What is a hysterectomy?
A hysterectomy is a procedure, whereby the uterus is removed from a woman’s body. There are, however, different types of hysterectomy:
- Total hysterectomy with removal of ovaries
- Standards/total hysterectomy
- Partial hysterectomy
What types of Hysterectomy are there?
Total hysterectomy with removal of ovaries
A total hysterectomy with removal of ovaries is where the uterus, ovaries and cervix are all removed. This is usually performed when there is a cancer diagnosis, and doctors want to be sure that there are no cancerous cells remaining.
A standard/total hysterectomy is where only the uterus and cervix are removed, leaving the ovaries. If there is a lower risk of ovarian cancer, doctors may opt to leave healthy ovaries intact, as they can release hormones that help with things like bone health later in life.
A partial hysterectomy is where only the uterus is removed, leaving the cervix and ovaries intact.While removal of the cervix is generally advised because it is a potential cancer site, some women feel that it serves a purpose during penetrative sex. If the cervix is kept, regular cervical screening is still necessary.
Why might a hysterectomy be necessary?
Reasons for a hysterectomy procedure vary, but include:
Uterine fibroids are noncancerous growths that form in the uterus. They’re the most common reason for a hysterectomy. Your doctor may first recommend medications or other less-invasive procedures, such as a myomectomy, removing only the fibroids and leaving the uterus intact. If other measures fail or fibroids continue to regrow and produce bothersome symptoms, a hysterectomy may be an option.
Heavy periods can negatively affect a woman’s quality of life, but they don’t have to. Cramps and heavy bleeding can be solved by less invasive treatment options, however, if these are ineffective, then your doctor may suggest a hysterectomy.
Long-term pelvic pain:
This may be caused by Pelvic Inflammatory Disease (PID), a bacterial infection of the reproductive system. Initially, this can be treated by antibiotics, however, if pain and infection persist, then a hysterectomy may be a better solution.
Cancer is the reason about10 percent of all hysterectomies are performed. A hysterectomy might be needed if you have cancer of the:
Your treatment approach will depend on the type of cancer you have, how advanced it is, and your overall health. Other options may include chemotherapy and radiation.
Endometriosis is a condition where tissue that normally lines the uterus grows outside of it. Endometriosis can cause pain and irregular periods, and can also lead to infertility. Hormone therapy and medical procedures to remove endometrial tissue are usually tried before a hysterectomy.
Prolapse of the uterus:
Uterine prolapsehappens when your uterus slips from its normal place and falls into the vagina. This condition is more common in women who’ve had multiple vaginal births. Treatment options often depend on how severe the prolapse is, but if more minimally invasive measures are ineffective or aren’t a good fit, a hysterectomy may be the treatment of choice.
While some women may be dealing with one of the conditions above, a hysterectomy may not always be necessary. A gynaecologist may suggest other treatment options before recommending a hysterectomy. Furthermore, if a hysterectomy is suggested, then the type of hysterectomy performed may depend on the condition.
Recovery after a hysterectomy
Depending on the surgical methods used (Laparoscopically, vaginally or abdominally) and the type of hysterectomy, recovery may differ.
The hospital stays for a hysterectomy is usually relatively short, around 2-4 days depending on the procedure type and any complications. In the case of an abdominal hysterectomy, a roughly 10cm horizontal incision will be made across the top of your pubic hairline, although occasionally vertical incisions are used. Patients are placed under general anaesthetic for this procedure.
After surgery, depending on whether you have stitches, staples or glue, your doctors will advise you shortly after surgery on wound care and dressings. Occasionally a small drain will be inserted to get rid of any accumulated blood and fluid.
You may experience vaginal bleeding for one to two weeks after surgery which is completely normal and to is expected. There may also be some pain and discomfort in the lower abdomen due to trapped wind, and/or the procedure itself. The doctors will prescribe pain medications that should relieve this.
Recovery will be helped primarily by making sure you get lots of rest, however, it is recommended that you move around a little, and partake in light household activities. Eating a healthy and balanced diet will also improve the rate and quality of recovery.
Pelvic floor muscle exercises are good for easing side effects from the surgery, for example preventing prolapse of the pelvic organs, maintaining bladder control and improving sexual satisfaction. Hormone replacement therapy may also be suggested. Your recovery may be slowed down if you have other health problems, if you are obese, or if you are a smoker.
