When is a Hysterectomy the Best Course of Action?

If you deal with consistently troublesome symptoms associated with your period, you may wish you could just remove your organs and end the problem. That operation — a hysterectomy — might be the right course of action, but it’s never the first choice. 

Sometimes, other options can work well to resolve your symptoms without removing your uterus (a surgical operation called a hysterectomy.)

At Darin L. Weyhrich, MD, we offer multiple conservative approaches to treating chronic pelvic pain, endometriosis, long, heavy periods, and fibroids. In this blog, Dr. Weyhrich explains when a hysterectomy is best for you, highlights the different types of hysterectomy procedures, and provides information about alternative treatments.

Should I Get a Hysterectomy? How to Decide

Not all women have manageable periods that last about five days and present only minor discomforts, such as mild cramping. Many have complicated, painful, life-disrupting menstrual cycles. There are multiple possible culprits behind these nightmarish periods, and our priority is identifying the underlying cause. Often, when we treat the source, the symptoms disappear. 

However, persistent issues not resolved with conservative treatments may warrant a hysterectomy. Some of the symptoms that may call for surgical intervention include the following:

Heavy menstrual bleeding

What, exactly, is considered heavy menstrual bleeding? After all, it’s normal for women to have some variations in flow from one cycle to the next. A generally accepted definition of heavy menstrual bleeding is when you need to change your tampon or pad every hour or double up with both.

Prolonged bleeding

The average period lasts 5-7 days, but for some women, it continues for much longer. You may consider a hysterectomy if you experience longer bleeding (especially if it continues for several weeks) or have long periods frequently.

Endometriosis

If you have this condition, it means that the lining of your uterus appears in places outside your uterus, such as in your ovaries, Fallopian tubes, or pelvic cavity. Endometriosis is generally very painful, and while it’s incurable, we can help you manage it.

Pelvic pain

If you have pelvic pain, it goes far beyond just cramping. Whether it’s due to vulvodynia (pain in your genitals that lasts for at least 3 months), a history of sexual abuse, uterine fibroids, or pelvic inflammatory disease, pelvic pain always includes severe pain and discomfort.  There are other causes of pelvic pain, such as ovarian cancer or even irritable bowel syndrome. We can help you to identify what’s causing your pain.

Uterine prolapse

Ligaments and muscles hold your uterus in your pelvic cavity or “pelvic floor.” As you get older or if you’ve had multiple vaginal births, these ligaments and muscles in your pelvic floor become too weak to hold your uterus in place. We call this organ-dropping condition uterine prolapse; you may even feel your uterus coming out through your vaginal opening.

Uterine fibroids

Fibroids are very common, especially in Black women, although any woman of any race can get them. These growths on your uterus are almost always noncancerous. If your fibroids are small, you may not even know that you have them. However, larger fibroids can cause you to have heavier periods and increased cramping. 

Uterine cancer

Although this is not the most common reason to need a hysterectomy, uterine cancer sometimes happens, and the only solution is to remove it.

If you have these symptoms, Dr. Weyhrich treats the root cause to resolve the issue before resorting to surgery.

Alternatives to hysterectomy

You may hesitate to get a hysterectomy, especially if you’re still many years away from menopause or unsure if your family is complete. 

You have other options if you want to avoid or delay a hysterectomy. One is endometrial ablation, a procedure that destroys the lining of your uterus. Your uterine lining sheds every month when you get your period. After an endometrial ablation, you may stop having periods altogether. If they do return, they’re often much lighter.

Another option is a surgical procedure that’s less invasive surgery than a hysterectomy called a myomectomy. This procedure removes fibroids growing in your uterus, usually resulting in lighter menstrual bleeding. The results may or may not be permanent.

Deciding on a hysterectomy

Sometimes, a hysterectomy is the best course of action. If you have heavy bleeding or your periods last longer than the standard 5-7 days, you may become anemic and lose minerals, such as iron and calcium. You could also suffer from symptoms like chronic fatigue, brittle hair, or slow growth of your hair and nails.

Maybe you’ve had endometrial ablation or a myomectomy or tried taking medications to reduce your estrogen levels, and it didn’t eliminate your symptoms. At this point, Dr. Weyhrich discusses your hysterectomy options.

If Dr. Weyhrich recommends a hysterectomy, know that he only considers this an option when he believes your quality of life will improve afterward. Contact Darin L. Weyhrich, MD, today for a consultation or request an appointment online.