Hysterectomies are the second-most common surgery for women of child-bearing age in the United States (second only to cesarian sections). A hysterectomy is a full surgical procedure used to remove a woman’s uterus, or womb, and is used to treat a range of medical conditions, including severe endometriosis, unmanageable vaginal bleeding, uterine fibroid tumors, invasive cancers of the uterus, cervix, vagina, fallopian tubes or ovaries, unmanageable infections and severe complications from childbirth.
The problem is that historically, hysterectomies have been over-prescribed as a treatment. A study published in the March 2015 issue of the American Journal of Obstetrics and Gynecology found that one in five hysterectomies was unnecessary and that the condition warranting the surgical procedure could have been treated otherwise. And, currently, about 30% of women 60-years and over have had a hysterectomy. That’s pretty startling information.
Are you interested in receiving a second opinion about whether or not you need a hysterectomy? Contact the all-women team here at Women’s Health Associates so we can support you as you make the best decision for your body.
Consider getting a Second Opinion Before Getting a Hysterectomy
For this reason, unless the diagnosis is life threatening or involves a condition unable to be treated less-invasively, we recommend having a serious conversation with your gynecologist – exploring all the options. If you don’t feel completely confident about pursuing a hysterectomy and your physician is adamant, you should pursue a second opinion.
In decades gone by, hysterectomies often included the removal of the fallopian tubes and/or ovaries. Now called a radical hysterectomy, this procedure is more rare and is only recommended when cancer or infection affects or threatens the fallopian tubes and/or ovaries. Radical hysterectomies require post-surgical hormone therapy to replace hormones no longer produced without the ovaries. Be aware that women who have radical hysterectomies are at significantly higher risk of developing other cancers than women who undergo full or partial hysterectomies.
Most of the hysterectomies performed today are either full hysterectomies, which
remove the entire uterus and the cervix, or supracervical hysterectomies, meaning the uterus is removed but the cervix remains in place.
Serious surgeries can result in serious side effects, and even after the surgical procedure is over, there can be physical effects that last for the rest of your life.
Some of the more serious risks and side-effects associated with hysterectomies are:
- Infection. The risk of infection is present for any patient receiving a surgical procedure. In the case of hysterectomies, these infections occur most often in the incision above the vagina. There is about a 30% chance of surgical complications while you’re in hospital, the large majority of which are fever and/or infection. Most infections are treated using antibiotics. Infections that don’t respond to antibiotics often require the use of secondary surgical interventions to treat the infected area.
- Blood loss. If you already suffer from heavier-than-normal menstrual bleeding, discuss this risk with your doctor as you are at risk for higher levels of blood loss during the procedure than your counterparts. Also, abdominal hysterectomies result in higher blood loss than laparoscopic or vaginal versions.
- Organ damage. The uterus is surrounding by a host of soft, vulnerable abdominal organs, including the bowels, the urinary tract and the bladder. All of these are at risk during surgery. Surgeons pay particular attention to surgery-related injuries so they are (hopefully) repaired in real-time. Organ damage that occurs without warranting attention in the moment can cause severe side-effects – including serious infection if bowels were nicked – later on.
- Spreading cancer cells. Unfortunately, evidence shows that certain surgical techniques – and certain tools used to perform hysterectomies – have a higher risk of spreading cancer cells to other areas in the pelvic and abdominal cavities than others. Discuss your surgeon’s technique of choice in detail so you feel confident she’s using the safest and least-invasive method required.
Less-Risky Side Effects of Hysterectomies
Once the surgery is over, and you have healed, there are other potential side effects worthy of your consideration:
- Early onset menopause. This is one of the biggest. Even if your ovaries are left untouched, women who undergo a hysterectomy before the age of 50 are likely to experience menopause as much as four or five years earlier than they would have otherwise. This may not seem like such a big deal, but it is. Once a woman goes through menopause, she is at higher risk for certain medical conditions and her ability to retain bone density diminishes, making her more likely to develop osteoporosis if she doesn’t take precautions.
- Increased risk of heart disease and stroke. Post-menopausal women have a higher risk of developing heart disease, suffering from a heart attack and/or having a stroke. All that changes when estrogen levels dip after menopause. Since women with hysterectomies tend to go through menopause early, their risk of heart attacks and strokes is higher than it would have been otherwise. If you’re not staring at a life-threatening disease or diagnosis, or a medical condition that affects your quality of life to a dramatic degree, it may be worth holding off on getting your hysterectomy until you’re through menopause on your own.
- Urinary or fecal incontinence. Women have a higher risk of developing urinary and fecal incontinence after the surgery. Outside of the organ damage risk we discussed above, removing the uterus may put you at risk for more severe prolapse of pelvic organs since organs can shift after the surgery. We recommend reading, Living With and Healing Incontinence, to learn more about the natural ways you can treat undesirable incontinence and to learn simple daily exercises that strengthen the pelvic floor – before, after or without ever having a hysterectomy.
- Pelvic pain or sexual discomfort. Scar tissue, inflammation and hormone fluctuations – even without a removal of the ovaries – can occur after a hysterectomy. As a result, women with hysterectomies are more likely to experience pelvic pain, pain or discomfort during intercourse and permanent vaginal dryness. If you have or are experiencing any of these, let your gynecologist know. There are several remedies as well as physical therapy options that can help.
While we in no way want a woman to avoid a surgery that can treat a medical condition, we also want women to remain informed, educated and empowered about the choices they make for their bodies.
Have questions about a recent diagnosis that may result in hysterectomy as a treatment? Interested in receiving a second opinion or learning more about the treatments available to you? Schedule a consultation at Women’s Health Associates and we’ll support you as you sift through information, options and referrals.
image: commons.wikipedia