(Part 1 of 2) An overwhelming number of women who ask questions or make comments on this site are questioning their doctor’s recommendation about a hysterectomy, or wondering whether their hysterectomy is causing their dire menopausal symptoms. It amazes and annoys me that their health care provider is either
A) unapproachable about this topic or
B) hasn’t taken the time to really explain the options to a hysterectomy or give details about what to expect for years afterward.
Hysterectomies are incredibly common—too common, according to a lot of doctors and experts in the field of women’s health. There are medical reasons for a hysterectomy to be performed, but often the medical reasons are overshadowed by a woman in pain who will do anything to make the pain go away, and a doctor too eager to operate.
Hysterectomies are controversial because they can be so emotionally and physically damaging. And there are options. So if your doctor says you need one, or your friends say you need one, do your homework.
Remember, all types of hysterectomy end a woman’s chances of becoming pregnant. Depending on your age and other social factors, that may sound ok, but if your hysterectomy includes removal of ovaries, it will also throw you into menopause, with all of the associated symptoms. If you’re already working your way through menopause or you're past it, there are still effects you need to know about.
First, if you are in pain or suffer from almost constant bleeding— know that there are options to a hysterectomy. In either case, don't wait. Talk to a doctor, and ask him or her to consider these options:
- Some women try a nerve block, where the nerve that is sending the pain messages to the brain is essentially blocked. This is often performed in a hospital as an outpatient, so no overnight stay, and no pain. It doesn’t last forever, but can alleviate the pain long enough for you to think through some other options. For some women, it’s all that’s needed.
- Uterine problems can sometimes be treated with medications. Prescription medications are used to treat both the symptoms and causes. In some cases, hormore therapy or pain meds are sufficient. Of course, hormone therapy carries some risks; talk to your doctor about that.
- Minimal surgery called a myomectomy can often remove fibroids, growths in the uterus that are a common cause of pain. This is outpatient surgery, and doesn’t mess with your hormones like removal of your uterus and ovaries.
- Excessive or chronic bleeding (meaning it never stops) can be caused by endometrial tissue that lines the uterus. That tissue is what builds up each month in preparation for pregnancy, and is sloughed off during menstruation. When the endometrium just keeps bleeding, a physician can sometimes treat it with ablation, which cuts or sears the tissue. This is not an option if you want to become pregnant, however.
- Another procedure that destroys the endometrial lining is called balloon therapy, where a medical balloon is inserted into the uterus, inflated and then filled with hot water for a few minutes. This kills the tissue, so should not be performed if you want to become pregnant.
Before you determine that a hysterectomy is right for you, look into these options. Ask your medical provider if any of these might work. In some cases, they are better first steps that a total hysterectomy, depending on your symptoms. They are less invasive and most have reduced side effects.
Next: The types of hysterectomies and what you need to know before signing the consent to operate.