Why it's necessary

A hysterectomy is a major operation for a woman that's only recommended if other treatment options have been unsuccessful.

The most common reasons for having a hysterectomy include:

• heavy periods – which can be caused by fibroids
• pelvic pain – which may be caused by endometriosis, unsuccessfully treated pelvic inflammatory disease (PID), adenomyosis or fibroids
• prolapse of the uterus
• cancer of the womb, ovaries or cervix

Heavy periods

Many women lose a large amount of blood during their periods. They may also experience other symptoms, such as pain and stomach cramps.

For some women, the symptoms can have a significant impact on their quality of life.

Sometimes heavy periods can be caused by fibroids, but in many cases there's no obvious cause.

In some cases, removing the womb may be the only way of stopping persistent heavy menstrual bleeding when:

• other treatments have not worked
• the bleeding has a significant impact on quality of life and it's preferable for periods to stop
• the woman no longer wishes to have children

Find out more about heavy periods

Pelvic inflammatory disease (PID)

PID is a bacterial infection of the female reproductive system.

If detected early, the infection can be treated with antibiotics. But if it spreads, it can damage the womb and fallopian tubes, causing infertility and long-term pain. It can also increase the chance of an ectopic pregnancy.

A hysterectomy to remove the womb and fallopian tubes may be recommended if the infection is severe and a woman no longer wants children.

Find out more about pelvic inflammatory disease (PID)

Endometriosis

Endometriosis is a condition where tissue similar to the lining of the womb starts to grow in other places, such as the ovaries and fallopian tubes.

This can lead to pain, heavy and irregular periods, and infertility.

A hysterectomy may remove the areas of endometrial tissue causing the pain.

But it'll usually only be considered if other less invasive treatments have not worked and the woman decides not to have – or is unable to have – any children.

Find out more about endometriosis

Fibroids

Fibroids are non-cancerous growths in or around the womb (uterus). The growths are made up of muscle and fibrous tissue, and vary in size.

The symptoms of fibroids can include:

• heavy or painful periods
• pelvic pain
• frequent urination or constipation
• pain or discomfort during sex

A hysterectomy may be recommended if you have large fibroids or severe bleeding and you do not want to have any more children.

Find out more about fibroids

Adenomyosis

Adenomyosis is where the tissue that normally lines the womb starts to grow within the muscular wall of the womb.

This extra tissue can make your periods particularly painful and cause pelvic pain.

A hysterectomy can cure adenomyosis, but will only be considered if all other treatments have failed and you do not want to have any more children.

Prolapse of the uterus

A prolapsed uterus happens when the tissues and ligaments that support the womb become weak, causing it to drop down from its normal position.

Symptoms can include:

• back pain
• a feeling that something is coming down out of your vagina
• leaking urine (urinary incontinence)
• difficulty having sex

A prolapsed uterus can often occur as a result of childbirth.

A hysterectomy resolves the symptoms of a prolapse because it removes the entire womb.

It may be recommended if the tissues and ligaments that support the womb are severely weakened and the woman does not want any more children.

Find out more about prolapse of the uterus

Cancer

A hysterectomy may be recommended for these cancers:

• cervical cancer
• ovarian cancer
• cancer of the fallopian tubes
• cancer of the womb (uterus)

If the cancer has spread and reached an advanced stage, a hysterectomy may be the only possible treatment option.

Deciding to have a hysterectomy

If you have cancer, a hysterectomy may be the only treatment option.

For other health problems, it's a good idea to ask yourself these questions before deciding to have the procedure:

• Are my symptoms seriously affecting my quality of life?
• Have I explored all other treatment options?
• Am I prepared for the possibility of an early menopause?
• Do I still want to have children?

Do not be afraid to ask your doctor as many questions as you want.