It’s a given that you never want to go through surgery. You want the body to function normally and not have to deal with any form of invasive – and often painful – procedures.
The human body’s an amazing machine; it’s more complex than anything else we know about on this planet – the framework of bone, cartilage, blood, cells and tissues, keeps us going, keeps our organs ticking over, and it all works in sync to keep our bodies functioning. There are so many physiological processes that are occurring every second – intricate processes that enable us to do certain things.
But sometimes things happen – things that can’t be helped or rectified without some form of medical intervention. Sometimes some of these physiological processes go wrong, or something alien happens to the body which we can’t fight off.
You’ve probably all heard the argument that a woman’s physiological machinery is far more complex than a man’s. What a man has to go through in comparison to a woman, is relatively easy – but let’s not delve into that can of worms right now. But being a woman does mean that you may have to contend with certain health issues in your lifetime, some of which could have long-lasting health implications and may require surgery.
You’ve probably heard of a hysterectomy – it is the second most common surgery had by women in the U.S. If you’ve heard the term thrown about, get clued up in addition to having a frank discussion with your doctor before going under the knife. These are 15 things to know about getting a hysterectomy:
15 Tests Leading Up To A Hysterectomy
Hysterectomies are usually carried out when a woman experiences extreme or chronic forms of pelvic pain; but don’t worry, your physician won’t recommend a hysterectomy in haste. Pelvic pain could be due to any number of issues, so a number of tests will be carried out, either to find the cause of the pelvic pain or to confirm a diagnosis. Often there are alternatives – medication for example – instead of surgery, which we’re sure everybody would prefer.
Prior to the hysterectomy procedure, there’ll have to be a pelvic examination. This may involve a pap smear – a quick and painless screening test so that cells can be examined – and/or a laparoscopy – minor surgery which involves making small keyholes in the abdomen.
Medication which may include hormonal treatment could be trialled for a period, but if there’s no improvement, a hysterectomy could be the only way to go. If the pain’s intense and is accompanied by heavy bleeding and other issues, a hysterectomy could be the only option.
14 What Actually Is A Hysterectomy?
Firstly, it’s important to note that a hysterectomy could be recommended due to any number of issues. Go to your doctor with pelvic pain and a hysterectomy could be on the cards; it could be a necessity if examinations reveal noncancerous tumours – known as fibroids – in or around the reproductive organs, heavy vaginal bleeding – due periods or childbirth for example – a dropped uterus, or just severe chronic pelvic pain, the cause of which can’t be figured out.
A hysterectomy is an invasive procedure. There are different types; a partial hysterectomy, myomectomy, total hysterectomy and in some extreme cases – which are very rare – something that’s known as a radical hysterectomy may be carried out.
Hysterectomies essentially involve the removal of certain organs, parts of organs or growths, in order to relieve pain. During a partial hysterectomy, the uterus will be removed; a myomectomy will remove tumors; a total hysterectomy will remove the uterus and the cervix; radical hysterectomies will remove all of this, plus the upper vagina.
13 How Is It Performed?
So, we’ve established what a hysterectomy is, that it’s highly invasive and involves the removal of cellular growths or reproductive organs, but what actually happens during the two hour long surgical procedure?
In the past, vaginal hysterectomies used to be performed by gaining access through the abdomen – making a small cut in the abdomen and then going down to access the reproductive organs. This method of performing a hysterectomy was very painful, long and resulted in a longer recovery period.
Nowadays the majority of hysterectomies are performed through the vagina – you’d think since this is the logical option and that this would have always been the case!
There are different techniques associated with the different types of hysterectomies; laparoscopic hysterectomy is the most common hysterectomy that’s performed. This form of hysterectomy is also known as keyhole surgery. Surgeons will insert a telescope through the vagina – or abdomen depending on what reproductive organs are being removed – which will allow them to see what they’re dealing with. Surgical instruments will then be inserted through the same opening and they’ll begin to remove parts of the reproductive system. You’ll be under general anaesthetic for the entire procedure and won’t feel a thing.
12 Is It Necessary?
If the pain’s intense and your doctor thinks that the situation can only be rectified with a hysterectomy, it may be a necessity and something that you should seriously consider getting done right away; having said that, a doctor will very rarely get you into surgery without trying other methods or attempting to find the cause of the problem.
So is a hysterectomy necessary? The obvious answer is only if your doctor deems it to be so. But even then, it’s really up to you. If you have fibroids, for example, growing in your uterus – they’re non-cancerous but could still be causing you a tremendous amount of pain. The only real way to solve this issue is to have them removed – this would involve a hysterectomy. But if you’re totally against surgery unless it’s life threatening, medication could shrink the tumors; they could still cause you pain even after having been shrunken down, but if you’re happy to live like that, that’s really up to you.
