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Some hysterectomies also include removal of the ovaries, so the supply of essential female hormones is greatly reduced. This can have various effects. These are general facts related to hysterectomy.
Whether or not to have a hysterectomy
Hysterectomy is one treatment for a number of diseases and conditions. If you have cancer of the uterus or ovaries or hemorrhage (uncontrollable bleeding) of the uterus, this operation may save your life.
In most other cases, a hysterectomy is an elective procedure. The operation is done to improve the quality of life: to relieve pain, heavy bleeding or other chronic conditions and discomfort.
There may be other ways of treating or dealing with these problems. Together with your doctor you should weigh all the alternatives and effects of the different choices to help you decide what is right for you.
Cancer of the uterus
Cancerous organs and, in some cases, adjoining organs and structures, are removed in order to stop the spread of this life-threatening disease.
Fibroids
These are common non-cancerous (benign) tumors of the uterus and they are the most frequent reason for recommending a hysterectomy. They grow from the muscular wall of the uterus and are made up of muscle and fibrous tissue. Many women over 35 have fibroids, but usually have no symptoms.
In some women, however, fibroids (myomas) may cause heavy bleeding, pelvic discomfort and pain and occasionally pressure on other organs. These symptoms may require treatment, but not always a hysterectomy. Some women choose to do nothing since fibroids will often shrink in size as a woman goes through menopause.
Endometriosis
Another common reason for recommending a hysterectomy is endometriosis. This is a non cancerous condition in which cells from the uterine lining grow like islands outside of the uterus. This growth occurs most commonly on the ovaries, fallopian tubes, bladder, bowel and other pelvic structures, including the uterine wall. These cells may cause pain and discomfort by bleeding at the time of menstruation. Endometriosis may also cause scarring, adhesions and infertility.
Symptoms can vary greatly and some women choose to do nothing, or find that drug therapy, pain relief medication or more localized surgery are effective. When these are not effective, hysterectomy may be the treatment of choice.
Cancer of the cervix
Precancerous changes in the cervix are often found on routine Pap smears. These lesions or abnormalities must be treated, but rarely with a hysterectomy. When detected early and treated effectively, most of these conditions do not progress to invasive, life-threatening cancer. It is only in the case of invasive cancer of the cervix that hysterectomy may be the treatment of choice.
Unusually heavy bleeding
It is normal for the amount and length of menstrual flow to vary from woman to woman. There may also be differences in menstrual flow from one cycle to the next. If bleeding that is unusually heavy or frequent for you occurs, this may be due to a variety of causes. The most common causes are fibroids and hormonal changes.
Because there can be many reasons for unusually heavy bleeding, getting an accurate diagnosis is vital before deciding on a course of treatment. Depending on the diagnosis, drug therapy or minor surgery may be indicated. Rarely, there can be hemorrhage of the uterus in which case a hysterectomy can be life saving.
We will discuss the benefits and risks involved in undergoing hysterectomy in our next article on this subject.
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