Usually, just one organ is removed.
Hysterectomy is removal of the uterus—just the uterus, not the ovaries, not the tubes, and not the vagina, Streicher explains. A hysterectomy usually does include removal of the cervix (the lower end of the uterus), which is called a total hysterectomy. The other type—a supracervical hysterectomy or subtotal hysterectomy—is when the cervix is left in place, but the rest of the uterus is removed.Whether the cervix can stay depends on why you need the hysterectomy to begin with, so that’s a conversation you’ll need to have with your MD, Streicher says. But if you don’t have cancer and the condition does not otherwise involve the cervix, a subtotal hysterectomy might be an option. It comes with the benefit of less surgery and slightly lowers the risks for complications and infection that come with any surgery.
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You may still need regular Pap tests.
If the cervix was removed as part of the hysterectomy (i.e., total hysterectomy), risk of cervical cancer is also eliminated, so you will not need regular Pap tests (which screen for cervical cancer), Steicher says. But you will still need your regular Pap after a subtotal hysterectomy (which doesn’t remove the cervix).
It means no more periods and no pregnancy.
These are the No. 1 and 2 consequences of hysterectomy, Streicher says. Your period is, by definition, the discharge of blood and tissue from the lining of your uterus. Since the uterus is removed during hysterectomy, that means no more monthly flow. And because the uterus is where a baby grows during pregnancy, having a hysterectomy also means that becoming pregnant is no longer possible.You will not go into early menopause.
Menopause is defined as when your ovaries stop producing estrogen—menopause is not defined by no longer having menstrual periods, Streicher explains. Unless you have another procedure with hysterectomy to remove the ovaries (called oophorectomy), the ovaries remain intact and will continue to produce hormones, which means hysterectomy does not and cannot cause menopause. (Check out these 9 triggers that could cause early menopause.)
You might not need it.
Unless you have cancer, there is an alternative treatment option for virtually every other reason you might be considering a hysterectomy, Streicher says. And that’s a very important message, she adds, because “too many women aren’t given options and get hysterectomies when they don’t need them or don’t want them.”
For example, sometimes hormonal birth control or an intrauterine device (IUD) might successfully treat endometriosis or heavy vaginal bleeding. These options might also help control symptoms of fibroids (which can also include heavy bleeding), according to the American Congress of Obstetricians and Gynecologists (ACOG). But in general, whether or not there is a viable alternative to hysterectomy really depends on the individual and what the problem is, Streicher says. “Sometimes hysterectomy is the very best solution—and sometimes the alternative is.”
You will lower your risk of uterine and ovarian cancer.
Having a hysterectomy eliminates the risk of uterine cancer, which is the most common gynecological cancer, Streicher says. And hysterectomy also dramatically lowers the risk of ovarian cancer, she adds. That’s because most ovarian cancer develops in the fallopian tubes and travels into the ovaries—and because hysterectomy cuts into the tubes (which in some cases are removed as part of the procedure), risk of developing ovarian cancer after having the procedure drops, too.
You might be able to put it off.
Even if hysterectomy might be the best option at some point, depending on why you need the procedure, you might want to wait. “If a 30-year-old who has fibroids with hemorrhaging every month to the point she needs to get a transfusion but still wants to have children comes to see me, I’m going to offer her every alternative in the book to having a hysterectomy,” Streicher says. That said, a hysterectomy to remove the fibroids still might be the best option for that woman down the line after she is finished having children, she adds.Sex might be different.
A small percentage of women may notice a change in orgasms, Streicher says. That’s because some have a uterine contraction during orgasm, which they won’t feel after having a hysterectomy.
But for most women, sex will not change.
The No. 1 predictor of what sex is like after hysterectomy is what sex is like before hysterectomy, Streicher says. Hysterectomy does not cause hormonal changes, so complications like vaginal dryness or decreased libido are not a result of having the procedure—those changes are linked to removal of the ovaries, she explains. (Try these 13 tips for seriously better sex.) If you do notice changes during sex after you’ve had a hysterectomy, speak to your doctor—they may not be related to the surgery and can almost always be fixed, Streicher notes.