Hysterectomy: what is it?

The uterus is the organ where a pregnancy grows and where menstrual bleeding begins. A hysterectomy may be considered for troublesome Uterine Fibroids, Endometriosis, Adenomyosis, persistent heavy periods, Endometrial Hyperplasia or cancer. It can be total, with the uterus and cervix removed, or subtotal, with the cervix left in place. The ovaries are not automatically removed. Their removal changes hormone production and may cause menopause symptoms; keeping them may preserve ovarian hormone production. Because the uterus is removed, periods stop and carrying a pregnancy is no longer possible.

Ask your gynaecologist to explain the diagnosis, alternatives and why hysterectomy is being suggested now. Discuss fertility, ovarian removal, cervical screening, the surgical route and expected recovery. Tell the team about medicines, allergies, previous operations and health conditions. Before going home, make sure you know how to care for the wound, manage pain, move safely and recognise symptoms that should be reported.

After surgery, contact your care team for fever, worsening pelvic or abdominal pain, increasing bleeding, foul-smelling discharge, vomiting, trouble passing urine or a red, swollen wound. Sudden breathlessness, chest pain, collapse or severe pain needs emergency assessment. Do not assume new bleeding is a period after hysterectomy.

What exactly will be removed? Are there alternatives? How might this affect hormones, fertility and sex? Which warning signs should prompt a same-day call, and when is follow-up arranged?