Life After a Hysterectomy: What Changes — and What Doesn't

Has your gynecologist suggested you may need a hysterectomy? As you’re making your decision, it’s important to get the facts — and understand that much of what you may have heard about this common surgical procedure might not be true. First, let’s look at why a woman might need a hysterectomy and the three options.

Why You Might Need a Hysterectomy

There are more than a dozen reasons why your doctor might recommend a hysterectomy, including:

• Uterine fibroids that cause heavy bleeding every month
• If you have endometriosis and other solutions have not been effective
• Uterine prolapse where the uterus has dropped and is pushing into the vaginal canal, leading to pressure and discomfort
• Any cancer found affecting the uterus, cervix, ovaries or endometrium

What Are the Types of Hysterectomies?

• A partial hysterectomy removes the upper portion of the uterus but leaves the cervix.
• A total hysterectomy removes the uterus and cervix in their entirety. The ovaries and fallopian tubes may remain. This is the most common type.
• A radical hysterectomy removes the uterus, cervix, upper portion of the vagina and surrounding tissues. This is pretty rare but may be what most people think of when they think of a hysterectomy.

6 Myths About Having a Hysterectomy

You may choose to keep your fallopian tubes. Whenever your entire uterus is removed, the default is that your tubes are also removed because they are connected. Removing the uterus decreases your risk of endometrial and uterine cancer. Removing your tubes further reduces your risk of ovarian cancer as ovarian cancer often starts in the fallopian tubes.

Your sex life is better if you keep your cervix. Your cervix doesn’t affect your sex life. Your ability to enjoy sex won’t change if you don’t have a cervix. If you have concerns or reasons why you may want to keep your cervix, those are worth discussing with your doctor.

Your risk of pelvic organ prolapse is much higher. Your risk of prolapse may increase ever so slightly. Recent data shows no significant difference of pelvic organ prolapse between supracervical and total hysterectomy.

If you have a hysterectomy in your 20s, 30s or 40s, you will immediately undergo menopause. The uterus is nothing more than a big muscle. When needed, it holds a baby and then pushes it out. Hormones are produced in the ovaries, not the uterus. There’s only a slight risk of early menopause. For every woman, the way in which a hysterectomy affects menopause is different. Sometimes there is no effect. Sometimes it leads to menopause starting in two or three years. There isn’t a strong and undisputed causation.

Having any kind of hysterectomy means you will never bleed again. If you remove your cervix, this is true. However, if you have a hysterectomy but keep your cervix, you may still experience some cyclical bleeding, but it’s typically much less than what it would be if you still had a uterus.

You will have permanent bladder problems. It’s natural to have some concerns that you feel the urge to pee all the time after a hysterectomy. This can happen because the uterus and bladder sit close together. When one is removed, the bladder isn’t as propped up. Only some women experience this sensation, and for those who do, it typically resolves on its own with time. If it doesn’t, talk to your doctor. There are actions you can take, including pelvic floor physical therapy to strengthen those muscles and help alleviate this issue.

6 Truths About Having a Hysterectomy

You can have a hysterectomy and keep your ovaries. Your doctor will likely try to keep your ovaries if you’re premenopausal because they continue to make hormones that help with sexual desire and your long-term health. If you’re 50 years or older or past menopause, your ovaries have ceased producing eggs and hormones. If this is the case, your doctor will likely recommend that you remove your ovaries at the time of surgery. This reduces your risk of ovarian cancer and the possible need for future surgery if a complication arises.

You will need to refrain from sex during the surgery recovery period. A hysterectomy is a big surgery that requires about six weeks of recovery and rest time before you can return to your usual sex life. That six-week recovery period is an estimate. Your doctor will ask you to return for a check-in exam to see how your healing is progressing. The incisions at the top of the vagina need to be well healed. Some women need eight to 10 weeks to heal. After you have healed, you can resume enjoying the same sex life you had before.

Your sex life may change. Whether or not your sex life changes depends heavily on which type of hysterectomy you have and your own bodily response to the surgery. Research tells us that your libido, vaginal lubrication and sexual pleasure should be unchanged. However, some women find that orgasms are less intense due to the removal of the uterus, which can no longer contract. If your ovaries are removed and you experience menopause, you may find your libido decreases and vaginal dryness increases.

You might regret having the procedure. In most cases, women are happy with the result. But some women regret having a hysterectomy because they realized afterward that they wanted another child. This is a surgery that cannot be undone, so it’s important to be sure you do not want to carry any more biological children.

Even after a hysterectomy, you still need to see your gynecologist. If you still have a cervix, you’ll continue to need pap smears. If you have no history of abnormal pap smears and your cervix has been removed, you no longer need pap smears, but you do still need your annual well-woman visit with your gynecologist, especially if you have a history of precancer or cancer.

Your gynecologist still recommends annual visits to do pelvic exams to check for the presence of skin cancer, which does not need to be caused by overexposure to sunshine, on the vulva and vagina. It’s also a time to address other gynecologic health concerns or needs.

Having a hysterectomy can feel freeing. Once your uterus is gone, you won’t have periods or get pregnant. Many women think it’s freeing to no longer worry about either of these things. Many women who undergo hysterectomy procedures because of fibroids or overly heavy bleeding find it a huge relief to not need to worry about using menstrual products and managing their bleeding. For women who have fibroids and live with big tumors in their uterus, this surgery can bring a better quality of life.

Talk To Your Provider for More Information

If you are a candidate for a hysterectomy and you still have questions, consider making an appointment with your doctor to talk more about the procedure, and address any concerns you may still have.

This content is not AI generated.