Hysterectomy - Why it is necessary 

Why a hysterectomy is necessary 

A hysterectomy is a major operation that will only be recommended if other treatment options have been unsuccessful.

The most common reasons for having a hysterectomy include:

Heavy periods

Many women lose a large amount of blood during their monthly periods. They may also experience other symptoms, such as pain and stomach cramps.

For some women, the symptoms can have a significant impact on their quality of life. Sometimes, heavy periods can be caused by fibroids, but in many cases there is no obvious cause.

In some cases, removing the womb may be the only way of stopping persistent heavy menstural bleeding when:

  • other treatments have proved ineffective
  • the bleeding has a significant impact on quality of life and it is preferable for periods to stop
  • the woman no longer wishes to have children

Read more about heavy periods.

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is a bacterial infection of the female reproductive system.

If detected early, the infection can be treated with antibiotics. However, if it spreads, it can damage the womb and fallopian tubes, resulting in long-term pain.

A hysterectomy to remove the womb and fallopian tubes may be recommended if a woman has severe pain from PID and no longer wants children.

Read more about pelvic inflammatory disease.

Endometriosis

Endometriosis is a condition where cells that line the womb are also found in other areas of the body and reproductive system, such as the ovaries, fallopian tubes, bladder and rectum.

If the cells that make up the lining of the womb become trapped in other areas of the body, it can cause the surrounding tissue to become inflamed and damaged. This can lead to pain, heavy and irregular periods and infertility (inability to conceive).

A hysterectomy may remove the areas of endometrial tissue causing the pain. However, it will usually only be considered if other, less invasive treatments have not worked and the woman decides not to have any more children.

Read more about endometriosis.

Prolapse of the uterus

A prolapsed uterus happens when the tissues and ligaments that support the womb become weak, causing it to drop down from its normal position.

Symptoms can include back pain, a feeling that someting is coming down out of your vagina, leaking urine (urinary incontinence) and difficulty having sex. A prolapsed uterus can often occur as a result of childbirth.

A hysterectomy resolves the symptoms of a prolapse because it removes the entire womb. It may be recommended if the tissues and ligaments that support the womb are severely weakened and the woman does not want any more children.

Read more about prolapse of the uterus.

Cancer

A hysterectomy may be recommended in cases of the following types of cancer:

If the cancer has spread and reached an advanced stage, a hysterectomy may be the only viable treatment option.

Last reviewed: 22/02/2012

Next review due: 22/02/2014

Deciding to have a hysterectomy

In the case of cancer, a hysterectomy may be the only treatment option. For other conditions, you should ask yourself the questions listed below before deciding to have the procedure.

  • Are my symptoms seriously affecting my quality of life?
  • Have I explored all other alternative treatment options?
  • Am I prepared for the possibility of an early menopause?
  • Do I still want to have children?

Do not be afraid to ask your doctor as many questions as you want.