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BellaOnline's Gynecology Editor

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Hysterectomy - Making an Informed Decision

Guest Author - Linda Reid

There are many legitimate reasons to have a hysterectomy, but if the reasons are not life-threatening, careful consideration should be given before undergoing this procedure. When a woman is experiencing pain and discomfort, and problems with her reproductive system are impacting on her quality of life, a hysterectomy might seem like a simple and straightforward solution but no one should submit to such a radical alteration to her body until they are aware of the consequences and possible alternative treatments.

It is important to always maintain a dialogue with your gynecologist. Make sure you know why a hysterectomy is preferable for treatment. Find out if there are alternatives. Show your doctor that you are willing to work with her/him to find ways to make yourself feel better. While you need to place your trust in the opinions of a professional, it is your right to know the reasoning behind any kind of treatment. Don’t be afraid to ask questions.

Really Good Reasons to Have a Hysterectomy

The following is a list of conditions that may warrant a hysterectomy:

• Cancer: Your doctor will explore the various treatment options with you. Hysterectomy is one of them.

• Fibroids: Determine if the condition is severe enough to justify removal of the uterus. Uncontrolled bleeding, intense pain, compression of urinary tubes, are reasons why a hysterectomy might be warranted.

• Emergency obstetrical complications such as a pregnancy outside the uterus.

• Severe haemorrhaging or rupture of the uterus.

Not Necessarily Good Reasons to Have a Hysterectomy

A hysterectomy might be the final solution if all else has failed for the following:

• Dysfunctional Uterine Bleeding: Excessive bleeding that won’t stop after other kinds of medical interventions. The pros and cons should be carefully considered before having a hysterectomy for this reason.

• Endometriosis: A hysterectomy is usually desired in this case for pain relief but should be a last-ditch attempt after all other avenues of treatment have been explored.

• Uterine Prolapse: Prolapse can cause a blockage in the urinary tract and restrict bowel movements. In some cases, the cervix falls outside the vagina and becomes irritated. Alternatives to a hysterectomy exist, such as corrective surgery, using a pessary and urinary balloons.

• Chronic Pelvic Pain: The pain should be severe enough to have an impact on the quality of life, before choosing a hysterectomy.

Considering the Consequences

The following are consequences that may occur. It can depend on the extent of the surgery (for instance, a partial hysterectomy in which some parts such as ovaries or the cervix remain intact vs a full hysterectomy which involves removal of all the reproductive system), the skill of the surgeon, and the reason for the surgery:

• Greater risk of heart disease and osteoporisis.
• Depression associated with female self-image.
• Low libido.
• Inability to achieve orgasm or achieving a less intense orgasm than prior to surgery.
• Other sexual dysfunction.
• Can no longer have children.
• Weight-gain.
• Urinary incontinence.
• Decreased estrogen levels and the accompanying side effects such as vaginal dryness and hot flashes.
• Onset of menopause.

Many women report that their sex life improved after a hysterectomy especially if the medical problem was causing bleeding and pain. For some, the fear of an unwanted pregnancy inhibited the ability to enjoy sexual relations so the elimination of that fear via hysterectomy allowed increased pleasure. Quality of life improved after pain and discomfort were gone. And most women don’t miss the inconvenience of a monthly period.

Making the Final Decision

If you are facing the possibility of having a hysterectomy, make sure the reasons are sound. Ask your health-care provider if you might be a candidate for an alternative treatment. Find out all you can about your diagnosis. Get a second opinion. And if your doctor has determined that a hysterectomy will save your life, don’t put it off. You might not want to but you can live without your uterus. Just make sure you need to before you do.

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Content copyright © 2014 by Linda Reid. All rights reserved.
This content was written by Linda Reid. If you wish to use this content in any manner, you need written permission. Contact Dr. Denise Howard for details.

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