When Angelina Jolie made headlines announcing that she was removing her ovaries, she admitted it was not an easy decision. Although common- 1 in 3 women in the U.S. have had a hysterectomy by age 60- the procedure to remove all or part of the uterus, cervix, and possibly the fallopian tubes and ovaries can take a toll on your body. Find out what a hysterectomy could mean for your hormones, sex life, and emotional well-being:
1. You have options. Your doctor may recommend a hysterectomy if you have fibroids, endometriosis, prolapse (a dropped uterus), or cancer. But in most cases, there are alternative treatments you can try first.
“If cancer is present, treatment would generally include surgery, but all other diagnoses can often be treated with either medications or minimally-invasive procedures that have less surgical risks than a hysterectomy,” says Elizabeth West, M.D., OB-GYN at the Long Beach Memorial Center in Long Beach, Calif.
2. New advances lead to faster recovery. A patient will need a hysterectomy if cancer is present, they have abnormal bleeding that isn’t controlled with medication, or the size and number of fibroids can’t be treated with other methods. Also, women with severe uterine prolapse may require surgery. Fortunately, many patients can now opt for minimally-invasive laparoscopic, robotic-assisted, or vaginal surgeries that allow them to go home the same day.
“By avoiding the large abdominal incision of an open hysterectomy, recovery is enhanced and women can return to normal activity within four weeks,” says Marc Winter, M.D., a gynecologist nationally-recognized in robotic surgery and medical director of Minimally Invasive Surgery at Saddleback Memorial Medical Center in Laguna Hills, Calif.
3. You can still make hormones. “We generally preserve a woman’s ovaries unless she’s over 65, so she still benefits from the hormones the ovaries secrete, which helps with sexual function,” says Dr. West. “Removing a patient’s ovaries puts them into immediate menopause, but even patients who are post-menopausal may notice a hormonal difference after surgical removal of the ovaries, such as vaginal dryness.”
But for women with a family history of reproductive cancer who are BRCA positive (genetic mutations that raise the risk of developing breast and ovarian cancer), Dr. Winter recommends removing the fallopian tubes and ovaries. “The incidence of ovarian cancer increases with age,” he says.
4. Your sex life isn’t over. Though it’s important to let the vagina heal after a hysterectomy, most women will regain a normal sex life. “In fact, without a large fibroid or abnormal bleeding, many times their sex life improves after a hysterectomy,” says Dr. Winter.
Still, some women may experience post-operative pain, scarring, nerve damage, and a risk of prolapse due to the disruption in ligaments that support the pelvic floor when the uterus is removed, cautions Dr. West. These changes can effect sexual function. “Therefore, we only operate on patients when we think the benefits outweigh the risks,” she explains.
5. Expect emotional healing to take time. While medical advancements can shorten recovery time, emotional healing following a hysterectomy can take longer, especially if a woman didn’t want surgery but needed to due to a medical necessity. In these cases, Dr. West recommends pre-operative counseling services.
“Additionally, I’ve had patients who’ve looked toward meditation to help with the pain and stress of surgery,” she says.
Removing all or part of a woman’s uterus can trigger emotions in women ranging from anxiety and depression to a sense of loss. Have a support system in place to help you if you’re planning to have a hysterectomy.
6. Communication with your doctor is key. If you’re considering a hysterectomy, talk with your doctor about minimally-invasive options for a quicker recovery and less pain. Ask about ways to maximize your recovery following surgery. Dr. Winter recommends patients take a protein supplement to enhance recovery after a hysterectomy. He also recommends getting a second opinion if you are unsure of anything you’re told about your need for surgery.
7. Your quality of life could improve. Many women live with such uncomfortable symptoms like pelvic pressure, frequency of urination, or heavy and painful periods that they feel much better after a hysterectomy.
“I commonly hear the statement ‘If I knew how I’d feel now (after a hysterectomy), I would have done this a long time ago,’” says Dr. Winter.