A hysterectomy is a serious surgery that is sometimes required in the course of treatment. It may be a recommended protocol for benign conditions such as pelvic inflammatory disease or uterine fibroids, or it may be recommended for something as serious as cancer. Whether a full or partial hysterectomy, a woman will no longer be able to conceive and have children and it may induce premature menopause. Some studies have also shown that it can also trigger severe depression.
There are two primary types of hysterectomy. The first is a partial hysterectomy which generally involves the removal of the uterus only. This is the preferred method when it is an available option because it leaves the ovaries and hormonal balance intact. However, in the case of an aggressive cancer it is not an option left open to women.
A full, or radical, hysterectomy involves the removal of the uterus, ovaries and sometimes the cervix. Almost immediately the woman will be thrown into premature menopause and hormone replacement therapy is highly recommended, especially for younger women. The loss of the ovaries has a serious side effect to the hormonal balance in a woman\’s body but, it is the best treatment for an aggressive form of cancer where spreading to the rest of the reproductive tract is too high of a risk. (1)
Following a full hysterectomy most women find that they are able to enjoy the same sex life they enjoyed prior to surgery. In some instances there may be enough scar tissue that intercourse becomes uncomfortable, but for the most part physicians can correct that problem if necessary. The ability of the woman to enjoy her sex life will often depend upon the stage of life in which a full hysterectomy was performed as well as the preparation prior to surgery.
Another issue which must be addressed prior to surgery is the recovery time from a full hysterectomy. This recovery time can take up to six weeks during which the woman should be resting and not do any heavy lifting. (2) Unfortunately, this may also mean that she has plenty of time to get bored. Without the ability to go back to work or consistently leave the house (because of driving limitations in the first four to six weeks) she should spend time preparing for her recovery period prior to having surgery.
With the advances in health care and technology many women are surprised by how smooth the recovery period seems to go. Physicians will often start their patient almost immediately on hormone replacement therapy because they will go through an immediate withdrawal with the removal of the ovaries. These hormones help to stabilize a woman\’s body as she is accommodating to the surgical procedure and recovery time necessary.
Surgical menopause continues to be a difficult process for a woman, even when hormonal replacement is used. Some symptoms will show up immediately while others will come on within the first six months after surgery. Some women have also found better results using bio identical hormone replacement which is different from standard hormone replacements. It needs to be thoroughly researched by the individual however because physicians are not well educated in this arena. The use of bio identical hormones can have some significant side effects in must be addressed both realistically and responsibly.
When a hysterectomy is necessary because of abnormal bleeding the woman will also find that she will quickly regains her blood counts so that she is no longer anemic. This also contributes to the perception that recovery time is going well and smoothly.
However, it is highly important that the woman not over do her activity level before being cleared by her surgeon is in order that she not cause more long-term problems by overdoing it. (3)
A full hysterectomy can also results in a significant weight gain that is usually associated with menopause. However, since the surgery has put the woman\’s body into surgical menopause she also has the added disadvantage of slowing her metabolism down significantly and increasing the amount of weight that she gains, eating the same food she ate before.
The emotional after effects of a full hysterectomy can also be debilitating. Because our society\’s image of what a \”whole\” woman looks like it can have a dramatic effect on her self image and how she feels about herself. For some women who wanted more children this can have a debilitating effect on her ability to function on a daily basis, and sadly may lead to clinical depression.
The use of a full hysterectomy is often contemplated only for aggressive disease processes which have significantly negative outcomes themselves, such as cancer. With adequate pre-surgical preparation, counseling, education and postsurgical support most women are able to continue to function well.
(1) WomensHealth.gov: Hesterectomy Fact Sheet
(2) Mayoclinic.com: Abdominal Hysterectomy
(3) Johns Hopkins Medicine: Laparscopic Hysterectomy
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