A hysterectomy is a common gynecological procedure used in the treatment of uterine and cervical cancer, as well as other conditions such as uterine fibrosis, chronic pelvic pain, and adenomyosis, just to name a few. As with any major surgery, there are both advantages and disadvantages we should be aware of. In this article, we are going to focus on the side effects of hysterectomy and the life changes that come with it.
What Is a Hysterectomy?
A hysterectomy is a surgery to remove a woman’s uterus. There are many reasons why a patient may need this procedure. It is used to treat severe menstrual cramps, various chronic pain conditions, excessive bleeding, and a common treatment of certain types of cancer.
Types of Hysterectomy
There are three types of hysterectomies. All include the removal of the uterus:
- Partial hysterectomy. A gynecologist will only remove the upper part of the uterus. The cervix will remain intact.
- Total hysterectomy. In this case, both the uterus and the cervix will be removed.
- Removal of ovaries and tubes, or Bilateral Salpingoophorectomy, BSO, may be performed with either a Partial or Total hysterectomy depending on the clinical situation.
- Radical hysterectomy. A more extensive medical procedure, it is used when the condition requires the removal of the uterus, ovaries, cervix, fallopian tubes, upper vagina and surrounding tissue, as well as the lymph nodes.
Who Needs a Hysterectomy?
Over 600,000 women in the U.S. undergo a hysterectomy each year. It is the second most common surgery after the caesarean section delivery. However, some professionals claim that more than 90% of hysterectomies are, in fact, unnecessary. Others, on the other hand, estimate that only 30% of hysterectomies are not needed. Either way, both statistics are cause for further questioning and concern.
The main reasons why some women undergo a hysterectomy include:
- Cancer. This procedure is, in some cases, the only possible treatment option for cervical and ovarian cancer, cancer of the uterus, and cancer of the fallopian
- Prolapse of the uterus. This happens when the tissue and ligaments supporting the uterus become weak. This causes the reproductive organ to drop from a normal position.
- Heavy bleeding. Known as dysfunctional uterine bleeding, this is an abnormal genital tract bleeding usually caused by hormonal disturbances. While there are other ways to manage it, hysterectomies are often performed.
- Postmenopausal bleeding. No amount of spotting is normal after menopause. The reasons why some women bleed after having completed menopause include polyps, endometrial atrophy, endometrial hyperplasia, endometrial cancer, and other causes such as certain medications.
- Adenomyosis. This diagnosis refers to constant heavy bleeding with an unknown cause. Some specialists associate it with uterine trauma. It may also be linked to endometriosis.
- Fibroids. These non-cancerous tumors grow in or around the uterus. If the patient has large fibroids or severe bleeding, the doctor may recommend a hysterectomy.
- Endometriosis. Women suffering from this condition have cells that line the uterus in other parts of the body. In this case, the tissue surrounding the cells becomes inflamed and can lead to heavy periods, pain, and infertility.
Side Effects of Hysterectomy
Because there are various types of hysterectomy, the benefits and risks vary as well. The most common side effects of hysterectomy include:
Women who undergo with removal of both ovaries will experience surgical menopause as a result of having their ovaries removed. This causes menopausal symptoms such as hot flashes, vaginal dryness, night sweats, and increases the risk of heart disease and osteoporosis. Patients undergoing partial hysterectomy in some cases will experience menopause earlier than normal. These symptoms can be minimized by taking natural herbal remedies, medications, or hormone replacement therapy.
Because of having their female organs removed, some women feel like they are no longer real women. Others suffer from depression due to no longer having the possibility of bearing children. Furthermore, those that experience early or surgical menopause feel that they have aged prematurely.
These feelings can interfere with daily life. Consequently, women undergoing hysterectomy struggling with these feelings should always seek counseling to help with the psychological side effects of hysterectomy. However, many women are very happy after a hysterectomy and feel like they got their life back because their energy levels can increase and symptoms of bleeding, cramping, and pain are completely gone.
While most women note an improved sex life after a hysterectomy, some others who have their ovaries removed report sexual problems. This is due to a decrease in estrogen levels that cause both vaginal dryness and thinning of the vaginal tissue. These two issues can make sex painful. Hormone replacement therapy is one treatment option that can treat vaginal dryness and vaginal thinning. There are also non hormonal therapies that can work very well also
Although one of the rarer side effects of hysterectomy, in some instances, bladder injury may occur. This results in infection, difficult urination, rehospitalization, or incontinence. If it is not discovered until after surgery, then patients must undergo a second surgery to treat these two issues. Even though this happens very infrequently, most of the time it is corrected during the hysterectomy by the surgeon or a urologist is consulted intraoperatively to come to the surgery to fix it while the patient is still asleep.
During the operation, some patients may have need for a transfusion due to excessive bleeding. In some conditions, the patient may have to donate blood before the operation to have extra blood available. Excessive bleeding is more common during an abdominal hysterectomy and very rare with a laparoscopic, robotic, or vaginal hysterectomy.
Common Anesthesia Effects
As with any major surgery, the patient may feel the effects of anesthesia for a few days after the procedure. They include moodiness, weakness, tiredness, and nausea. The doctor can prescribe certain medications to help with these side effects if they occur.
Other Side Effects
A smaller number of women also experience the following side effects of hysterectomy: weight gain from not exercising or water retention from the IV fluids, fatigue while healing, constipation from post op pain meds, and pelvic pain if scar tissue forms in the pelvis.
Alternatives to Hysterectomy
In many cases, a hysterectomy is not the first option and in those cases it is not yet necessary. There are other alternatives one should consider, and they include:
- Endometrial ablation. This surgical procedure results in the removal of the uterine lining with lasers, cryotherapy, or electro-surgery. Endometrial ablation can treat heavy bleeding, menorrhagia, polyps, and fibroids.
- Myomectomy. This is the surgical removal of fibroids that allows the uterus to be left in place. As a result, it gives hope to some women that would otherwise not be able to get pregnant. This is also an option for women who do not want a hysterectomy and just want the fibroids removed.
A hysterectomy is one of the definitive surgery procedures a woman can undergo. Sometimes, women may elect this procedure as the best way to solve her medical issues. In other situations, it is the only choice they have. However, this is not a surgery to be undertaken lightly. The benefits of a hysterectomy can be very beneficial, but some of the the side effects of hysterectomy can be difficult to manage, both physically and mentally. Get informed and ask your doctor about your options.
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