A hysterectomy is the surgical removal of the uterus. The hysterectomy is the second most frequently performed operation in the United States (following the Cesarean section). Most women who undergo a hysterectomy are between the ages of 35 and 54.

Hysterectomies can greatly benefit women who need them but it is not always necessary. Usually the procedure is elective although in some cases, it is a life-saving, mandatory treatment. A hysterectomy is often required if there is a presence of cancer, large fibroids, extreme uterine prolapse (the falling of the uterus) or heavy bleeding.

Many women have elective hysterectomies thinking it will relieve symptoms affecting their physical and emotional health. Unfortunately, many people view the uterus as being a ‘useless organ’ when women are no longer able to have children and therefore undergo elective surgery.

Before choosing to have a hysterectomy, you should carefully explore hysterectomy- alternatives and less invasive procedures if your condition is not life-threatening. It is your responsibility to understand the benefits, risks and physical and emotional aftermaths of surgery.

If elective, your decision to have this surgery should be well-thought out and well-planned with your healthcare provider to understand all of the possible consequences. A hysterectomy can greatly improve your quality of life but also can have long-term effects on your health, longevity, sexuality and induces surgical menopause.

0.1. Hysterectomy Facts

The following statistics are extrapolations of from the 2000 Census. Numbers may change when the 2010 Census is released.

• The rate of hysterectomy (5.6 per 1,000 women in 2005) is three times as high in the United States as it is in the United Kingdom and other nations of Western Europe.
• Incidence of hysterectomy geographically varies in the US (in the Northeast, the rate is lower than both the Midwest or the South).
• Incidence of hysterectomy correlates to non-clinical characteristics of patients (socioeconomic status, provider variables such as physician training and gender of physician).
• Some healthcare professionals believe that at least one-quarter of all hysterectomies done every year in the United States are unnecessary.
• By age 65, more than 37% of all women in the US will have had a hysterectomy.
• Uterine fibroids account for approximately one-third of all hysterectomies performed in the US.
• Endometriosis accounts for 18% of conditions leading to hysterectomies.
• Annual hospital costs for hysterectomy exceed $5 billion per year.

0.2. Types of Hysterectomies

Not all types of hysterectomy will trigger surgical menopause. See the types of hysterectomies listed below to find out if yours is likely to bring on surgical menopause.

Subtotal hysterectomy

• Ovaries are not removed
• You will NOT experience surgical menopause but you WILL undergo natural menopause later on

Total hysterectomy

• Ovaries are not removed
• You will NOT experience surgical menopause but you will undergo natural menopause later on

Total hysterectomy with salpingo-oophorectomy

• One or both of the ovaries is removed
• If only one ovary is removed, you will not experience surgical menopause; however, you will undergo natural menopause later on
• If both ovaries removed, you will probably experience surgical menopause

Radical (or Wertheim’s) hysterectomy

• One or both of the ovaries is removed
• If only one ovary is removed, you will not experience surgical menopause; however, you will undergo natural menopause later on
• If both ovaries are removed, you will probably experience surgical menopause

0.3. Hysterectomy Procedures

Your doctor will discuss the different procedures available for your hysterectomy and help you decide which is best for you. Your options include surgery with the use of one large incision, or multiple small incisions. Regardless, you will receive anesthetics and won't be aware during the actual procedure.

Procedures include:

• Abdominal Hysterectomy- Through an abdominal incision
• Vaginal Hysterectomy- With a vaginal incision
• Laparoscopic - Small incisions in the abdomen, which may be robotically assisted by a surgeon.

0.4. Partners in Hysterectomy

Red Hot Mamas in collaboration with Bruce Bekkar, MD and Novogyne Pharmaceuticals conducted a national educational initiative for couples’ education regarding hysterectomy—before and after. The program, “Partners in Hysterectomy” launched in October, 2005 at Sunrise Medical Center in Las Vegas, Nevada.

If you are interested in exploring this topic more, please read our November, 2004 issue of The Menopause Minute.

0.5. Hysterectomy Questions

Every year, approximately 600,000 women in the U.S. have hysterectomies - and each one of these women has questions, as do their husbands, boyfriends, children and friends.

Hysterectomy Questions

Hysterectomy Recovery