Hysterectomies experience their fair share of scrutiny these days, as they should be. For much too long, these invasive surgeries were used to “cure” everything from bona fide medical conditions, to mood disorders. In fact, hysterectomies continue to be the second-most common type of surgery for women, after caesarian sections.

Doctors didn’t think much about removing the uterus, fallopian tubes, ovaries (sometimes the cervix and parts of the vagina) when women were done having children. Now, with more research and wisdom on our side, OB/GYNs recognize hysterectomies have been over prescribed and that sometimes it makes safer and better sense for a woman’s long-term health to keep the uterus inside.

When, then, does it make the most sense to have a hysterectomy?

Always ask your doctor to review the full-range of treatment options, and consider the pros and cons to each, before making a final decision about a hysterectomy. Also, you should get a second opinion – or third- – whenever you’re not 100% clear about your decision.

Sometimes, a Hysterectomy Really Is the Best Treatment

Here are situations where we believe hysterectomies really are the best treatment method available to our patients.

Do keep in mind that you may only need a partial-hysterectomy – meaning we leave the

fallopian tubes and ovaries intact to maintain you normal hormone balance. With this type of surgery, you won’t need post-surgical hormone supplementation.

You’ve been diagnosed with cancer

If you’ve been diagnosed with a particular cancer of the reproductive organs, particularly the uterus or the endometrium, a hysterectomy if often a wise call, particularly if you’re done having children. This may be the best way to eradicate the cancer entirely, preventing it from metastasizing if possible.

All other options have been explored – to no avail

If cancer or other progressive diseases aren’t in the picture, hysterectomies should be considered a last-alternative because it is a surgery, and the end result forever changes the landscape of your pelvis and reproductive organs. We always recommend trying medication, alternative and/or less-invasive treatment methods first –landing on hysterectomy if none of them were successful.

Chronic bleeding or pain

Certain conditions, ranging from endometriosis to fibroid tumors, cause chronic bleeding. In addition to causing anemia, chronic fatigue and weakness – chronic bleeding is a major life disruptor. If treatments like hormonal therapy (such as an IUD), myomectomy, radiofrequency oblation, uterine artery embolization, etc., don’t work, then a hysterectomy might be the right choice for you.

Other times, patients have excruciating, unidentified pain in their uterus. Surgery may be the only alternative if other diagnostic/treatment methods are unsuccessful.

Severe uterine prolapse

Sometimes a woman’s uterus (along with other organs in the pelvic region) begin to prolapse (sink down) as the result of weakening connective tissues in the pelvis. Often, pelvic organ prolapse (POP) is treatable via physical therapy and/or a pessary. If, however, the prolapse is severe and/or causes terrible discomfort, it makes sense to remove the uterus and surgically support other affected organs.

Need a second opinion before pursuing a hysterectomy? Schedule a consultation at Women’s Health Associates and we’ll be happy to review your case and provide a woman-to-woman recommendation based on what we learn.