There are several medical reasons why a woman would consider having her uterus removed. It’s typically done as an elective surgery rather than a life-saving one.
Uterine Fibroids
Fibroids are benign (noncancerous) tumors that grow in the wall of the uterus. They can be as small as an apple seed or as large as a grapefruit.
Fibroids don’t always cause symptoms. When they do, they can cause heavy menstrual bleeding, prolonged menstrual periods (lasting more than a week), pelvic pain, lower back pain, or painful intercourse. While symptoms often respond to medication or nonsurgical treatment, sometimes the symptoms are severe enough to warrant hysterectomy, which is the only permanent solution for uterine fibroids.
Endometriosis
Endometriosis is a disease in which the uterine lining grows outside of the uterus, causing painful menstrual cramps, chronic pain in the lower back and pelvis, intestinal pain, bleeding or spotting between periods, and infertility. Most often endometriosis is found on the ovaries, fallopian tubes, and the peritoneum (pelvic sidewall).
Hormone therapy, pain medication, and minimally invasive procedures may be performed to treat this condition. But when those options fail to keep the disease at bay, a hysterectomy may be performed.
Pelvic Organ Prolapse
Pregnancy, childbirth, and aging can weaken or stretch a person’s pelvic supporting tissues and ligaments. In some cases, the uterus can lower or sag into the vagina. Women with this condition may experience pelvic pressure, urinary incontinence, or difficulty making a bowel movement. Hysterectomy may be recommended for this condition.
Abnormal Uterine Bleeding
Heavy bleeding during your period is one example of abnormal uterine bleeding. Other instances include bleeding and spotting between periods, bleeding or spotting after sex, menstrual cycles that last longer than 38 days or shorter than 24 days, and bleeding after menopause.
Benign growths in the uterus — either polyps or fibroids — are common causes of abnormal uterine bleeding. Medication and surgical procedures like endometrial ablation or uterine artery embolization are common treatments, but a person may opt for a hysterectomy as a solution.
Chronic Pelvic Pain
Chronic pelvic pain typically lasts six months or longer. Most chronic pelvic pain can be attributed to endometriosis. Other conditions that can lead to chronic pelvic pain include fibroids, ovarian cysts, irritable bowel syndrome, and interstitial cystitis (painful bladder syndrome).
Depending on the condition, treatment for pelvic pain can include medication, physical therapy, biofeedback, or minimally invasive procedures like trigger point injections or peripheral nerve blocks. As a last resort, hysterectomy may be suggested for chronic pelvic pain that hasn’t responded to any other treatment.
Adenomyosis
Adenomyosis is a condition in which the tissue that lines the uterus grows inside the walls of the uterus, where it doesn’t belong. The displaced tissue continues to act normally — thickening, breaking down, and bleeding — during each menstrual cycle. The condition sometimes results in an enlarged uterus and painful, heavy periods. This usually resolves after menopause. Doctors treat it the same way they treat endometriosis, and hysterectomy may be recommended.
Gynecologic Cancers
Hysterectomies are routinely performed to treat gynecologic cancer. Hysterectomy is the main treatment for endometrial cancer, which is the most common type. Physicians consider the surgery the best treatment option in many cases.
Treatment for ovarian cancer usually involves a combination of surgery and chemotherapy. The surgery may involve hysterectomy, especially if the cancer is advanced.
Hysterectomy is also a common treatment for invasive cervical cancers.
