As scary as it may sound, a hysterectomy is sometimes medically necessary. In fact, it’s the second most common surgery performed among women.

First of all, a hysterectomy is a surgical operation that removes either all or part of the uterus. In a partial hysterectomy, only the uterus is removed, while, in a total hysterectomy, the entire uterus and cervix are completely removed. Sometimes, the ovaries and fallopian tubes are removed as well. As a last resort, there is also radical hysterectomy. Rarely used, it involves the removal of the uterus, cervix and upper vagina.

Lately, the case has often been presented that most hysterectomies could be completely avoided due to the availability of numerous alternative treatments. A less invasive surgery called a laparoscopic or robotic-assisted hysterectomy may also be an option in some cases, with the former actually being used in 45% of hysterectomy cases nowadays.

All of these treatments and alternatives should definitely be discussed with a doctor, especially when taking into account the fact that most hysterectomies performed nowadays fail to meet the criteria for this kind of surgery.

Many women, however, choose a hysterectomy because of symptoms that while not life-threatening, affect the quality of their day-to-day lives.

It’s these common reasons for a hysterectomy after giving birth that will be explored in this article. It’s important to also keep in mind the 15 Scary Complications That Can Accompany A Hysterectomy, some of which include an increased risk of cancer, death, infection, hemorrhage and cardiovascular issues.

14 Complications Following Birth

Although complications during pregnancy used to be fatal, most of these are easily remedied in the present day. Pregnant mommies are closely monitored and intervention is usually swift when something goes wrong.

In extremely rare circumstances, a uterine rupture can occur, especially in cases when a previous c-section scar tears open again. Signs usually include a tremendous amount of pain and bleeding, but in most cases, a uterine rupture happens during labor.

Although scary to read, there are numerous stories on the web of women waking up to find out that doctors had to perform an emergency hysterectomy. “Sarah” shared: “I was in a life or death situation after giving birth late 2003 due to severe blood loss and l was told the only option was to remove my uterus.”

Some women during their pregnancies will also debate either having a hysterectomy or getting their tubes tied immediately after the birth. Although these are options that should always be discussed with a doctor, it’s recommended that the hysterectomy route be taken only as a last-ditch resort, especially for women under 40 years of age because of the risk of complications.

13 Cases Of Severe Pain

There is no way to sugarcoat it: endometriosis sucks. During menstruation, the endometrial tissue is discarded each month. In cases of endometriosis, the endometrial tissue grows in places other than just the uterus and can be found on the Fallopian tubes, the ovaries, the surface of the uterus, and even the bowels.

The biggest symptom with endometriosis is pain and a lot of it. Famous actress Susan Sarandon has been quoted saying: “When all you know is pain you don’t know that that is not normal.“

A popular misconception is that hysterectomy “cures” endometriosis. Although it can be a tremendous positive step towards dealing with endometriosis, oftentimes eliminating the pain, it unfortunately doesn’t cure it.

Depending on certain facts, like whether the hysterectomy is full or partial, there is a chance that endometriosis will come back. Statistics have also shown that women who keep their ovaries will require further surgery for endometriosis.

12 When Infections Take Over

Pelvis Inflammatory Disease (PID) is a pelvic infection that usually starts in the fallopian tubes and proceeds to move to the uterus and ovaries. Many cases of PID are due to sexual diseases, the use of tampons, and sometimes even from IUDs. Basically, bacteria can be introduced into the vagina in virtually any way and thus, lead to PID.

Although antibiotics are usually prescribed to eliminate the infection, in cases where the infection has caused permanent damage to the Fallopian tubes and ovaries, then a hysterectomy may be the only solution. Usually in these cases, a hysterectomy will also be performed for other reasons, that may be affecting a woman’s quality of life.

Cara’s story shows just how frustrating PID can be: “I got PID from childbirth 14+ yrs ago. It was the reason for my hyster actually. I had acquired chronic cervicitis from the PID. Most PID is from an STD, but it can actually start from any infection in the pelvic cavity. My firstborn dropped his heart-rate bad and in the ensuing chaos to get him out, somehow some bacteria was introduced up in the pelvic cavity. The thing is with PID is that it can get very serious. I battled mine for over 14 yrs and then even after my hyster I acquired another MAJOR pelvic infection that resulted in another major surgery. My Dr believes it all stemmed from the PID.”

11 Cancer Of The Womb, Ovaries Or Cervix

Each year, around 20,000 women in the United States are diagnosed with ovarian cancer. Depending on the type and stage of the cancer, a hysterectomy can be performed. In fact, about 10% off all hysterectomies are usually performed because of cancer. Numerous factors come into play in determining whether a hysterectomy should be performed for cancer, such as the woman’s age, desire for kids, how advanced the cancer is, along with other health conditions.

