There are several circumstances when you may be recommended to have a hysterectomy. The most common reasons include:
- heavy periods
- pelvic inflammatory disease (PID)
- endometriosis
- prolapse of the uterus
- cancer
Heavy periods
Many women find they lose an excessive amount of blood during their periods. Other symptoms such as stomach cramps, menstrual pain (dysmenorrhoea) and anaemia may occur. For some, the symptoms can seriously affect their quality of life.
Sometimes heavy periods result from fibroids. But for many women, there is no obvious cause (hormone imbalances).
A hysterectomy is usually only recommended as a treatment for heavy menstrual bleeding when:
- other treatments have not been effective
- bleeding has a severe impact on quality of life and it is preferable for periods to stop
- the woman no longer wishes to have any children
For more information on heavy periods, go to Health A-Z: heavy periods.
Pelvic inflammatory disease
Pelvic inflammatory disease (PID) is an infection of the female reproductive system. If detected early, PID can be treated with antibiotics. However, if the infection spreads it can damage the fallopian tubes and womb and lead to chronic (long-term) episodes of pain. A hysterectomy can treat severe PID by removing the womb and fallopian tubes and taking away the source of pain.
If the pain from PID is severe and the woman no longer wants any children, a hysterectomy may be recommended.
For more information on PID, go to Health A-Z: PID.
Endometriosis
Endometriosis is a condition in which the cells that normally line the womb are also found in other parts of the body and reproductive system, such as the ovaries, fallopian tubes, bladder and rectum.
These cells and blood are shed during a period in the same way that the lining of the womb is shed. This can cause problems as the released blood has nowhere to go and causes inflammation and damage in the surrounding tissues, damaging them. This can cause pain, irregular and heavy periods, and infertility.
A hysterectomy may be able to remove the areas of endometrial tissue causing the pain. It is usually only considered if other, less invasive, treatments have not worked and the woman decides not to have any more children.
For more information on endometriosis, go to Health A-Z: endometriosis.
Prolapse of the uterus (womb)
A prolapse occurs when the ligaments and tissues supporting the womb become weak, causing it to drop down from its normal position. Symptoms may include back pain, dragging pain, difficulty passing urine or faeces and seeing or feeling a lump or bulge in the vagina.
A prolapse of the womb is often a result of childbirth. Other causes include stretching of tissues from heavy lifting, chronic cough, obesity and increasing age.
A hysterectomy is the most effective form of treatment for a prolapse because it removes the womb. It may be recommended if the ligaments and tissues supporting the womb have been severely weakened, and the woman in question does not wish to have any more children.
For more information on prolapse of the womb, go to Health A-Z: prolapse of the uterus.
Cancer
A hysterectomy may be needed in cases of the following types of cancer:
- cancer of the cervix
- cancer of the ovaries
- cancer of the endometrium (also known as cancer of the womb)
- cancer of the fallopian tubes
Cancer of the ovaries and the cervix are the most common. Approximately 3,000 women are diagnosed with cervical cancer every year, and 7,000 with cancer of the ovaries.
If the cancer has reached an advanced stage, a hysterectomy may be the only viable treatment option to remove the cancer.
