HYSTERECTOMY
By Paul MacKoul, MD – Laparoscopic GYN Surgeon and Co-Founder of CIGC.
Life After a Hysterectomy – Changes to Your Body
A hysterectomy, which is the surgical removal of the uterus, can be a positive life-changing procedure for patients who are no longer interested in fertility. The extent of changes to your body will depend on your reason for having a hysterectomy and the type of procedure being performed.
Be sure to consult with a GYN specialist who can review your options and help you determine the right procedure for your individual needs.
Physical Changes After a Hysterectomy
End of Periods and Pregnancy
Since the uterus, or womb, is removed regardless of what type of hysterectomy is performed, periods will stop and pregnancy will no longer be possible.
Hormone and Physiology Changes – Weight Gain, Depression, Anxiety, Hair Growth, etc.
Although some of these changes can occur if the ovaries are removed, performing a partial hysterectomy with retention of the ovaries will not cause any of these symptoms. Since estrogen, progesterone, and testosterone continue to be produced, the hormone profile won’t change.
Removing the ovaries can lead to some of these symptoms if they are removed during the hysterectomy. For those patients that require or want ovarian removal, hormone replacement therapy is an excellent treatment option and, in many cases, may provide complete relief from these symptoms.
Sexual Function
Patients who retain one or both ovaries after hysterectomy (partial) in general do not have complaints of dryness in the vagina or altered sexual function. In fact, many women report that sexual intercourse is often improved due to the removal of a very large bulky uterus that caused pain with intercourse, or difficulty with penetration. Complete hysterectomy does remove the ovaries and will lead to menopause (see below for more information).
Some patients undergo supracervical hysterectomy, which retains the cervix as well as the ovaries. This maintains normal vaginal function so that the top of the vagina is not affected by the surgery. Lubrication is not affected from the cervix, and normal ovarian function maintains estrogen production to keep the walls of the vagina healthy and maintain lubrication. This becomes a good option for patients who are younger and sexually active. Pap smear history and a history of prior cervical dysplasia must be evaluated to ensure this is the correct approach for each patient.
Prolapse, or “Drop down” of Internal Organs
Hysterectomy has been shown in multiple studies not to cause prolapse. Prolapse is much more common in those patients who have delivered vaginally, and with larger baby weights. Patients who have had Cesarean section, or not had any deliveries are much more unlikely to have problems with prolapse. Some believe that retention of the cervix may prevent prolapse, but data on this are equivocal.
Menopause in Complete Hysterectomy
Menopause only occurs after a complete hysterectomy in which both ovaries are removed. The ovaries produce the hormones estrogen and progesterone, which work in tandem to maintain reproductive and sexual function. Without at least one ovary, a woman who has not yet begun natural menopause is likely to develop menopausal symptoms. Estrogen-only hormone replacement therapy can help improve these symptoms. Talk to your doctor to see if this treatment is right for you.
Menopause will not occur if a partial hysterectomy is performed, or a supracervical hysterectomy is performed with the ovaries retained.
Relief From Gynecological Symptoms
Removing the uterus can be an effective way to treat chronic, severe GYN conditions such as uterine fibroids, adenomyosis and endometriosis.
Once their hysterectomy has freed them from extreme pelvic pain, excessive bleeding and/or other symptoms, most women find their quality of life to be significantly better.
Is a Myomectomy an Option?
A hysterectomy is an effective treatment for uterine fibroids, endometriosis and other GYN conditions, but it is often not the only choice. With our LAAM® myomectomy procedure, for example, patients who are capable of fertility can have their fibroids removed while in most cases their uterus is preserved.
Other surgical procedures, medications and alternative health care treatments may be appropriate for you. It’s important to see a highly trained expert who specializes in complex GYN conditions so you can consider all your options.
When to Call Your Health Care Provider
CIGC’s advanced surgical method for performing a hysterectomy, DualPortGYN®, has been shown in studies to provide the lowest complication rates during and after surgery compared to other hysterectomy approaches. As with any surgery, however, you should know what signs to be aware of and when to contact your doctor.
