Being told that you may need a hysterectomy is scary. The uterus, ovaries and cervix are not just parts of an organ in a woman’s body; they’re a source of reproduction, pleasure and hormones necessary for healthy functioning. About 20 million American women have undergone this surgery, and approximately 600,000 women per year will get a hysterectomy in our country. These rates are higher than other first-world countries, and because unnecessary hysterectomies are on the rise, it’s important to know the facts.
Know your options
About 90% of hysterectomies are considered unnecessary, which means they’re elective based on what problems a woman experience. Dr. Lawrence Lo, a doctor of obstetrics and gynecology at Hancock Health, says that a hysterectomy should be considered a “surgery of last resort.” For serious and malignant conditions, such as cancer of the uterus, ovaries or cervix, a hysterectomy is, of course, the best option to keep the disease from spreading. Other conditions — pelvic pain, painful intercourse, endometriosis, heavy menstrual periods, prolapse, fibroids and polyps — are reasons for a woman to elect for a hysterectomy, but there are other options that should be tried first.
For instance, women experiencing painful menstruation may benefit from medications, diet or lifestyle changes or other alternative therapies before opting for surgery. Likewise, for a woman experiencing prolapse, a pessary is a better option than a full surgery that equals a difficult recovery time and hormonal implications. Lo counsels patients throughout their decision process because the surgery does not always make sense, especially in benign diseases, unless other avenues have been exhausted first.
Hysterectomies are not created equal
A hysterectomy doesn’t always involve the removal of the ovaries, uterus and cervix. In fact, the ovaries and the cervix are often left behind because they help hormone production as well as maintain the vagina’s structure. The cervix helps prevent prolapse and preserves sexual function. If the uterus and cervix are both removed, it’s a complete, or “total,” hysterectomy. A partial hysterectomy removes only the top part of the uterus, or the “uterine corpus,” leaving the cervix in place. These are less common when there’s a malignant condition. “In the United States, we generally remove the cervix as well because we are cancer phobic,” says Lo about the practices in America compared to other countries.
The root of the surgery is another decision for a patient and provider to make. The root is where the incision will be made; this can significantly impact recovery time. An abdominal hysterectomy, in which an incision is made on the lower abdomen, has the longest recovery time but may be non-negotiable in some cases. Vaginal and laparoscopic hysterectomies, however, require a bit less intense recovery because the incisions are smaller. The root depends on the purpose for the surgery.
Recuperation times differ for women depending on activity level and healing ability. But know that this is a serious surgery, and recovery should not be taken lightly. A patient will generally experience soreness and difficulty managing any tasks for about a week after surgery. From there, they may be able to be self-sufficient and can begin slow and mindful movements. Women should not exercise vigorously for at least six to eight weeks no matter what type of hysterectomy was performed.
After a hysterectomy, a patient will meet with their doctor to discuss healing as well as any side effects they’re experiencing. A hysterectomy involving the ovaries will cause menopause to happen immediately, while those leaving the ovaries intact will generally cause the patient to experience an earlier menopause than they would have otherwise. While Lo says he prefers to try other things besides hormone-replacement therapy, sometimes it become necessary if a woman experiences symptoms that affect her quality of life.
Lo and the team at Hancock Regional Obstetrics and Gynecology are available for any concerns regarding women’s health, including conditions that may meet criteria for surgical intervention. With gentle guidance and knowledgeable doctors, the staff at Hancock OBGYN is passionate about serving women. Contact them today to schedule an appointment.