4 Things No-One Tells You About Hysterectomy

Hysterectomy, defined as “the surgical removal of the uterus”, is a major medical procedure that affects millions of women worldwide. Often dismissed as a straight-forward procedure that can offer relief from a variety of conditions and in some cases, even be lifesaving surgery, there are some lesser known aspects that are rarely discussed with women before undergoing surgery.  

There are different forms of hysterectomy and each procedure will have different considerations during your recovery and quality of life post-hysterectomy. The different procedures are as follows:

  1. Total Hysterectomy: In this procedure, the entire uterus, including the cervix, is removed. Total hysterectomy may be recommended for conditions such as cancer or severe endometriosis affecting the entire uterus.
  2. Partial or Supracervical Hysterectomy: Also known as subtotal hysterectomy, this procedure involves removing the upper part of the uterus while leaving the cervix intact. Partial hysterectomy may be an option for certain conditions, offering a shorter recovery time and potentially preserving sexual function.
  3. Radical Hysterectomy: Typically performed for gynecologic cancers, radical hysterectomy involves removing the uterus, cervix, upper part of the vagina, and surrounding tissues, such as lymph nodes. This extensive procedure aims to remove cancerous tissue and may have more significant implications for recovery and long-term quality of life.
  4. Hysterectomy with Bilateral Salpingo-Oophorectomy (BSO): In addition to removing the uterus, this procedure involves removing both ovaries and fallopian tubes. It is often recommended for conditions such as ovarian cancer, high-risk of ovarian cancer, or to manage hormone-related conditions. However, BSO can induce immediate menopause and may have implications for bone health and cardiovascular health.
  5. Laparoscopic or Minimally Invasive Hysterectomy: These procedures involve using small incisions and specialized instruments to remove the uterus. Laparoscopic hysterectomy, including robotic-assisted techniques, generally offers shorter hospital stays, quicker recovery times, and reduced scarring compared to traditional open surgery.

Hysterectomy is advised or offered as a treatment choice for various reasons, including addressing conditions such as uterine fibroids, endometriosis, uterine prolapse, adenomyosis, and gynecologic cancers. Uterine fibroids, benign growths in the uterus, can lead to symptoms like pelvic pain and heavy menstrual bleeding, often necessitating removal when other treatments fail. Endometriosis, characterized by tissue growth outside the uterus, may require hysterectomy if symptoms persist despite conservative measures. Uterine prolapse, where the uterus descends into the vaginal canal, and adenomyosis, involving tissue growth into the uterine wall, may also warrant hysterectomy for symptom relief. Additionally, hysterectomy may be indicated for treating gynecologic cancers, such as cervical or ovarian cancer, particularly in cases where the disease is advanced or recurrent.

1. Post-hysterectomy recovery is a personal journey

Hysterectomy is, of course, a common surgical procedure that many women undertake globally every day. But what is important to remember is that recovering from major abdominal surgery is unique to your set of circumstances, lifestyle and health and involves more than physically healing.

Many women experience a mix of emotions post-surgery. For some, there is a huge relief and reassurance, and feel happy that the surgery has been a positive decision for their health. For others, post-surgery may bring about negative feelings and perhaps even a bereavement for the parts of our body that have been removed. You may feel content, even elated; or you may feel low and a sense of sadness. Every emotion is valid and part of the healing process.

Physically, resting and returning to full capacity slowly over the course of a few weeks can be challenging for women who are used to be busy and active, but it’s important to follow your doctors advice, avoiding lifting and ‘burning out’ by trying to do too much, too soon. Taking time to allow your body to heal internally is important, and your hormones will thank you for it too!

Hannah shares her recovery experience

“I had a laparoscopic subtotal-hysterectomy and wow, I didn’t expect how hard the recovery was! I went into the surgery really positively and feel confident that it was the best decision for my health. What I didn’t expect was how exhausted I would feel in the first few months – not weeks – after surgery. I think, in total, it took around 4 months for me to finally feel back to ‘normal’ and not need to rest if I had overdone it. My advice for anyone about to have the surgery is to expect the recovery to take longer than you expect and for life to be a bit slow for a while as you heal inside and out.”

