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The menopause and HRT: what every women needs to know

Fact sheet four: Having a hysterectomy

What is a hysterectomy?

The word hysterectomy refers to the removal of the womb by means of a surgical operation.

Why might I have a hysterectomy?

There are a number of reasons why you might have a hysterectomy:

  • Continual period problems which don’t respond to other treatments, especially if your family is complete.
  • Fibroids (lumps of muscle in the womb), if they are large or cause painful or heavy periods.
  • Cancer of the lining of the womb, cervix or ovaries.
  • Endometriosis, when cells, which normally line the womb, appear in other places near the womb causing bleeding, inflammation and pain.
  • A prolapse, when the womb drops into the vagina.
  • Emergency e.g termination of pregnancy.

What does the operation involve?

There are two main ways of doing a hysterectomy, either by making a cut in your abdomen usually along your bikini line (abdominal hysterectomy) or removing the womb through the vagina in which case there is no scar (vaginal hysterectomy).

There are also three different types of hysterectomy:
  • Sub total hysterectomy, only the womb is removed, leaving the cervix in place.
  • Total hysterectomy, the womb and the cervix are removed, leaving the ovaries in place.
  • Radical hysterectomy, ovaries and fallopian tubes are removed as well as the womb and cervix.

How will a hysterectomy affect my life?

Whatever type of hysterectomy you have, you will spend some time in hospital and will then need to rest for a least six weeks. This allows your muscle and tissues to fully heal. If you have your ovaries removed at the same time as the womb, you will have an immediate menopause. Your gynaecologist will discuss HRT with you because in the short term, you are likely to experience hot flushes and night sweats. If you have a total hysterectomy, this tends to lead to an earlier menopause. Again, it is important that you talk to your doctor if you start to experience symptoms of the menopause.

As with women, who have a natural menopause, you will still be at greater risk of heart disease and osteoporosis due to the lack of oestrogen in your body.

As with all operations, the more you know before hand and the more prepared you are both emotionally and physically, then the better your recovery after the operation. It is important that you speak with your gynaecologist and family doctor about any concerns or uncertainties you have, whether about the operation or about taking HRT.

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