by Rose Hayes

From recovery time to your post-surgery sex life, we’re debunking some of the common misconceptions. 

Hysterectomies, surgeries to remove the uterus, are extremely common in the United States. In fact, they’re the most frequently-performed surgical procedure for reproductive-aged American women, after cesarean sections. But you may have heard—perhaps from your older female relatives—that the surgery is one to dread.

While your great aunt probably wasn’t exaggerating—hysterectomies used to be major, invasive surgeries with big drawbacks like long recovery times—modern medicine has come a long way in the last 30 years. Today, the procedure may be effective for women with conditions including uterine fibroids, endometriosis, bleeding and uterine cancer.

So, whether you’re weighing your treatment options or about to go in for surgery, clearing up some of the most persistent hysterectomy myths can help you stress less. From our OBGYN Jen Mushtaler, MD.

Myth #1: A Hysterectomy Will Take Away Your Womanhood

Fact: A hysterectomy won’t make you any less of a woman.

“For many women, there’s a strong sense of identity associated with the uterus, so some women think that by removing they won’t be a complete woman anymore,” says Dr. Mushtaler.

It’s true that the uterus is an important part of a woman’s body—it can carry a pregnancy and causes your period every month—but removing it won't affect your hormones or change who you are, explains Dr. Mushtaler.

If you’re struggling emotionally because you can’t have children post-hysterectomy, reach out to a counselor or support group for help. Your OBGYN can point you in the direction of helpful resources, too.

Myth #2: You’ll Start Menopause Right After Surgery

Fact: Unless your ovaries are removed, a hysterectomy won’t cause menopause.

Natural menopause is a process marked by going a full year without having a menstrual period. During your 30s and 40s, your ovaries begin to make less of the female hormone estrogen, and menopause—which for most women occurs in their early 50s—means your ovaries have stopped making estrogen completely. If your ovaries are removed for any reason, that would also send you into menopause immediately.

But since a hysterectomy typically only involves the removal of the uterus, it doesn’t result in menopause. “While many cancer surgeries involve removing the ovaries, we prefer to leave the ovaries intact for benign hysterectomies and thus conserve a woman’s natural hormones.”

Even though your periods will stop after a hysterectomy, that doesn’t mean menopause has arrived; your body will likely keep making estrogen until around the time your hormone levels would naturally begin to decline.

Myth #3: You Won’t Want to—or Won’t Be Able to—Have Sex

Fact: You’ll still be able to have sex and orgasms may feel even better.

You might have heard that a hysterectomy will kill your sex drive. Many women actually find that sex after a hysterectomy is better, since the procedure can resolve issues like bleeding or pain that may have interfered with pleasure before. But a hysterectomy would only affect your sex hormones—estrogen and testosterone—if you also have surgery to take out your ovaries.

That said, in most cases, you’ll want to wait at least six weeks after the procedure before having sex to give your body time to recover. But once your doctor gives you the all clear, you’re free to have intercourse again.

Sex might feel a little different but you can still have orgasms—and good ones at that!  

“Whatever led us to do the hysterectomy was often making the patient uncomfortable during sex,” says Dr. Mushtaler. “After surgery, many patients report that they are able to appreciate how much better sex can be.”

Myth #4: It’s Always a Major Surgery with a Tough Recovery

Fact: The recovery time varies, based on the type of hysterectomy.

While there are different kinds of hysterectomies, recovery time usually doesn’t exceed six weeks.

The least risky type with the quickest recovery is a vaginal hysterectomy, says Dr. Mushtaler. This procedure involves taking out the uterus through your vagina and is recommended as the first option whenever possible. You’ll spend the day and maybe one night in the hospital and upon returning home, you’ll want to take it easy for two to four weeks as you recover.

The recovery time is similar for a laparoscopic hysterectomy, during which doctors make small cuts in your belly, then send a tiny camera and tools for surgery through those incisions to remove your uterus.

An abdominal hysterectomy, also known as a traditional hysterectomy, involves removing the uterus through an incision made in the lower part of the abdomen. This is usually the last option suggested for removal of the uterus and is typically recommended if your uterus is large or if there are adhesions, or abnormal scar tissue. Since it is an open surgery, this kind of hysterectomy does require more time in the hospital and recovery usually lasts about six weeks.

No matter what type of surgery you have, your doctor will guide you through the recovery process.

Myth #5: You’ll Be Trapped in Bed for Weeks

Fact: Moving around after surgery is better for your health.

After surgery, you may want to take it easy for a while. Instead, you’ll have doctors and nurses encouraging you to get out of bed that very same day.

“We tell women to not exert themselves too much,” says Dr. Mushtaler, “but we want you up and moving around the day of the surgery. Walking around will prevent blood clots, not to mention it’ll improve your healing by getting good blood flow to your wounds.”

You should start slowly and try to increase your walking distance a little bit every day. Just be sure to ask your nurse for help before getting out of bed, move slowly at first and avoid any heavy lifting. You can usually get back to your regular exercise routine within six weeks.

Myth #6: A Hysterectomy Will Make Your Vagina Fall Out

Fact: It can actually treat or help prevent vaginal prolapse.

Vaginal prolapse is when the muscles and tissues around your vagina get weak or tear, causing your vagina to descend from its usual place. In some cases, the uterus may hang down out of the vagina’s opening. Vaginal childbirth (especially multiple births), obesity, smoking and menopause can up your risk of prolapse. If your uterus falls, prolapse may actually be the reason you have a hysterectomy in the first place, says Dr. Mushtaler.

It’s possible to have a prolapse after a hysterectomy too, but surgeons now take extra steps to suspend the vagina during surgery to keep that from happening.

Myth #7: You’re Going to Have a Big Scar

Fact: It depends on the type of hysterectomy, but it will heal regardless.

Since vaginal hysterectomies are done through the vagina, the scarring that occurs is not noticeable. Laparoscopic hysterectomies do involve very small incisions, so you may have some scarring, but not a lot.

If you need an abdominal hysterectomy, however, you’re likely to have a scar post-surgery. Sometimes surgeons make a vertical incision, while other times they’ll use a more horizontal or bikini-line-type incision.

No matter what type of scar you have, there are treatment options, both dermatological and natural, to try to minimize the appearance of scarring.

Myth #8: A Hysterectomy is your only option.

Fact: It depends on your condition.

“Very rarely are there no alternatives,” says Dr. Mushtaler. “Removing the uterus should be the last resort in many cases.” Women with uterine cancer or dangerous bleeding probably need a hysterectomy right away. But in many cases, your doctor may be able to recommend other treatments.

You and your doctor can talk through your options and you should do your own research and ask plenty of questions. For example, if your uterus has prolapsed or fallen down, physical therapy may be able to help. For other conditions, like endometriosis, your doctor might be able to suggest other surgeries or medications.

Just remember: if you do have a health condition that requires attention and a hysterectomy is the best option, there are often fewer drawbacks to the procedure than you might realize.

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