2. Menopause can quickly advance post-surgery 

Dependent on the type of hysterectomy that you have, your ovaries may be removed during the operation (sometimes, for subtotal-hysterectomies they are left in situ) and this can mean that you will experience hormonal imbalance post-surgery. As our founder and CEO, Ana G.Herrera recently shared, it can feel like ‘dropping off a cliff edge’, with a very sudden and rapid onset of menopause symptoms such as hot flushes and night sweats, migraines and brain fog being the most common. This sudden dip into menopause is referred to as surgical menopause.

Preparing for your surgery can help with this. Speak to your surgeon and OB-GYN about how surgical menopause symptoms will be managed and whether they support the use of topical supplementation in advance and post surgery, such as Glow by Hormone University’s Menopause SOS, which offers a natural and holistic approach to managing some of the trickiest symptoms such as low mood, brain fog, exhaustion and night sweats.

Sheree shares her experience of surgical menopause

“I read Ana’s experience and it sure did speak to me. I too plunged into surgical menopause and it was so fast, so quick that it really overwhelmed me mentally. My doctor had told me to expect it but I didn’t expect so many symptoms so quickly. The night sweats for me were the worse aspect – the bed sheets would be dripping with sweat and my partner had to move into the next room it was bad. So yes, it’s very important that you know to expect the ‘cliff edge’, as Ana called it, and look into hormone therapy (or a suitable alternative for you) as quickly as possible.”

3. Changes to the way you perceive your body 

Something that is rarely discussed about hysterectomy is how it can change your sense of self, and the way you perceive your body. This is a very personal aspect of the recovery process, and validating your connection to your body and the removal of your uterus will be different for everyone, as we discussed above.

For many women, there’s a sense of finality that comes with hysterectomy; whether related to fertility or to the end of suffering with a particular condition. It may also offer a sense of new beginnings, a life free from pain or risk to your health.

There is also the connection that we have to our ‘female identity’, that goes beyond whether you have a uterus or not. As girls and women, so much of our lives revolves in some way around our gynaecological function; from hormone fluctuations and conditions, to puberty, menstruation, fertility, preventing conception or trying to conceive… the list goes on. Having this aspect of your life end may bring about feelings of relief (no more periods!), or create a sense of loss, bereavement and grief.

Engaging in activities that promote self-care and self-acceptance, such as gentle exercise, journaling, and therapy can help you to process these emotions and the change to your body.

Lori shares her experience of how hysterectomy affected her sense of self:

“For me, having a hysterectomy was something that was needed to be done rather than I ever wanted or expected to happen. I think that was partly why I felt out of sync with my body for some time after, it’s so hard to explain. I didn’t feel ‘whole’ for a while, like I had lost a part of myself.”

4. Your libido may change (and possibly also your orgasm)

For some women, hysterectomy can change their experience of sex and how they orgasm. For some women, they find that being pain-free and with less stress about their health there is a freedom that enhances their libido, aids greater desire and pleasure and they feel more empowered sexually.

For others, the physical changes post-surgery can adversely affect their sex lives, with women sharing experiences of their orgasm ‘changing’ and feeling different which takes them by surprise, and some experience a total loss of libido due the relationship they have with their body post hysterectomy, or because of hormone imbalance and surgical menopause symptoms such as vulval dryness. Understanding that this is normal and can be overcome is an important part of rediscovering your sexual self post-surgery, and you might find using an vulval moisturizer, such as Glow by Hormone University’s Intimate Hydrator, is a good first step to supporting your libido after hysterectomy.

Athena shares her experience of changes to her libido

“I’ve always been able to climax easily, but after having my operation, this changed and was so frustrating! I think they should tell you about this – I realised that before, I experienced contractions in my uterus as part of the orgasm and so obviously, this was not now possible. That meant that I needed to get used to the ‘new orgasm’ and it felt quite weird at first! I use more lubricant during intimacy as well, and I think that should be part of every woman’s post-surgery kit!”

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