nevada Surgery and Cancer Care. Located in Las Vegas, Nevada, NVSCC treats gynecologic cancers including Ovarian, Cervical, Endometrial, Vulvar and Vaginal. NVSCC specializes in Da Vinci robot-assisted surgery, treating fibroids, endometriosis and other complex gynecologic conditions with a minimally invasive approach.

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