What Happens to Your Body When You Have A Hysterectomy?

The effects of a hysterectomy vary depending on the type of procedure. Total hysterectomy, for example, may cause more menopause symptoms than lest drastic procedures.

A hysterectomy is a surgical procedure performed on women to remove the uterus (womb) and cervix. In some cases, the fallopian tubes and ovaries are also removed. 

About 600,000 hysterectomies are performed on women each year in the U.S., making it the most common type of non–pregnancy-related major surgery.

A hysterectomy is performed to treat various conditions, such as:

• Uterine cancer
• Ovarian cancer
• Endometrial cancer
• Some cases of cervical cancer
• Other conditions that can cause disabling levels of pain, abnormal uterine bleeding, and emotional stress
  • Uterine fibroids: noncancerous growths in the wall of the uterus that can cause pain and heavy menstrual bleeding
  • Endometriosis: endometrial cells (the lining of the uterus) grow outside of the uterus and can cause severe pain and bleeding between periods
  • Uterine prolapse: occurs when the muscles and tissues of the pelvic floor can no longer support the uterus, and it slips down into the vagina which can cause urinary and bowel problems and pelvic pressure
  • Adenomyosis: the inner lining of the uterus grows into the muscle wall of the uterus (myometrium) causing severe pain and heavy menstrual periods
  • Heavy or irregular vaginal bleeding

There are different types of hysterectomies, depending on what other structures are removed along with the uterus. 

• Total hysterectomy
  • The most common type of hysterectomy
  • Removal of all of the uterus, including the cervix
  • Ovaries and fallopian tubes may or may not be removed
• Partial hysterectomy (also called subtotal or supracervical hysterectomy)
  • Removal of only the upper part of the uterus, leaving the cervix in place
  • Ovaries may or may not be removed
• Radical hysterectomy
  • Removal of all of the uterus, cervix, the tissue on both sides of the cervix, and the upper part of the vagina
  • Used to treat certain types of cancer, such as cervical cancer
• Fallopian tubes and ovaries may or may not be removed

The decision to remove the ovaries usually depends on the reason for the hysterectomy. Ovaries may be removed in some patients to lower the risk for ovarian cancer. Ovaries are often left intact in women who are not at risk for ovarian cancer because they produce estrogen, which helps protect women from conditions such as heart disease and osteoporosis. 

There are several ways a hysterectomy may be performed, depending on the reason for the procedure and the patient’s overall health. 

• Abdominal hysterectomy is performed with an incision, usually in the lower abdomen
• Vaginal hysterectomy is performed through a small incision in the vagina
• Laparoscopic hysterectomy involves small incisions in the abdomen or the vagina through which a thin, lighted tube and a small camera are inserted, and the uterus is removed through the small incisions
• Robotic surgery uses a robotic arm guided by the doctor that is inserted into small incisions in the lower abdomen, similar to a laparoscopic hysterectomy

Immediately following a hysterectomy, patients may stay in the hospital for several days and it can take up to 4 months for recovery, depending on the type of procedure and the reasons it was performed. 

A hysterectomy should provide relief from the symptoms of the condition which necessitated the surgery. 

Because the uterus has been removed, women are no longer able to become pregnant.  

Women will also experience a cessation of menstrual periods. If the ovaries are not removed, women will not experience other symptoms of menopause right away, though they may have menopausal symptoms a little earlier than the average age for menopause, which is 52 years. 

Other changes women may experience after a hysterectomy include:

• Changes in sexual desire/responsiveness
  • Vaginal dryness
  • Reduced interest in sex (especially when the ovaries are also removed)
• Increased risk for other health problems
  • If both ovaries are removed, women may be at higher risk for:
    • Bone loss/osteoporosis
    • Heart disease
    • Urinary incontinence
• Grief or depression over the loss of fertility or bodily changes
• Menopausal symptoms, if the ovaries are also removed
  • Because hormone levels drop quickly, symptoms may be more intense than would occur with natural menopause
    • Common menopausal symptoms include: 
    • Hot flashes (the most common symptom)
    • Night sweats 
    • Sleep problems such as insomnia
    • Vaginal dryness that can cause discomfort, itching, or pain during sex
    • Depression
    • Anxiety
    • Mood swings 
    • Irritability
    • Decreased interest in sex
    • Problems with memory and concentration
    • Urinary incontinence

Complications of a hysterectomy include:

• Excessive bleeding
• Infection
• Injury to adjacent organs such as the bowel, bladder, ureter, or major blood vessels
• Urinary tract infection (UTI)
• Nerve damage
• Postoperative blood clot (thromboembolism)
• Atelectasis
• Early onset of menopause
• Loss of ovarian function
• Possible greater increase in body mass index (BMI) in the years following the procedure