How dangerous is having a hysterectomy? What are the side effects of having surgery? Hysterectomy side effects during and after the surgery can affect your quality of life if not controlled and treated properly.
All forms of surgery can have complications, and hysterectomy is no exception. The danger of complications include:
- You may react badly to the anesthetic and require resuscitation.
- During the surgery, you may bleed excessively and require a blood transfusion (up to 3.4% of patients).
- Your neighboring internal organs could be damaged if your surgeon severs nerves near the pedicles (up to 1.8% of patients). Consequently, you may later experience involuntary loss of urine from the bladder (incontinence). If the sides of the bowel stick together because of adhesions, you may require another surgery to free the blockage and allow the stool to pass normally.
- Blood clots (thrombi) can develop; if they travel to the lungs, heart or brain (emboli) they can cause heart attack or stroke.
- If your incision becomes infected, you will require prescription antibiotics and an extended hospital stay (up to 4% of patients). An infection can cause sloughed skin or tissue death (necrosis).
- Fluid pocket formation and uneven pigmentation can result from any surgery.
- The loss of any body part sets off a period of mourning and adjustment, for which psychological counseling and antidepressants may be required. This is particularly true of hysterectomy because the sudden fluctuation of hormones induces temporary mood swings, especially with the removal of the ovaries.
- Over time, your remaining internal organs may fall downward (prolapse) and you could have pain when eliminating waste, or engaging in penetrative sex (dyspareunia), or during pelvic exams.
Your doctor should explain all of the possible complications to you in detail and answer your questions as part of obtaining informed consent prior to the operation. You will be required to sign a release form acknowledging that these complications have been explained to you and that you understand them and accept the possibility before surgery can proceed.
If you are unconscious at the time, due to injury or complications, then your doctor explains the complications to your next-of-kin or the person who holds your Power of Attorney, and obtains a signed consent from him/her as your proxy.
Are there alternatives to hysterectomy?
Hysterectomy is a life-altering, permanent decision. It is female castration and is irreversible. You have the legal right to obtain a second, third and if necessary a fourth opinion. You have the ethical right to discuss alternatives to hysterectomy with your doctor.
It is quite acceptable for you to ask your surgeon these questions during the initial consultation:
1. How long have you been in practice?
2. How many hysterectomies have you performed?
3. How many of your patients have had complications?
4. What kind of complications did they have?
5. What other options can you offer me?
6. Why do you not favour these options?
Some of the surgical options you may want to discuss depending upon why the hysterectomy is being recommended, include uterine fibroid embolization (UFE), myomectomy (shelling out the fibroids like pea pods), endometrial ablation (burning away the lining of the uterus) and endometrial resection.
The majority of symptoms that lead to the recommendation for hysterectomy are hormone-based. Synthetic pharmaceutical hormones do not adequately treat most of the major symptoms that lead to hysterectomy, especially uterine fibroids, endometriosis and heavy menstrual bleeding. These conditions are the result of estrogen dominance and are generally very responsive to the hormone progesterone.
Progesterone is the hormone that opposes the action of estrogen and is vital for holding the uterine lining together during the menstrual cycle. It is extremely important that patients who are considering the hysterectomy option understand the principles of estrogen dominance and know just why their body has changed so radically. Estrogen dominance is reversible and if addressed early enough, hysterectomy prevention through the use of progesterone is a realistic option. For example, if hysterectomy is recommended to treatment heavy periods it is usually the case that there is an overall progesterone deficiency and estrogen dominance which leads to the heavy/uncontrolled bleeds.
Synthetic progestagens do not work in the same way as natural progesterone. Using aÂ pharmaceutical grade natural progesterone creamÂ generally results in control and predictability of bleeding patterns, and achieves an improvement in quality of life within three months.
This improvement usually continues with extended use and can negate the requirement for surgery. Natural progesterone creams like ProFemeÂ will not reverse continual flooding, an enlarged or bulky uterus, prolapse or severe Stage IV endometriosis.
To learn more about estrogen dominance and progesterone deficiency download this FREEÂ estrogen dominanceÂ booklet.
Who is not a good candidate for hysterectomy?
If you are very obese, or use alcohol, anabolic steroids, or marijuana, then you are not a good candidate for any elective surgery. The surgical team may decline to perform the hysterectomy until you lose weight and stop taking drugs.
If you have a pre-existing medical condition that contributed to the need for hysterectomy, like iron deficiency anemia, diabetes, liver, heart, or lung disease, then you are not a good candidate for surgery. Your doctor will likely recommend conservative medical treatment because the benefits of surgery do not outweigh the risks.
Why do I need hormone supplements after surgery?
If your ovaries are removed (oophorectomy) during the surgery, then you will experience immediate menopause because of the abrupt drop in hormones circulating through your bloodstream. In young women this early menopause has great significance and requires comprehensive medical and psychological support both pre- and post surgery. Even if you retain your ovaries after the hysterectomy, chances are that you will experience menopause within the first five years after surgery, although you still may be very young.
Some of the signs and symptoms of surgically-induced menopause are:
- Hot flashes
- Night sweats that disturb sleep (insomnia)
- Migraine headaches
- Lack of vaginal lubrication that makes intercourse painfulÂ (dyspareunia)
- Heart palpitations
- Mood swings
- Weight gain
- Shifting of fat from the buttocks and thighs to the abdomenÂ (apple shape)
- Diminished sex drive (lowered libido)
Menopause is normally a gradual, winding-down process, whereas hysterectomy brings on a hormonal shock, especially when the ovaries are removed. Your doctor may offer you estrogen replacement after hysterectomy to prevent some of these unpleasant symptoms, providing you do not have a hormone-dependent cancerous tumor. If you have a form of cancer that is stimulated by hormones, then you are not a candidate for hormone replacement therapy and your recovery will likely be prolonged and intense.
When the ovaries are removed in a pre or perimenopausal women, estrogen, progesterone and testosterone levels all dramatically decline. Just replacing estrogen will address symptoms such as hot flashes and night sweats; however, it will have minimal effect on many other menopausal symptoms.Â Natural progesteroneÂ andÂ testosteroneÂ are essential to maintain hormonal balance by assisting the nervous system and can help you to deal with the emotional effects of instant menopause induced by hysterectomy and ovarian removal, protection of bones from thinning (osteoporosis), maintenance of sexual function, energyÂ levels and blood sugar regulation. Natural estrogen (NATRAGENÂ® or the adhesive estrogen skin patches) are better forms of estrogen than synthetic tableted forms of estrogen.
Understand more on Hysterectomy:
The information in this article has been taken with permission from the official Lawley booklet onÂ Understanding Hysterectomy.