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How will a hysterectomy affect my body?
A hysterectomy means you will no longer have menstrual periods, and you will not be able to become pregnant. Depending on your procedure this means that you will experience an immediate, or likely early menopause. You may experience some weight gain during recovery, and/or as a result of early-onset menopause. This is normal and to be expected.
If you have had a partial hysterectomy, then your cervix will still be intact, meaning that you could still be at risk for cervical cancer, therefore it is important to continue with regular screening.
How will a hysterectomy affect my hormones?
Owing to the removal of sex organs, a hysterectomy will affect your hormone levels. This depends, however, on what type of procedure you have had, and whether or not you decide to have Hormone Replacement Therapy.
If you have a total hysterectomy and your ovaries are removed, you will experience immediate menopause, regardless of your age. This is known as surgical menopause. If your ovaries are left intact, then you will likely start menopause within 5 years of your operation.
Hormone replacement therapy
If you experience surgical menopause then you should be offered hormone replacement therapy (HRT). Hormone replacement therapy can help with menopausal symptoms caused by surgical menopause such as hot flushes, mood swings and reduced sex drive. They can be prescribed by a GP after an assessment if wanted and/or required.
Most women can have HRT, however, you may want to avoid it if you have a history of breast cancer, blood clots, high blood pressure or liver disease. Depending on the procedure, either oestrogen or a combination of oestrogen and progesterone may be recommended. These can be taken as tablets, through skin patches, gels, vaginal creams, pessaries or rings. These are usually taken for a few years until the menopausal symptoms pass.
Sex after a hysterectomy
It is recommended that patients do not have sex for around 4-6 weeks after a hysterectomy, to allow your body to heal. After this, so long as it is comfortable, you may continue having sex as normal. You may experience a lower sex drive after a hysterectomy which is completely normal, and this may improve with recovery time.
A hysterectomy will not make you unable to have orgasms! Surgical menopause, however, may cause vaginal dryness leading to discomfort during sex. This is not a cause for worry and can be helped by using a sexual lubricant that can be bought over the counter.
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“After my hysterectomy, I’m living my best life” – Lakisha Watson-Moore
Lakisha is a US Navy veteran, who was experiencing pain and heavy periods, resulting from uterine fibroids. Her family had a history of uterine fibroids, and after her sister had a hysterectomy, she urged Lakisha to consult a gynaecologist about having one also.
Being a “workout junkie”, Lakisha was struggling against her pain, and despite her hard work, was finding it difficult to maintain her desired fitness level. Having been told she was a good candidate, she scheduled her hysterectomy, and thisradically changed her life.
Lakisha can now work out pain-free and is no longer held back by her heavy periods. She is finally living up to her full fitness potential!
Lakisha’s ovaries were left intact, and she explained that it took some time for her body to adjust hormonally. She also shared that her recovery was more difficult than she expected and that she struggled mentally from not being able to work out.
Nonetheless, Lakisha feels that her hysterectomy was 100% worth the short term recovery, and maintains that it is the “best decision she has ever made”. She recommends making a plan for after surgery, to help with recovery. This could be things like keeping snacks next to your bed, having lots of pillows to support you, and making sure that you have a friend, family member, or doctor who you can contact if you need anything, and to help you do the things you can’t initially.
Finally, Lakisha encourages any women who may be considering a hysterectomy to speak openly about it with their doctors, friends or family. She wants to break the taboo around women’s bodies, and help women to speak out about their experiences, as hysterectomies and uteruses are all part of our experiences as women, and are nothing to be worried about or ashamed of.
For more information and support, before and after your hysterectomy, visit “HysterSisters” at:https://www.hystersisters.com
Using Elara Care, along with period tracking, you can gain an accurate breakdown of your hormonal changes and how this impacts all areas of your wellbeing, including mood, energy, libido, focus, physical strength and mental wellness. You can also find more information and resources regarding sexual health, mental wellbeing, nutrition and fitness, to learn more about the female body and how it is affected by your hormones and menstrual cycle.
Click here to learn more about the elara care app
Royal College of Obstetricians and Gynaecologists – https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/recovering-well/abdominal-hysterectomy.pdf