When Lena Dunham was barely 30 years old, she went public about her decision to deal with a severe case of endometriosis by undergoing a hysterectomy. And no surprise to anyone, a global conversation about her decision as well as endometriosis and hysterectomies followed on social media.
Having a hysterectomy is something that almost all women consider at one time or another in their lives, so let’s look at some up-to-date information on the subject.
- About 600,000 hysterectomies are performed in the United States each year.
- A hysterectomy is the second most common major surgery undergone by American women, ranking only behind C-sections.
- A hysterectomy is a surgical procedure to remove the uterus. The ovaries and other reproductive organs may be left intact, but in some cases, they are removed as well.
Common reasons to have a hysterectomy?
- Removal of cancerous growths: About 10% of hysterectomies are the result of cancerous growth in a woman’s uterus or cervix.
- Abnormally heavy bleeding during menstrual periods: Heavy periods can be painful, debilitating, and major lifestyle disruption. Severe bleeding is sometimes caused by hyperplasia, a condition in which the lining of the uterus becomes too thick.
- Prevention of potential future cancer: Women with either a family history of uterine cancer or cervical cancer or a genetic predisposition toward such cancer (BRCA 1 or BRCA 2 gene defects), can significantly reduce their chances of incurring uterine or cervical cancer through a hysterectomy.
- Removal of benign fibroid growths in the muscles of the uterus: Uterine fibroids are often symptom-free, but they sometimes cause seriously heavy bleeding and severe pain.
- Uterine prolapse: In this condition, weakened uterine muscles and ligaments allow the uterus to drift down into the vagina. This can lead to pelvic pressure and problems eliminating waste.
Are there different types of hysterectomies?
Yes. A partial hysterectomy removes only the uterus. A total hysterectomy removes the uterus and ovaries. A woman who wants to preserve the chance of a surrogate pregnancy may wish to either retain her ovaries or freeze some of her eggs.
In the not so distant past, the uterus was viewed by some as being readily expendable after a woman’s childbearing years. But current research shows that the uterus may play a role in maintaining healthy hormonal production. Doctors now are not so casual about prescribing hysterectomies.
Are there are alternatives to hysterectomy?
Yes. When a hysterectomy is elective, rather than required to save a woman’s life, serious consideration, in close consultation with your doctor, is necessary.
Please remember that in many places in the United States, hysterectomies are still a major surgical procedure with all the attendant risks, a large incision and several days in the hospital recuperating. Especially with larger tumors or growths that need to be removed.
The way that I perform most hysterectomies is via an outpatient procedure where my patient goes home several hours after the procedure. This advanced technology provides a dramatically less invasive way of dealing with many of the problems that resulted from a traditional hysterectomy.
Hysterectomy and hormones
A woman’s ovaries produce the female hormones estrogen and progesterone. A total hysterectomy can, therefore, be the equivalent of surgical menopause. Hormone replacement therapy is available after a hysterectomy, but that therapy carries with it increased risks of stroke, blood clots, and heart disease.
Hysterectomy for endometriosis
A hysterectomy for endometriosis is not necessarily a surefire cure. In cases of endometriosis, the tissue that is meant to form the inner lining of the uterus inexplicably migrates. It begins to grow in locations outside the uterus.
All hysterectomies remove the uterus, and an absent uterus won’t produce any more vagrant tissue to cause problems. But when a hysterectomy is prescribed to remedy endometriosis, the surgeon must remove more than just the uterus and/or ovaries. All the misplaced tissue currently causing the endometriosis must also be surgically excised.
About Dr. Thaïs Aliabadi
As one of the nation’s leading OB-GYNs, Dr. Thaïs Aliabadi offers the very best in gynecological and obstetric care. Together with her warm professional team, Dr. Aliabadi supports women through all phases of life. She fosters a special one-on-one relationship between patient and doctor.
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Supported by her warm professional team, Dr. Aliabadi treats women through all phases of life and cherishes the special one-on-one relationship between patient and doctor.