11 Love Life
This is a common concern amongst women who have had, are due to have or are contemplating having a hysterectomy. Will my sex life be affected if I have a hysterectomy? The answer really depends on the type of hysterectomy. A myomectomy for example, which removes the tumors – if all’s a success it won’t adversely affect your sex life; of course -as is the case with all forms of surgery - you’ll need a little time to heal, but after the healing period, your sex life won’t be affected – if anything you’ll have a better time of it because you’ll be pain-free!
If you’re having any reproductive organs removed as part of the hysterectomy, after the 4-6-week healing time, there shouldn’t generally be any discomfort. But of course different people react differently to surgery.
It might be embarrassing, but it’s a good idea to ask your doctor, because based on the specifics of the surgery – and your sex life – there could be certain things that you’d have to refrain from doing for a bit longer.
10 Hormones
Will my hormones be all out of whack? This is a common concern amongst those contemplating going under the knife. The majority of women who undergo hysterectomies are in the 40-60 age bracket, meaning that certain hormone levels are already on the decline – a concern is that having a hysterectomy may accelerate the process.
Well, there is a cause for concern when it comes to hysterectomy procedures and hormones, but again it largely depends on the type of hysterectomy that you have. If you have entire organs removed – organs that produce hormones, such as the ovaries for example – this will inevitably lead to hormonal problems; many who have this done often choose to go on hormone replacement therapy – we’ll get into ovarian hysterectomies in the next section.
If you’re having the surgery solely to remove non-cancerous tumors, there’s nothing to worry about as this won’t have any impact on your hormone levels.
9 Ovaries And Fallopian Tubes
The removal of the ovaries during the hysterectomy is what’s known as oophorectomy. This is commonly carried out when a person is suffering from ovarian cancer – it’s often the best and most effective form of treatment, as it eliminates the likelihood of the cancer returning.
Many women choose to have an oophorectomy, despite not actually having cancer. That’s because due to medical advances, women are able to undergo ovarian cancer screening – those who are at an increased risk of developing ovarian cancer due to family history, or a faulty gene. They may choose to have their ovaries removed to eliminate the risk of developing ovarian cancer.
Bilateral salpingectomy – the removal of the fallopian tubes – is also commonly carried out to reduce the risk of developing certain types of ovarian cancers. This won’t be carried out unless a direct problem with the fallopian tubes has been identified, but many women who are at an increased risk of developing ovarian cancer choose to have the fallopian tubes removed in conjunction with the ovaries – just to be safe.
8 Radical Hysterectomies
This is one hysterectomy you don’t get out of choice – you get it done out of necessity. Radical hysterectomies are commonly carried out to treat cancers of the cervix; it’s highly invasive and the most extreme type of hysterectomy around, which also makes it an extremely rare procedure.
When doctors have tried and failed curing your illness using alternative procedures such as chemotherapy and radiotherapy, often the next step is a hysterectomy – radical hysterectomy depending on the severity of the cancer.
Most hysterectomies involve the removal of one or two, or parts of certain reproductive organs, but with a radical hysterectomy, you can expect multiple parts of your reproductive system to be removed. Often the entire womb and cervix are removed, in addition to the fallopian tubes, ovaries, lymph glands, the upper parts of the vagina and other tissues where the cancer may have spread to.
You’ve got to be extremely unfortunate if your doctor’s even contemplating carrying out a radical hysterectomy, but sometimes it is the only option.
7 It’s Not A Cure
It’s very important to realise that having a hysterectomy isn’t a cure for certain conditions. Have ovarian cancer and undergo a hysterectomy to remove the ovaries and fallopian tubes and it may prevent the cancer from spreading to other reproductive organs or from coming back. But have a hysterectomy for pelvic pain, and it may relieve your pain – you may even be totally pain-free for some time – but there’s nothing to stop the pain from returning.
Many people undergo a hysterectomy procedure as a result of endometriosis – tissues like the endometrium are found outside the womb. It can be a chronic and extremely painful condition, but it’s important to reiterate that by removing the womb or parts of the womb, the pain won’t necessarily disappear. This is something a lot of women tend to overlook; hysterectomy procedures aren’t complete cures for certain conditions; it can help but it’s not always a cure.
6 Menopause
This is a common concern and something that you should definitely be aware of before you go under the knife. In some cases, having a hysterectomy can induce menopause. This is the case with any type of hysterectomy that involves the removal of the ovaries and the fallopian tubes.
