Hysterectomies: Are They Always Non-Negotiable?

Understand your options before getting a hysterectomy

By: Holly L. Thacker, MD

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Many women hear that they need a hysterectomy to cure problems like heavy vaginal bleeding. After all, removing the uterus and/or ovaries has been the standard treatment for many years.

But hysterectomy is not a woman’s only option today.

Hysterectomy has major implications for your body and life. You need to ask yourself questions like, ‘Do I want to have more children?’ ‘Am I prepared for menopause and other consequences’?

When to ask about alternatives

If your doctor suggests a hysterectomy to treat one of these benign conditions, get a second opinion — and maybe a third:

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  • Fibroids
  • Uterine prolapse
  • Endometriosis
  • Benign ovarian cysts
  • Severe PMS (premenstrual syndrome)
  • Adenomyosis
  • Heavy bleeding

There often is more than one appropriate treatment or procedure for these conditions. But sometimes hysterectomy can’t be avoided.

When hysterectomy is your best option

Hysterectomy is most likely to bring relief from fibroids that are rapidly growing or are causing severe pain and inflammation. The same is true when painful endometriosis can’t be controlled by other means and you don’t want any more children.

When your life is at stake, hysterectomy is the only alternative. This is true if:

  • You have been diagnosed with cervical, uterine or ovarian cancer
  • You carry a gene that indicates a high risk for breast or ovarian cancer and are done bearing children

Ask for partial hysterectomy when possible

If you’re under 65 years old, it’s best if your ovaries are not removed unless you are at high risk for breast or ovarian cancer. This is called a partial hysterectomy. Keeping your ovaries will not only prevent you from entering medical menopause, but your chance of survival is also higher.

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Bottom line: Be informed. Remember, it’s your body, your hormones and, ultimately, your choice.

More information about menopause-related topics is available in Dr. Thacker’s book, The Cleveland Clinic Guide to Menopause (Kaplan Publishing).

Speaking of Women’s Health

Speaking of Women’s Health is a national women’s health education program by Cleveland Clinic.

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