When should I consider a hysterectomy?

A hysterectomy, generally, is not an operation that must be performed immediately unless the diagnosis is cancer, uterine hemorrhage, intractable pain, or an obstetrical emergency. Therefore, you have time to thoroughly discuss the operation with your physicians and even to ask whether there may still be a chance that an alternative to hysterectomy might better address your reproductive system disorder. If the answer to that question is no,
and when symptoms have continued unabated despite earlier treatment through an alternative to hysterectomy (and the consensus opinion of your physicians is a recommendation of hysterectomy), then the surgery may be your best option. Again, the primary reasons for the surgery are cancer, obstetrical emergencies, uterine
prolapse, excessive bleeding that leads to severe anemia and exhaustion, or intractable pain.

If you are not undergoing the surgery for a malignant condition, you may want to ask yourself some tough questions:What would the loss of a uterus, or possibly even both ovaries, mean to me? Do I want to take estrogen replacement therapy? Am I prepared to handle the psychological fallout from the operation, such as the thought of never being able to bear children (if
you are of reproductive age)?

Of course, you may want to frame your questions in other ways:What new interests can I pursue once I am freed from excessive bleeding and pain? How much happier will I be when I am no longer worried about unpredictable bleeding?

Another thought to keep in mind if you are strongly considering the surgery is your time spent recuperating from it. Hysterectomy is considered major surgery, and at least a month or more is needed for recovery. Can you be away from work for 6 weeks, which is the standard amount of recovery time for an abdominal operation?
Finally, you may want to be honest with yourself and ask whether you have tried every possible conservative approach before consenting to invasive surgery.

Kimberlee’s comment:

In 2003, I began to feel some of the pain, and then later the heavy periods began to emerge. I began having the ultrasounds to determine the size and location of the tumors, and I knew that another procedure was in my future. Reluctant at first, I tried to hold off as long as I could, but by mid-2008 I was becoming anemic and I knew that I needed to take care of the problem. After careful consideration, we opted for a hysterectomy. I knew that this was going to greatly improve my quality of life and I would no longer have to deal with this very frightening and stressful disease. Also, I wanted to be sure that if I had to experience another procedure it would be the last. At 44, single, with a 10-year-old son, I was no longer interested in giving birth, and although I would consider a blended family, having babies was no longer desirable to me.

Deborah’s comment:

I knew it was time to finally go through with a hysterectomy when my period came unexpectedly while vacationing in Europe in September 2008 and prevented me from participating on a paid tour to Peru and Bolivia in November 2008 at the eleventh hour. Since at age 46, fertility is no longer an issue for me and having a high quality of life is far more important, my uterus was finally removed on April 8, 2009. It was actually the size of a basketball and the equivalent of the size of a uterus belonging to a woman who is five months pregnant!

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