By the age of 60, more than one-third of women in the United States will have had a hysterectomy. This surgical procedure, which removes a woman’s uterus, may be performed to treat several medical conditions, including painful uterine fibroids, cancer and endometriosis. Depending on a woman’s medical needs, the surgeon may remove other reproductive organs, such as the ovaries and fallopian tubes as well.
Hysterectomy used to involve open surgery with a long incision across the abdomen to remove the uterus, followed by a lengthy recovery. However, minimally invasive laparoscopic surgery has now replaced open surgery in many cases.
Because laparoscopic surgery requires only a few small incisions, most women have less pain and bleeding, a faster recovery time and minimal scarring. Moreover, robotic surgical techniques have made it possible for some women to have a hysterectomy through a single incision in the belly button.
Women who have been told they need a hysterectomy may feel uncomfortable asking their doctors about how the procedure may affect their sexual relationships, menstrual cycle and more – but they shouldn’t.
“Where your body and your health are concerned, there are no embarrassing questions,” says Anupam "Bobby" Garg, MD, OB-GYN and robotic surgeon at Scripps Clinic. “We want to help you feel comfortable about your procedure and make sure we address your concerns.”
Dr. Garg answers four of the most frequently asked questions about hysterectomy.
In most cases, you’ll get the green light for intercourse about four to six weeks after surgery. This is generally enough time for your incisions to heal, and any vaginal bleeding or discharge to stop. Most women say sex feels the same; if your condition caused painful intercourse before your hysterectomy, it will likely feel better. If you do experience discomfort or bleeding during intercourse, let your doctor know.
Hysterectomy should not have any long-term effects on your bladder. Some women do experience bladder spasms during the first several weeks after surgery, but these generally improve with time. If you have spasms that are painful, your doctor may be able to prescribe medication to relieve them.
Pelvic organ prolapse occurs when the pelvic floor muscles that hold your reproductive organs in place become weakened or damaged. As a result, the organs may prolapse or drop out of position.
Minimally invasive hysterectomy usually does not increase the risk of pelvic organ prolapse. Your doctor may recommend exercises to strengthen your pelvic floor muscles and prevent organ prolapse. In rare cases where treatment is needed, minimally invasive surgery can correct the condition.
Removing only your uterus will not send you into menopause. You will still ovulate, but you will not have a menstrual period or be able to become pregnant. If your ovaries are removed as well, you will no longer ovulate and will be in menopause.
“The type of hysterectomy that is best for you depends on your medical condition, your plans for a family and other individual factors,” says Dr. Garg. “Discuss your concerns with your doctor, and together you will determine the approach that is best for you.”