Hysterectomy Basics You Should Know

Teaching basic information about hysterectomy is important and with May being Hysterectomy Awareness Month, this is the perfect time to share this article from the Philadelphia Tribune.

Hysterectomy, the surgical removal of the uterus, is a procedure surrounded by controversy — and for good reason. Hysterectomy is the second most common major operation performed in the United States today, second only to caesarian section (the delivery of a baby by surgical incision through the abdominal wall and uterus — from the belief Julius Caesar was born that way). Approximately 600,000 American women have a hysterectomy every year. By the age of 60, one out of every three women in the U.S. has had a hysterectomy. Hysterectomy is defined as the “surgical removal of the uterus” (womb). The rate of hysterectomies among Black women with fibroids is higher than for white women (50 percent versus 30 percent).

As with any other major surgical procedures, hysterectomy is associated with certain risks and side effects.

Following this operation a woman will no longer have periods, will not be fertile and will not be able to have any more children. Reasons to have a hysterectomy are: save the woman’s life (usually advanced cancer, severe bleeding or infection), restore function (severe prolapsed uterus) and relieve pain. Even so, hysterectomy should not be done when there are alternative, effective and less drastic measures available.

If a woman does not have a clear diagnosis, she should not have a hysterectomy. In the past, hysterectomies were done for symptoms, not just disease. Bleeding and pain are symptoms. While the goal may be to stop these, your doctor needs to know what is behind those symptoms before hysterectomy should proceed. If you have a lot of other medical problems that would make any surgery more risky, it should be avoided. It also has no place in the management of menopausal or P.M.S. symptoms.

The majority of hysterectomies are performed when a woman is aged between 40 — 50, however many do occur before and after this age group. Women who have a hysterectomy that removes their ovaries, as well as other organs, will go through the menopause immediately (if they haven’t already) following the operation regardless of their age. Women who have a hysterectomy that leaves one or both of their ovaries intact have a 50 percent chance of going through the menopause within five years of their operation, again regardless of their age.

In addition to the direct surgical risks, there may be longer-term physical and psychological effects, such as heart disease; osteoporosis; bone, joint and muscle pain and immobility; loss of sexual desire, arousal, sensation; painful intercourse, vaginal damage; displacement of bladder, bowel and other pelvic organs; urinary tract infections, frequency, incontinence; chronic constipation and digestive disorders; chronic exhaustion; altered body odor; and loss of short-term memory.

If a woman’s ovaries are removed during a hysterectomy (a complete hysterectomy), her body is instantly pushed into menopause. The ovaries produce estrogen, progesterone and androstenedione. When they are removed, the levels of these hormones drop dramatically and the effects on a woman’s body can be varied. One of the frequent complaints of women who have had a hysterectomy is weight gain, particularly around the waist. This is a complaint they share with many women who experience a similar type of weight gain as they grow older and go through menopause.

As with any major abdominal or pelvic operation, serious complications such as blood clots, severe infection, adhesions, postoperative (after surgery) bleeding, bowel obstruction or injury to the urinary tract can happen. Rarely, even death can occur.

In making a decision, you should remember a hysterectomy is not reversible. After a hysterectomy, you will no longer be able to bear children and you will no longer menstruate. You need to think about the impact these changes would have on you.

Talk about your concerns with your doctor or a counselor and your partner. You may want to bring your partner to your doctor’s office to discuss concerns before having the operation.

Read the full Philadelphia Tribune Article:  A Primer on Having a Hysterectomy

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