Hysterectomy or removal of the uterus is a very common procedure. Each year about 600,000 hysterectomies is performed. This procedure is a form of permanent sterilization so you cannot become pregnant if your uterus is removed. The reason for removing your uterus is different for each person. Some common reasons include irregular vaginal bleeding, pelvic pain, benign tumors or cancer. Sometimes a hysterectomy is performed at the time of surgery for pelvic organ prolapse, but this is rarely the primary procedure. The uterus can be removed in many different ways: it can be removed by making small cuts on the abdominal wall during laparoscopy or robotic surgery. It can also be performed through larger incisions on the abdomen or through the vaginal opening. At times a combination of these approaches may be necessary to safely remove your uterus.
There are different types of hysterectomies
Prior to your surgery it is important to ask what type of hysterectomy you will be having and where your incisions will be. You should also ask if the cervix will be removed, as this will determine if you need to continue with screening for cervical cancer. A frequent cause of confusion amongst women is the difference between a total or partial hysterectomy. Just to clarify, a person has a total hysterectomy when both the uterus and cervix are removed. What this means is that you can have a total hysterectomy and still keep your ovaries.
While we’re on the topic of ovaries, having a discussion about removing or keeping your ovaries is an important part of the discussion regarding your hysterectomy. While it is common to have total hysterectomy while leaving your ovaries in place, many experts recommend removing the ovaries or fallopian tubes at the time of a hysterectomy because it reduces your risk of cancer. If you have a personal history of breast cancer or a family history of cancer, then your doctor may recommend removing the ovaries with the uterus.
Will having a hysterectomy lead to menopause?
It is important to note that if you remove both the uterus and cervix (total hysterectomy) then you will no longer have periods, but that does not mean that you will go into menopause. Your ovaries make the hormones which control menopause not the uterus. Women who remove the uterus without removing their ovaries can still experience hot flushes and other menopausal changes many years after their hysterectomies because the ovaries still make hormones even when the uterus is removed. Hormones are usually unnecessary if you have already undergone menopause.
Overall, a hysterectomy is a common procedure and in your discussion with your doctor be sure to ask questions about the type of hysterectomy, ovarian removal and hormones prior to your surgery.
I am board certified in Obsetrics and Gynecology (OBGYN) and Female Pelvic Medicine and Reconstructive Surgery (FPMRS). I currently serve as the Medical Director of Female Pelvic Medicine for the Crozer Health Medical Group in the greater Philadelphia area. I obtained my residency training in OBGYN at the Los Angeles County+ University of Southern California Medical Center and fellowship training in FPMRS at Johns Hopkins. I am passionate about the field of Women’s Health and the treatment of pelvic floor disorders like urinary incontinence and pelvic organ prolapse.