Hysterectomy: One of many treatment options
Hysterectomy is a surgical procedure during which a woman’s uterus is removed, and in the past has been used as a first-line treatment for a wide variety of gynecological issues, including cancer (cervical, uterine, ovarian), fibroids, heaving menstrual bleeding, endometriosis, and pelvic pain. However, in the 21st century, hysterectomy has become just one of many options to treat these issues.
Many women express attachment to their uterus, under the misconception that the uterus is what makes them feel like a woman. To clarify, the uterus has one, maybe two important functions for a woman. First and foremost, it is an incubator—a warm, nurturing place for a baby to grow. Its questionable second function is to remind you that it’s an incubator, by bringing you your monthly period! However, when it comes to feeling like a woman, in terms of having well-rounded breasts and vaginal lubrication, your uterus is not responsible. Your ovaries are responsible for the maintenance of these feminine characteristics by producing hormones. In the case that a hysterectomy (without removal of the ovaries) is indicated, lasting side effects are limited once the woman has healed. For women who are pre-menopausal, they will no longer be able to carry a child and will not have a monthly period. However, it is important to note that a woman will not go into full menopause if the ovaries are left intact. In cases where hysterectomy with removal of the ovaries is indicated (e.g., some cancer cases), a pre-menopausal woman will experience acute onset of menopause symptoms, which may include: hot flashes, night sweats, increased emotional lability, vaginal dryness, decreased sex drive, osteoporosis, pain during sex (dyspareunia) and decreased genital sensation.
With that said, there are lots of medical reasons to consider a hysterectomy, or removal of the uterus. For cervical, uterine and ovarian cancer, hysterectomy is often a treatment option that is seriously considered, but varies on an individual woman’s circumstances (e.g., of child bearing age, intent to reproduce, etc.). For conditions such as fibroids, endometriosis, heavy menstrual bleeding and pelvic pain, a hysterectomy is one of many options. While hysterectomy may be an option with the proper indications, there are many other non-surgical or less invasive procedures that a woman can choose from during an informed consent with her gynecologist or gynecological oncologist. Options include ongoing monitoring with your doctor, medications, hormone therapy, focused ultrasound, and other surgical procedures based on your particular issue and circumstances. Essentially, hysterectomy is no longer the primary answer for these wide ranging gynecological issues, so it is important to discuss your concerns and your options with your physician.
Stay tuned for upcoming blogs on treatment options for some of these gynecological conditions (e.g., fibroids)!