Hysterectomy side effects and recovery

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According to ACOG, there are three broad types of hysterectomy:

• Total hysterectomy: This surgery involves the complete removal of the uterus and cervix.
• Supracervical hysterectomy: During this procedure, surgeons remove the uterus but not the cervix. A doctor may also refer to this procedure as a subtotal or partial hysterectomy.
• Radical hysterectomy: This surgery removes the uterus, cervix, and surrounding support tissue. Doctors often recommend this type of hysterectomy for people with cancer.

Additionally, a hysterectomy with oophorectomy is when surgeons remove the uterus and one or both ovaries during the same surgery.

A hysterectomy with salpingo-oophorectomy involves removing the fallopian tubes.

Also, surgeons can perform a hysterectomy in several different ways. They may remove the organs through the abdomen, or they may remove them through the vagina.

A laparoscopic-assisted hysterectomy involves a surgeon performing part of the surgery through the abdomen but removing the uterus through the vagina, combining both approaches.

It is common for people to experience pain, bleeding, vaginal discharge, and constipation after a hysterectomy. Pain medication and using sanitary pads can help with these side effects.

What other short-term side effects a person may experience depend on the type of hysterectomy they have.

Hysterectomy without oophorectomy

A hysterectomy that does not involve ovary removal may still affect the ovaries.

According to a 2020 review, research studies have found some evidence suggesting that some hysterectomies that spare the ovaries may speed up the onset of menopause.

A small, older study from 2006 found that hysterectomies may affect blood supply to the ovaries, which is one theory for why this could happen.

However, the evidence for this is still very mixed and dependent on the type of hysterectomy and what organs and surrounding tissues the surgeon removes.

Scientists are still investigating the long-term effects of hysterectomies and need to do further studies on the impact hysterectomies on ovarian function.

Hysterectomy with oophorectomy

If a person has undergone a hysterectomy with oophorectomy, this means they no longer have ovaries.

The ovaries produce the hormone estrogen. Without these organs, a person who had not undergone menopause already will experience menopause symptoms.

These side effects of hysterectomy with oophorectomy include:

• hot flashes
• night sweats
• vaginal dryness
• difficulty sleeping
• mood swings and irritability
• weight gain
• hair loss
• dry skin
• incontinence
• loss of bone density
• rapid heartbeat

The duration of these symptoms will vary from person to person. Due to the sudden drop in estrogen, people who have had an oophorectomy may experience exaggerated symptoms.

A doctor can prescribe hormone replacement therapy (HRT) to reduce menopause symptoms for people who are premenopausal.

According to the Office on Women’s Health, it typically takes 3–4 weeks to recover from a vaginal or laparoscopic hysterectomy.

It may take 4–6 weeks to recover from an abdominal hysterectomy.

A person’s age and overall health also influence their recovery time.

The Dana-Farber Cancer Institute say that after a hysterectomy, an individual:

• cannot drive for 2 weeks
• cannot lift objects heavier than a bag of groceries for 6 weeks
• may experience fatigue for the first 6 weeks
• may see spotting and vaginal discharge for 8 weeks
• cannot insert anything into the vagina for 8 weeks

A person can aid their recovery by:

• doing light exercise, such as walking
• getting plenty of rest
• keeping any surgical incisions clean and dry
• avoiding tight clothing
• checking incisions regularly for signs of infection
• avoiding water directly hitting an incision in the shower
• gently cleaning the area
• taking prescribed medications correctly

A person will typically stay in the hospital for 1–2 days following the procedure before returning home to recover. This time can vary depending on the type of hysterectomy. Abdominal surgery may require a stay of 2–3 days.

If someone has a hysterectomy due to cancer, they may need to stay for longer.

According to ACOG, the risks of an abdominal hysterectomy include:

• infection
• wound bleeding
• blood clots
• nerve or tissue damage

Vaginal or laparoscopic hysterectomies typically have a lower risk for complications. However, any type of hysterectomy can potentially cause these problems.

According to a 2018 study, having a hysterectomy before 35 years of age also increases a person’s risk factor for several medical conditions, including:

• 14% increased risk of lipid abnormalities
• 13% increased risk of high blood pressure
• 18% increased risk of obesity
• 33% increased risk of coronary artery disease
• 4.6-fold increased risk of congestive heart failure
• 2.5-fold increased risk of coronary artery disease

In addition to physical changes, a person who undergoes a hysterectomy may also experience changes in their mental health.

Hysterectomies mean a person can no longer get pregnant. For some, this causes grief and sadness, particularly if they had hoped to have more children.

A person will also not have periods anymore, which can make a female feel they have lost part of their identity or womanhood.

For others, losing their periods can be a relief. If someone has a painful or difficult health condition, their symptoms may improve, along with their quality of life.

People who do not want children may also feel relieved that they cannot become pregnant.

A study of females who underwent hysterectomies without ovary removal from 1980–2002 found that they had a 6.6% higher risk for new depression diagnoses and a 4.7% higher risk for anxiety diagnoses in the 20 years following their surgery.

The researchers are not sure why this occurred, so scientists need to carry out more research to understand this trend.

Hysterectomies are not reversible, so it is a good idea for people to ask for as much information as they need to feel confident with their decision.

Questions to ask could include:

• Will the procedure cure a condition or just treat the symptoms?
• Are there any alternatives to a hysterectomy that may help with symptoms?
• Will natural menopause improve the symptoms, and, if so, is a hysterectomy necessary?
• Could symptoms return after the procedure, and if so, what happens then?
• Is there a way to preserve eggs if I want a child in the future, via a surrogate, for example?
• What type of hysterectomy would you recommend?
• Will you remove the cervix, fallopian tubes, or surrounding tissue?
• What can I expect during and after the procedure?

According to Dana-Farber Cancer Institute, a person should contact their doctor or healthcare provider if they experience any of the following symptoms after their surgery:

• heavy vaginal bleeding that soaks a pad in less than 1 hour
• foul vaginal odor
• changes in urinary frequency or inability to urinate
• fever at or above 100.4^oF
• continuous constipation
• diarrhea
• vomiting or nausea
• swelling, pain, or tenderness around the incision
• any openings at the incision site
• chest pains or trouble breathing
• severe pain that does not improve with pain relief

Short-term hysterectomy side effects can include pain, bleeding, discharge, and constipation. A person may also temporarily experience menopause-like symptoms, such as hot flashes. These will resolve as a person recovers.

In the long term, a person may feel a sense of loss or sadness, or possibly relief following the procedure. People who have also had ovaries removed will experience menopause and may benefit from HRT.

Hysterectomies have some risks, and they also mean a person cannot become pregnant. The individual can talk to their doctor about all their options before undergoing surgery.