What Problems Can Women Face After a Hysterectomy?
After a hysterectomy periods stop and pregnancy is no longer possible. If the ovaries are removed, menopausal symptoms may appear; most women recover well.
In this article 5 sections
A hysterectomy, the removal of the womb, is a common and generally safe operation, and most women live healthy, normal lives afterwards. Some changes are certain, however: periods stop and pregnancy is no longer possible. There may also be some short-term problems after surgery, and if the ovaries are removed too, symptoms of menopause can appear. In the video, Dr. Sharmin Afroz briefly explains this topic.
01What a hysterectomy is and why it is done
A hysterectomy is the surgical removal of the uterus. Sometimes the cervix is left in place, and sometimes the fallopian tubes and ovaries are removed as well. It may be done for large fibroids, heavy periods that have not improved with other treatment, adenomyosis, endometriosis, prolapse of the womb or cancer. The operation can be done through an abdominal cut, by laparoscopy or through the vagina.
02Short-term problems after surgery
- Pain in the abdomen or wound and tiredness, which ease over a few weeks
- Light vaginal bleeding or discharge for a few weeks
- Temporary changes in bladder or bowel habits, constipation
- A risk of infection, bleeding or blood clots in the leg veins (DVT), which doctors take steps to prevent
- Rarely, injury to the bladder or bowel
03Long-term changes
If the ovaries are kept
The ovaries continue to produce hormones, so menopause usually does not start suddenly. However, some studies suggest that menopause may arrive somewhat earlier than expected in some women.
If the ovaries are removed
Menopause begins straight after the operation, known as surgical menopause. Hot flushes, night sweats, sleep problems, mood changes and vaginal dryness may occur. In the long term, the risk of bone thinning (osteoporosis) and heart disease can increase, especially if the ovaries are removed at a young age. Discuss with your doctor whether hormone replacement therapy (HRT) is suitable for you.
Emotional and sexual life
Some women feel low or experience a sense of loss for a while, particularly if they had hoped for more children. Family support and, if needed, counselling can help. After full recovery, most women’s sexual lives remain normal, and for many they improve because pain and bleeding problems are gone.
04How to stay healthy
- Start walking gradually as advised, and avoid heavy lifting for the first few weeks.
- Eat fibre-rich food and drink enough water to avoid constipation.
- Keep bones strong with calcium- and vitamin D-rich foods and regular exercise.
- If your cervix was kept, continue regular cervical screening.
When to see a doctor
After surgery, go to hospital without delay if you notice any of the following:
- Fever or shivering
- Severe or worsening abdominal pain
- Heavy vaginal bleeding or foul-smelling discharge
- A wound that becomes red, swollen or discharges pus
- Pain and swelling in one leg, breathlessness or chest pain
- Burning when passing urine or being unable to pass urine
Q & A
Frequently asked questions
Removing the womb alone does not usually cause weight gain. Less activity after surgery or menopausal changes can lead to weight gain, so a balanced diet and exercise are important.
Periods stop, but if the ovaries are kept they continue making hormones, so menopause does not usually start suddenly. If the ovaries are removed, menopause begins.
You are usually advised to wait several weeks to allow full healing. Your doctor will tell you the right time based on your operation.
Article & video by
Dr. Sharmin Afroz
Obstetrics, Gynaecology & Infertility Specialist and Laparoscopic Surgeon
Assistant Professor, Department of Obstetrics & Gynaecology, Anwer Khan Modern Medical College & Hospital.