During a hysterectomy performed as a result of cancer, the doctor will usually take biopsies of other areas where the cancer could have spread, such as the pelvis and abdomen.

Even when a hysterectomy is performed "just in case" of cancer possibly developing, it still does not completely eliminate the chance of getting ovarian cancer. In most cases, the ovaries are left intact during a hysterectomy, but even when the ovaries are removed, there is still a chance of developing ovarian cancer, or more specifically, primary peritoneal cancer. However, this is highly unlikely and most symptoms of ovarian cancer following a hysterectomy are usually because of a different diagnosis.

10 Non-Cancerous Growths

Requests for a hysterectomy due to fibroids is one of the most common reasons, accounting for about 30% off all procedures.

Usually non-cancerous, fibroids are growths in the muscular wall of the uterus. Uterine fibroids are a very common condition in women and although they cause no pain, in some cases, their presence will also lead to heavier menstruation, which in turn, can cause anemia. There can also be pain in the abdomen and back, constipation, as well as painful intercourse.

It’s for all of these symptoms that women will usually consider a hysterectomy. However, it’s important to keep in mind that according to some statistics, fibroids can even shrink or go away following menopause. Other treatments for fibroids are also available such as the removal of the fibroids, the removal of the endometrial lining and most popularly, shrinkage off the blood supply to the fibroids.

9 When More Support Is Needed

Giving birth, especially more than once, doesn’t come without its share of consequences. Unfortunately, it also increases the chance of having a uterine prolapse.

If that wasn’t enough, research also indicates that a vaginal prolapse is also most likely to happen after a hysterectomy, which is kind of mind-bending considering that many get a hysterectomy to deal with a prolapse.

It may sound confusing to get a prolapse after a hysterectomy for having gotten a prolapse to begin with, but it does make sense. A uterine prolapse happens when the uterus starts to bulge out of the vagina. To deal with this condition, many women get a hysterectomy. As we have already covered, a hysterectomy is the removal of the uterus, which helps to support the top of the vagina. Without anything to support it, the top of the vagina can also then start to fall out. In fact, this condition happens in up to 40% of hysterectomy patients, but I guess it’s worth the risk?

8 No More Kids

While there are some mommies who remain undecided as to whether they are done or not, for many others nowadays, the decision to stop having kids after a certain number is clear cut and easy-- whether the magic number of kids is five, two, or maybe even “one and done”.

Being dead set on closing shop can entail a whole slew of unpleasant worries though, from the anxiety of the kind of birth control to choose, all the way to worrying about having accidents and trying to figure out when the heck menstruation was last due.

Complications aside, for many, the decision to get a hysterectomy is an easier option to explore, especially when dealing with the other numerous issues described in this article. It’s important to note that a hysterectomy causes hormone levels to change, which can trigger early menopause. Sex drive may also plummet but for many, it returns as the recovery progresses.

7 Inner Lining Growing Into Uterus Muscles

Another major reason for considering a hysterectomy after birth is Adenomyosis, a condition that causes the inner lining of the uterus to break through the wall of the uterus. This has for effect a number of really unpleasant symptoms, such as heavier periods, painful cramps, lower abdominal pressure and even bloating.

Donna’s story serves to show us the benefits that a hysterectomy can truly have on one person’s life, despite the many tales online of these being performed uselessly nowadays. She had this to say of her post-surgery recovery: “I haven’t looked back, no pain and I have life back. I had no complications and sailed through the recovery. When I went for my six week check-up I was told that yes I did had adenomyosis and was totally relieved. My only concern was that I wish I had done it 10 yrs ago. I was 42 when I had it done so am now on HRT and have had no problems. I hope all my problems are over once and for all.”

6 "It's All In Your Head"

Chronic pain is often completely overlooked, with a significant number of patients being told it’s “all in your head”. So many suffer silently without any true relief and yet for some women with chronic pelvic pain, the only relief comes in the form of a hysterectomy.

Also known as CPP, Chronic Pelvic Pain is a painful condition that affects 15% of women. Given that chronic pain can be hard to pinpoint, diagnosing the problem can be difficult. Another major frustration is the fact that in many cases, a hysterectomy does not solve the problem of chronic pain.

With this condition, it’s especially important to exhaust all other options first to make sure that the pain isn’t potentially related to other conditions, such as fibroids, irritable bowel syndrome, pelvic floor issues, etc.

5 Frustratingly Heavy Periods

Although for many women, heavy periods are caused by the aforementioned fibroids, for many others, this isn’t the case. Countless women suffer from heavy menstruation without a satisfying answer as to why their flow is heavier.

