What Side Effects Can I Expect After a Hysterectomy?

A hysterectomy is a surgical procedure used to treat a variety of diseases and conditions, including gynecologic cancer. Women who are advised to have a hysterectomy are often concerned about the effects of the procedure and how their bodies will respond after the removal of their uterus.

These are valid concerns as the procedure can cause a variety of postoperative effects, depending upon which type of hysterectomy a woman undergoes.

There are three different types of hysterectomy your gynecologist might recommend in response to specific medical conditions.

• A total hysterectomy is a procedure which involves the removal of both the uterus and the cervix. It is the most common type performed in women.
• A radical hysterectomy involves the removal of the uterus, cervix, and upper part of the vagina. Tissues that support the uterus and the lymph nodes may also be removed. In cases of gynecologic cancer, this type of hysterectomy is most often recommended.
• A partial hysterectomy, also called a subtotal hysterectomy, is a  procedure that involves the removal of the uterus only, leaving the cervix intact.

During a hysterectomy, the ovaries may also be removed. This procedure is referred to as a hysterectomy plus bilateral salpingo-oophorectomy.

The side effects you can experience after a hysterectomy are dependent upon the type of hysterectomy you receive.

Considering that all hysterectomy surgeries involve the removal of the uterus, women who have not yet entered menopause will no longer menstruate (an event called forced or surgical menopause). Women who undergo a total hysterectomy plus bilateral salpingo-oophorectomy will experience these effects immediately.

Another consequence of having your uterus removed is, of course, infertility. The emotion aftermath can often be devastating for women in their childbearing years, particularly for those planning a family. Many turn to adoption or surrogacy or seek counseling to overcome the grief and loss they may feel.

(Researchers are currently exploring the possibility of uterine transplants for women who have had a hysterectomy or other medical conditions that prevent pregnancy. While several women successfully bore children in 2014 as the result of a transplant, it is still considered a highly controversial and experimental procedure.)

After a hysterectomy, you may experience a range of menopausal symptoms, such as:

• hot flashes
• mood swings
• decreased libido
• vaginal dryness
• night sweats

Women whose ovaries are spared often do experience many of the same physical effects as those who have had their ovaries removed, albeit to a lesser degree. Even if the ovaries remain, hormone production will be slowed, often significantly, resulting in the rise of menopausal symptoms.

Hormonal changes can also bring about mood swings, anxiety, depression, and irritability. If you experience any of these emotions, speak with your doctor. Treatment can depend on many factors, such as the type of hysterectomy performed and any other pre-existing health conditions you may have. Together, you and your doctor can plan a course of action tailored to both your emotional needs and medical history.

On the flip side, the prospect of no longer menstruating can be a relief for women who have undergone a hysterectomy, especially those who suffer from heavy periods or cramping. This aspect of the procedure is often referred to as the "silver lining" of hysterectomy surgery.

There is often confusion among women as to whether there is a need for cervical cancer screening following a hysterectomy, with some believing that it is no longer necessary. This can be a mistake.

If you have had a hysterectomy as a result of cervical cancer or have a history of cervical dysplasia, it is strongly recommended that you continue to have routine exams at your doctor’s discretion, including Pap smears and colposcopic exams. This is true even if your cervix has been removed.

Women who do not have a history of cervical cancer or cervical dysplasia, and have had their cervix removed, no longer need routine screening.