The MenopauseRx Hysterectomy Guide

"I'm having problems and I think I need a hysterectomy. Explain what I need to know to determine if it is necessary and what options are available."

Many women will notice gynecologic problems during their lifetime. Often, these problems can affect quality of life and/or daily routine. From prolonged, heavy and irregular periods to chronic pelvic pain there are many reasons for a hysterectomy. Hysterectomy is now commonly done in a minimally invasive manner, which means less pain post-operatively and a quicker recovery time. Fortunately, as technology advances, there are a number of alternatives for hysterectomy. Therefore, women today have many options to consider and a thorough discussion with your doctor is advised to tailor a solution to your gynecologic problems.

Prior to reviewing hysterectomy options, it is very important to understand a few basics about a hysterectomy. To better understand exactly what a hysterectomy is, please click here.

Do I Need a Hysterectomy?

While there are many reasons for a hysterectomy, the majority of hysterectomies are performed for either excessive bleeding or pain.

Bleeding:

Excessive menstrual flow (also known as menorrhaghia) can occur for a variety of reasons. The treatment usually depends on the cause. Typical reasons include both hormonal and structural causes. Hormonal reasons are likely to cause the lining (endometrium) of the uterus to become abnormally thickened, which can lead to heavier menstrual flow. This commonly occurs during the perimenopause transition.  Occasionally, the lining (endometrium) can become very thin which can also lead to abnormal bleeding.  Structural causes of heavy menstrual flow include the development and growth of polyps or fibroids within the uterine cavity/endometrium. Polyps are abnormal growths that can bleed and are either benign or cancerous. Fortunately, the majority are non-cancerous or benign. Fibroids are non-cancerous, abnormal growths that are made of muscle tissue.  They can develop and grow anywhere within the reproductive tract. Many women with fibroids have only minor symptoms and do not need treatement. Fibroids often shrink after menopause. If they become large or grow in or around the endometrium, they can lead to heavy and/or irregular bleeding.

Pelvic Pain:

Pelvic pain is another common cause for hysterectomy. Conditions associated with pelvic pain include endometriosis, fibroids, adenomyosis, and adhesions/scar tissue. Endometriosis occurs when the tissue that lines the uterus grows outside the uterus on the ovaries, fallopian tubes or other organs. This can lead to severe pain before and during a menstrual cycles and pain with intercourse. Adenomyosis is a condition where the lining of the uterus grows into the muscle part of the uterus and can cause severe pain, bleeding and an enlarged uterus.

Pelvic Prolapse:

Pelvic prolapse can lead to hysterectomy. This is a condition where the connective tissue supporting the uterus, bladder and/or rectum become weakened and the uterus and/or pelvic organs slips from its usual place down into the vagina. This weakness can lead to a ‘drop’ of these organs and cause pain, such as pulling, aching, or pressure.  Often, in addition to pain, bleeding from constant rubbing of prolapsed tissues or incontinence can occur.

Cancer:

Gynecologic cancers can lead to hysterectomy. Cervical, uterine, fallopian tube and ovarian cancers do occur with varying frequency and are, in most cases, treated surgically with hysterectomy. Some pre-cancerous changes on the cervix can be treated without hysterectomy by removing the abnormal areas.

What is the Next Step?

A detailed evaluation is necessary to determine if a hysterectomy is the best option. Click here to read about a proper ‘work up’.  The Survival Kit contains free educational materials and coupons for products to relieve menopause symptoms, including hysterectomy information.

Are There Other Options Besides a Hysterectomy?

Yes, many options exist. Click here to read more about a variety of options to discuss with your doctor.  Also, see the selection of FREE self-assessment quizzes that will help you determine the stage of menopause you may be at and your personal risk for some important health concerns in the MenopauseRx Health Center.