Years ago, I worked alongside a hilarious gynaecologist who frequently joked about the changes in women’s hormones after the age of 40. And 18 years ago, I thought he was mean. But then I turned 40 and many things started to change!I can clearly see why he found this observation amusing!
So when these changes occur, we either have to learn to cope or we have to seek intervention. There are many suitable interventions that are less permanent than a hysterectomy to potentially opt for, but it will of course depend on the symptoms or diseases you are experiencing. For cancer situations however, your options will be limited. Talking to one or more Gynaecologist’s can often point you in the right direction.
But what is a hysterectomy?
Historically a hysterectomy was treatment for ‘hysteria’. One can only assume that this meant to treat the mood swings associated with the diminishing reproductive hormones with age. These days age is a less common indication than debilitating symptoms for this surgery. A hysterectomy is the removal of the uterus from your body. A total or radical hysterectomy may also be done including fallopian tubes, cervix and even the top of the vagina. An oophorectomy may be included, removing the ovaries. Hysterectomies can be performed vaginally, laparascopically or abdominally – depending on the severity and causation.
So what are the reasons that your doctor may recommend a hysterectomy for you?
Fibroids
Approximately 65% of women over the age of 35 have fibroids. They are benign growths on the uterus that can contribute to pain and excessive bleeding and are believed to be caused by high oestrogen. Often after menopause, they shrink and cause less problem. Often you can have them and not even know.
Excessively heavy periods
If you experience very heavy menstrual bleeding and have tried other options to manage without success, this may be the solution for you. Heavy bleeding can also contribute to anaemia (iron deficiency), leaving you extremely fatigued. Iron deficiency and thyroid problems can also contribute to heavy bleeding – so be sure to investigate all causes first.
Chronic Pelvic Pain
Whether you know the cause or not, chronic pelvic pain can be very debilitating. When you have tried other options and not succeeded to manage the pain, your doctor may suggest a hysterectomy in an attempt to sort out the pain.
Prolapse
As we age reproductive hormones lower, and muscle integrity can decrease, the uterus may drop down in the pelvis and place uncomfortable pressure in the vaginal area, bladder and bowel. Previous surgery, pregnancy and childbirth can make you more prone. Whilst bladder and bowel prolapses can be repaired, uterine prolapses are usually resolved with the removal of the uterus.
Adenomyosis
Is a type of endometriosis, but specifically affects (and grows) inside the muscle of the uterine wall. It can be very painful and cause heavy menstrual bleeding. Screening tests can establish if this is your problem. Removal of the uterus removes the adenomyosis, but not endometriosis affecting other reproductive and abdominal organs.
Reproductive cancers
Any reproductive cancers will require a hysterectomy, usually a radical one to remove all affected areas and help prevent the spread. Often this will be followed by other treatments such as chemotherapy and radiotherapy. Sometimes the surgery will be recommended if you have specific genes for certain cancers and to prevent them from occurring.
Things to consider if you are faced with the option of hysterectomy:
It is permanent. Once the reproductive organs have been removed, they cannot be replaced! You will have no more periods. You will not be able to have any (more) children and you may require hormone supplements (either medical or natural – bioidentical hormones, herbal) if the ovaries are removed to help alleviate the rapid onset of menopause symptoms.
Recovery times may vary. For vaginal and laparoscopic procedures, recovery time is usually 2-6 weeks and for abdominal surgery, 6 weeks or more.
Having a hysterectomy can be emotionally challenging, especially if you really don’t want one. One can grieve the loss of their fertility and reproductive system. Counseling is advisable if you are faced with the decision.
Many worry that a hysterectomy will affect their libido and ability to have intercourse. If the ovaries are removed, hormone levels will change and have the ability to decrease libido. Hormone or natural treatments can assist with this. If you allow the appropriate healing time following the procedure, you should be able to resume intercourse with no issues. It’s more the loss of hormones that can affect the vaginal tissue and cause dryness. Lubricants, hormone replacement and even natural medicine can provide solutions to this.
Before you make your final decision:
- See your doctor or health practitioner(s) to discuss your individual case.
- Try other less invasive and less permanent options in non cancerous situations.
- Exhaust all possible reasons for the problem before opting for treatment.
- Sometimes the result can be simple and managed with little cost or effort.
- Talk through with a counselor if needed.
- Sometimes a second opinion is worth the effort.
- It is your personal journey and your body.
- Get a referral to a gynaecologist.
- Talk to your friends… a personal recommendation is often a great way to find a well suited specialist.
For what ever the reason you may need a hysterectomy, it will hopefully achieve the outcome you have been seeking. For many who have suffered for a long period of time, a hysterectomy may just solve your problems and be a blessing. And remember you will get through the whole experience better if you are in optimal health before the procedure.
