Is a Hysterectomy Right For You (Part Two)

Toni Hurst Health Guide
  • So, you're in pain and/or bleeding all the time and it's taking over your life. You're ready to rip your guts out but think a hysterectomy is a better way to go.  Is it right for you? And if so, what are the repercussions, side effects and dangers?

     

    A hysterectomy means different things to different people. It can mean the removal of the uterus, or removal of other reproductive organs. These can be performed in different ways.  Here is how the experts describe these variances:

    Radical hysterectomy: The uterus, cervix and ovaries are removed.

    Total hysterectomy: The uterus and the cervix are removed.

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    Partial hysterectomy: The upper portion of the uterus is removed, leaving the cervix and ovaries intact.

    In addition, the type of incision and where it is made can differ, too. You and your surgeon can opt for laparoscopy, which are tiny incisions that heal faster and leave less scarring than typical incisions.

    A serious side effect of having a hysterectomy is the onset of menopause due to the drastic change in hormone levels. If you have your ovaries removed, you will begin menopause after surgery, but even if you keep your ovaries, you may go into menopause earlier than usual. Don't let anyone tell you these side effects are mild.

    Many doctors recommend hormone replacement therapy (HRT) after surgery but of course, there are risks associated with HRT. Early-onset of menopause doesn't just mean suffering through hot flashes for a few years. Other symptoms that may not go away are depression, headaches, anxiety, moodiness, and a decreased sex drive. Some women require a lubricant to have sex without discomfort after their hysterectomy, as the upset in hormone levels can cause vaginal dryness.

    Many women's health advocates, including some respected physicians and surgeons, think there are entirely too many hysterectomies performed and that women are not given the whole story before they opt for such life-altering surgery. Dr. Stanley West,  former Chief of Reproductive Endocrinology and Infertility at St. Vincent's Hospital in New York City and a very well-respected physician, has written a book called, "The Hysterectomy Hoax" and in it he says that that 90% of all hysterectomies done in the U.S. are medically unnecessary.

    Some of the reader reviews on Amazon.com are interesting: They say not to let the title of the book scare you, that he is not a crackpot and that he lays out in very specific terms who should and who should not have a hysterectomy, plus the effects of the surgery. He says that the only good reason to have a hysterectomy is if you have malignant cancer.

    While that may be going a bit far, those considering a hysterectomy should definitely pick up the book at your library and thumb through it to see if he covers your medical condition. Even if you decide to go ahead with the surgery, read about the side effects because he doesn't sugar-coat them like many surgeons do.

    Other physicians have written about how hormonal imbalance causes the problems that lead to many hysterectomies, and that if you can bring your hormones into balance, you can avoid the surgery. That strategy has no doubt worked for some, and may be worth a try before resorting to surgery.  Dr. John R. Lee has written numerous books on the subject, including "Hormone Balance Made Simple." I haven't read it so I can't say whether it rings true or not, but the subject deserves your attention.  

  • Before you decide to go ahead with the surgery, take this list of questions to your doctor or surgeon and I suggest that you don't sign the consent form until you get answers to them:

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    • Which of my organs need to be removed, and why?  
    • What type of surgery will you use, and have you considered laparoscopic?
    • What side effects will I have?
    • Will I need to be on hormone replacement therapy afterwards, and if so, which ones and for how long?
    • What are the side effects of hormone replacement therapy?
    • What will it cost to be on hormone replacement therapy? (You might have to ask your insurance provider for this info).
    • What kind of discharge or bleeding is considered normal after the surgery?
    • What type of incision should I expect?
    • Where will the incision(s) be located?
    • How long will I be in the hospital?
    • How long should I take off of work?
    • When can I return to my normal level of activity?
    • Will I need Pap smears after surgery?
    • What symptoms will the hysterectomy alleviate and will they go away completely or partially?

    I wish you luck with this difficult decision. If you want to know how those who've already had a hysterectomy feel about their decision, post a question and see what they say.

Published On: September 07, 2009