Hysterectomy – reasons why it may be necessary

Hysterectomy is a common surgery among women, second only to cesarean sections.  In the United States alone, around 600,000 women have this procedure done which is a surgical removal of the uterus and sometimes the cervix and supporting tissues.  Once a woman has this procedure, she will no longer be able to get pregnant.  It is the most common non-pregnancy-related major surgery performed on women in the United States with one in three women having a hysterectomy by age 60. 

Generally, most hysterectomies are not emergency operations so a woman will have time to discuss with her doctor whether she should have one or not and time to think about her options. 

There are many and varied reasons why a woman may be recommended by her doctor to have a hysterectomy.  Every woman is an individual with her own unique reasons why the procedure may be necessary. 

Reasons why a woman may need a hysterectomy

There are three categories as to why a woman may be recommended or required to have a hysterectomy:

·      To save her life

·      To correct a serious problem that is interfering with normal functioning

·      To improve the quality of her life

Here are the more common reasons why a woman may need this procedure:

·      Uterine fibroids

The most common reason why hysterectomies are done is because of fibroids in the uterus.  Fibroids are common, benign (noncancerous) tumors that grow in the muscles of the uterus.  Many women may not even know they have them but for others, it can cause significant heavy bleeding or pain making it necessary to have a hysterectomy for relief. 

·      Endometriosis

A benign condition that affects the uterus is endometriosis.  It is the second most common reason why a woman may need a hysterectomy.  Endometriosis occurs when endometrial tissue (the inside lining of the uterus) begins to grow on the outside of the uterus and on nearby organs.  This condition may cause painful menstrual periods, abnormal vaginal bleeding and loss of fertility.

·      Cancer

Cancer found within the female reproductive organs accounts for about 10 percent of all hysterectomies.  Endometrial cancer, uterine sarcoma, cervical cancer, and cancer of the ovaries or fallopian tubes often require a hysterectomy.  Depending on the type and extent of cancer, other kinds of treatment such as radiation or hormonal therapy may be used as well.

·      Uterine prolapse

This is a benign condition in which the uterus moves from its usual place down into the vagina.  Uterine prolapse is due to weak and stretched pelvic ligaments and tissues, and can lead to urinary problems, pelvic pressure or difficulty with bowel movements.  Also contributing to the problem is childbirth, obesity and loss of estrogen.

·      Hyperplasia

This is when the lining of the uterus becomes too thick and causes abnormal bleeding.  It is believed to be caused by too much of the hormone estrogen.

·      Pelvic pain

This is a common symptom also for many women who are recommended to have a hysterectomy.  There can be a number of causes of pelvic pain which include endometriosis, fibroids, ovarian cysts, infection, or scar tissue. 

General considerations before having a hysterectomy

Like with any major surgery, a woman should make sure her physician has done a careful diagnosis that follows the protocol for recommending a hysterectomy.  The risks of hysterectomy include the risks of any major operation, although its surgical risks are among the lowest of surgeries.  All women should thoroughly discuss with her physician the pros and cons of this procedure and have a thorough understanding of what to expect before, during and after the operation.  The more a woman has done her research on why she needs a hysterectomy, the more likely she will have a good outcome after it is done.