Ovaries produce and release sex hormones; progesterone and estrogen. Estrogen’s what’s known as the ‘female hormone’ as it’s responsible for promoting female characteristics and certain physiological processes. Estrogen levels taper off as women reach menopausal age – having the ovaries removed during a hysterectomy could cause this to happen suddenly. In this circumstance, if a woman hasn’t yet reached the menopausal age, hormone replacement therapy could be an option.
But if the uterus – just the uterus – is removed, menopause – fortunately or unfortunately depending on how you look at it! – may not be affected and may still occur. Just because the uterus is removed, it doesn’t mean no menopause.
5 It’s Invasive
Hysterectomies will very rarely be given to you as the only option – your only choice of treatment. It’s often used as a last resort – when other methods used to try and relieve your pain haven’t proven to be affective – so if medication does the trick, you can forget about having to have a hysterectomy – for the time being anyway.
Medication could be prescribed, but also other procedures – some of which are still invasive but are certainly less invasive than a hysterectomy – could be recommended. If you’re considering a hysterectomy to remove tumors for example, a myomectomy – which removes the fibroids – is a less invasive option, as is having a uterine artery embolization – cuts of the blood supply to the tumors so that they cease to grow.
Having an ablation surgical procedure is another less invasive alternative. It’s carried out to stop heavy bleeding by freezing the lining of the uterus – if it’s successful it stops the whole uterus from having to be removed.
4 It Could Prevent Cancer
Many women choose to have a hysterectomy to reduce – or even eliminate – their chances of developing certain types of cancers. We’ve touched upon how having a hysterectomy can reduce the risk of developing ovarian cancer. Prophylactic oophorectomy is becoming an increasingly common surgical procedure during which both the ovaries are removed - can be carried out as part of a hysterectomy.
Due to genetic testing, women can discover whether they’re at greater risk of developing ovarian cancer. Testing can be carried out for the BRCA1 or BRCA2 gene defects. Approximately 55% of women who carry mutations in these genes develop ovarian cancer. After screening, if they’re carriers of this genetic defect, many choose to have a hysterectomy – many also choose to start a family beforehand or have their eggs frozen.
A hysterectomy that removes the ovaries decreases the risk of a women developing ovarian cancer by approximately 80% - so it’s understandable why many women go down this route out of choice.
3 It Could Be Used To Treat Cancer
A hysterectomy could be a pain-relieving option for issues in the womb, and it could also be carried out to prevent certain cancers. But if you’ve already got cancer, a hysterectomy may stop it from spreading or remove and cure it entirely.
If you have ovarian cancer, providing it hasn’t spread to other reproductive organs, by removing the ovaries and fallopian tubes, you stand a good chance of beating the cancer and reducing the likelihood of it returning.
The same can be said for endometrial cancer or cancer of the womb. The primary treatment for such a cancer is a hysterectomy – often carried out to treat stage 1 cancer; the womb contains and is connected to other reproductive organs, so removing the uterus will treat the cancer and prevent it from spreading.
It’s important to note that removing organs or certain parts of the womb doesn’t mean that the cancer won’t return.
2 You May Need Psychological Healing
Surgery can be a harrowing experience and there’s likely to be an adjustment period before you get back to daily life and begin to feel somewhat normal again. Of course it largely depends on the type of surgery you have, and your resolve and state of mind – surgery affects people in different ways.
But a hysterectomy is a really serious form of surgery in terms of what it entails and the long-lasting consequences of the surgery. After a hysterectomy there’ll be no periods, you won’t be able to get pregnant and won’t be able to carry a baby – unless you just have the ovaries removed, in which case you could have eggs harvested and implanted.
But it can be really traumatic to have to come to terms with never conceiving or having a baby naturally. Many women who undergo a hysterectomy suffer with depression and have to undergo some form of counselling – dealing with a hysterectomy could take a lot of time.
1 Pregnancy
Harvest your eggs before surgery and you could later have them fertilized in the lab and implanted into your womb. But have your womb removed as well, you’ll have to start looking at other options – a surrogate for example.
Whether or not you’ll be able to fall pregnant largely depends on what part of the womb and reproductive organs you have removed, but the bottom line is, no uterus, no (normal) pregnancy.
A hysterectomy could be necessary postpartum – immediately after childbirth due to complications with the pregnancy period. If there’s a haemorrhage for example or some form of severe trauma which causes excessive bleeding, a hysterectomy may be the only option – the most effective form of treatment.
Cesarean hysterectomy may also be carried out at the time of delivery, again due to trauma if the mother’s life is in danger. Cesarean hysterectomy will end all chances of future fertility.
Sources: Ncbi.nlm.nih.gov, WomensHealth.gov, Cancer.gov