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What is a hysterectomy?
A hysterectomy is an operation to remove a woman's uterus (womb). The uterus is where a baby grows when a woman is pregnant. Sometimes the fallopian tubes, ovaries, and cervix are removed at the same time the uterus is removed. These organs are located in a woman's lower abdomen (see image below). The cervix is the lower end of the uterus. The ovaries are organs that produce eggs and hormones. The fallopian tubes carry eggs from the ovaries to the uterus.
Image source: National Cancer Institute
If you haven't reached menopause yet, a hysterectomy will stop your monthly bleeding (periods). You also won't be able to get pregnant.
There are several types of hysterectomy:
Often one or both ovaries and fallopian tubes are removed at the same time a hysterectomy is done. When both ovaries and both tubes are removed, it is called a bilateral salpingo-oophorectomy.
If the ovaries are removed in a woman before she reaches menopause, the sudden loss of her main source of female hormones will cause her to suddenly enter menopause (surgical menopause). This can cause more severe symptoms than a natural menopause.
Hysterectomy is the second most common major surgery among women in the United States. (The most common major surgery that women have is cesarean section delivery.) Each year, more than 600,000 hysterectomies are done. About one third of women in the United States have had a hysterectomy by age 60.
Hysterectomies are done through a cut in the abdomen (abdominal hysterectomy) or the vagina (vaginal hysterectomy). Sometimes an instrument called a laparoscope is used to help see inside the abdomen. The type of surgery that is done depends on the reason for the surgery. Abdominal hysterectomies are more common than vaginal hysterectomies and usually require a longer recovery time.
Hysterectomies are most often done for the following reasons:
Cancers affecting the pelvic organs account for only about ten percent of all hysterectomies. Endometrial cancer (cancer of the lining of the uterus), uterine sarcoma, cervical cancer (cancer of the cervix), and cancer of the ovaries or fallopian tubes often require hysterectomy. Depending on the type and extent of the cancer, other kinds of treatment such as radiation or hormonal therapy may be used as well.
Other reasons why hysterectomies are done include chronic pelvic pain, heavy bleeding during or between periods, and chronic pelvic inflammatory disease.
If you have a condition that is not cancer, such as fibroids, endometriosis, or uterine prolapse, there are often other treatments that should be tried first. In most cases, a hysterectomy need not be done immediately. There is time for you to get more information and look into possible alternatives.
In cases of serious disease, such as cancer, a hysterectomy may not be optional and may be a life-saving choice. Before you decide what to do, it is important that you understand your condition and your options for dealing with it.
If you are suffering from continuing, severe problems with pelvic pain and abnormal uterine bleeding, and other treatments have not helped, a hysterectomy may provide welcome relief. Studies have shown that a hysterectomy often improves sexual functioning and quality of life for women suffering from these problems.
On the other hand, some women suffer serious complications from hysterectomy, even death. Most complications are less serious, and may include reactions to anesthetics, pain, infection, bleeding, and fatigue. Sometimes other pelvic organs such as the bladder and bowel are injured during a hysterectomy. Hysterectomy is also linked to urinary incontinence (problems holding your urine) and loss of ovarian function and early menopause. Some women experience depression and sexual dysfunction after hysterectomy.
If you are told that you should have a hysterectomy:
If you have had a total hysterectomy, in which the cervix was removed along with the uterus, you will not usually require Pap testing. An exception is if your hysterectomy was done because of cervical cancer or its precursors. Ask your health care provider if you need to have periodic Pap tests. It is important for all women who have had a hysterectomy to have regular gynecologic exams as part of their health care.
For more information
To learn more about hysterectomy, contact the National Women's Health Information Center (NWHIC) at 1-800-994-WOMAN or the following organizations:
Agency for Healthcare Research and Quality
American College of Obstetricians and Gynecologists (ACOG) Resource Center
American College of Surgeons
All material contained in the FAQs is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the Department of Health and Human Services; citation of the source is appreciated.