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Hysterectomy: What you should know before and after

A hysterectomy, the surgical removal of the uterus, is one of most common surgeries performed on American women. By age 60, one in three women will have had her uterus removed. If your doctor suggests you undergo a hysterectomy, you probably have many questions about what the surgery will mean for your quality of life. Learning what to expect can help you decide whether hysterectomy is right for you and ease any anxiety.

Many women undergo hysterectomies to treat endometriosis, uterine prolapse, abnormal uterine bleeding or chronic pelvic pain, but the surgery is most commonly performed to treat uterine fibroids. Gynecological cancers, such as uterine or endometrial, will require removing the uterus, also. For conditions other than cancer, you may have treatment options such as medication, embolization or other surgeries that leave your uterus in place. For many women, however, hysterectomy offers a final solution to pain, bleeding and other symptoms they might have endured for years.

Types of hysterectomies

What you can expect from your surgery depends on the other organs that will be removed with your uterus. Your surgery will likely be one of the following types:

  • Partial, or subtotal. Removes the upper part of the uterus but leaves the cervix in place.
  • Complete, or total. Removes the uterus and cervix. This is the most common type of hysterectomy.
  • Radical. Removes the uterus, cervix, upper part of the vagina and supporting tissues. This type is performed in some cancer cases.
  • Hysterectomy and bilateral salpingo-oophorectomy. Removes the uterus, cervix, fallopian tubes and ovaries.

No more periods

If just your uterus is removed, you’ll continue to ovulate until you reach natural menopause. However, your periods will stop and you won’t be able to get pregnant. Some research suggests that women who have only a hysterectomy, without ovary removal, may enter menopause two to three years earlier than expected.

If your ovaries are removed, you’ll begin menopause right away, and you may experience hot flashes and vaginal dryness. If you’re younger than age 45, removing the ovaries increases your risk for osteoporosis. Ask about treatments to manage menopausal symptoms and prevent bone loss.

Your recovery

After a hysterectomy, you’ll stay in the hospital for a few days. If you have vaginal surgery, you can expect to feel pretty good after two weeks. Recovery from the more common abdominal surgery takes four to eight weeks. In either case, plan to get plenty of rest. After six weeks, most women can take baths, lift heavy objects and resume sexual activities.

Mixed emotions

Although your hysterectomy may bring great relief from chronic pain or heavy periods, you may experience emotional effects, too. You may feel sad about not being able to have children anymore. Each woman is different. Ask your doctor to help you cope with any problems.