Heavy bleeding during menstruation, also called menorrhagia, happens when a woman bleeds for more than seven days and more than 80mL per cycle.

In most cases, the heavy bleeding will also have a severe impact on the woman's quality of life. We have all had “period accidents”, but for women suffering from heavier menstruation, it’s even worse. There’s also a considerably higher risk of anemia, frequent cramps, feeling of unease, and all the other menstrual symptoms. Socially, heavier periods can also throw a wrench into many plans.

There are other treatments to try first, such as taking a contraceptive pill to try and regulate the bleeding, but when these methods fail, a hysterectomy is often recommended for women who no longer wish to have children.

4 Looking To Alleviate Pain

When diagnosed with Polycystic Ovarian Syndrome (PCOS), it can be easy to just think: “Well, I’ll just have my uterus and ovaries removed – that will solve the problem!”

While it may seem like the kind of reasoning that would make sense, it actually doesn’t. Disregarding the fact that symptoms are related to the reproductive system, PCOS is first and foremost an endocrine disorder. To be clear, the endocrine system is the collection of glands that produces hormones.

As such, many gynecologists with a lack of knowledge for PCOS will recommend a hysterectomy as a way to “cure PCOS”. Unfortunately, this surgery does not cure it and many women will continue to experience certain symptoms.

However, there is the chance that a hysterectomy will alleviate some pain that a woman with PCOS might have been experiencing (i.e. from ovarian cysts) and from this perspective, it could be beneficial.

“Daria”, for instance, was happy to have had a hysterectomy: “I am in your minority club of ‘I want a hysterectomy’. In fact, when I learned I had a complex cyst on each of my ovaries - meaning they were not fluid filled like a normal cyst, and an MRI confirmed endometriosis, I had it with my female parts. Just before I finally got my hysterectomy, I bled for 3 weeks straight. I went through great pain every day […] I will honestly say though, the only downside to the hysterectomy is that for me, it did decrease my libido (even though ladies often said there was no impact, or an improvement to libido post hysterectomy. And vaginal dryness....oh my). And it does not eliminate the PCOS. But overall, am I glad I had the surgery, you bet. If it means that the surgery will give you an improvement to the quality of your daily life, then it is worth it. I have NO regrets of having my hysterectomy.”

3 Excessive Thickening Of The Uterus

Also known as hyperplasia, an excessive thickening of the uterus is another reason to consider a hysterectomy. Most typically, endometrial hyperplasia is caused by an imbalance between estrogen and progesterone. If there is too much estrogen without any progesterone, then ovulation fails to occur and the lining won’t get shed during menstruation. This can lead to excessive thickening of the uterus.

Although the lining doesn’t get shed, one of the major symptoms of hyperplasia is nonetheless heavier bleeding during menstruation. Any bleeding after menopause, as well as short menstrual cycles are both telltale signs of this condition as well.

As a result, although hyperplasia isn’t cancer, it can unfortunately lead to uterine cancer down the road. A hysterectomy is therefore the best treatment, especially in cases of atypical hyperplasia.

2 Unmanageable Polyps

Unlike fibroids, which originate in the uterine muscle tissue, polyps are benign tumors that can be found in the uterine lining.

Although polyps are the most common benign growths in the uterus, they can cause many problems that can drive women to seriously consider a hysterectomy.

Polyps can either bring about zero symptoms, or they can be quite troublesome, causing considerably heavier bleeding during menstruation. In some cases, a “heavy, watery and bloody” discharge may also be experienced.

As with most other conditions, other treatments may be tried first to get rid of the polyps. A hysteroscopy can be performed to remove the polyps with the help of surgical instruments. If the polyps are found to be cancerous, a hysterectomy is usually the best recourse.

1 When Standing Becomes Painful

Also known as pelvic vein incompetence or Pelvic Congestion Syndrome (PCS), pelvic congestion is caused by varicose veins in the lower abdomen. The main symptom of this condition is chronic pain that is dull and made worse when standing. Sexual intercourse can also be painful with PCS.

In cases of pelvic congestion, a hysterectomy is regarded as a last-resort solution only because of the many complications that can arise from having one’s reproductive organs removed.

Many other treatments can be tried first, namely a procedure that involves a radiologist to individually treat the varicose veins that are causing pain. It may even be possible for some varicose veins to be removed. According to some patients, alternative treatments can also be beneficial, such as: acupuncture, trigger point injections, and electrical nerve stimulation.

Sources: Endometriosis.org, WebMD.com, HysterSisters.com, Medscape.com, Healthtap.com, and NHS.uk.