What happens to your body after a hysterectomy?

Sumit Saraf, MD

Obstetrics and Gynecology

A hysterectomy, where the uterus is removed but not necessarily the ovaries, fallopian tubes or cervix, is the second most common gynecological surgical procedure in the United States. A hysterectomy might be performed for a variety of medical reasons, and many are curious as to what happens to your body after a hysterectomy, what the procedure involves and whether it’s safe.

Sumit Saraf, MD, explained the basics you need to know about hysterectomies, from the ways the surgery may be performed to whether you’ll have hot flashes or other symptoms usually associated with menopause afterward.

Why would someone need a hysterectomy?

“There are multiple reasons for a hysterectomy to be performed,” said Dr. Saraf. “The most common is due to heavy, irregular or painful menstrual cycles that don’t respond to other treatment options.”

Other medical conditions that can be helped by having a partial or full hysterectomy include:

• Fibroids
• Endometriosis
• Adenomyosis
• Precancerous or cancerous cells that come from the uterus, cervix or ovaries
• Infection, rarely

Are there different ways to perform a hysterectomy?

A hysterectomy can be open (or laparotomy), use a vaginal approach or be laparoscopic. An open hysterectomy involves the surgeon removing the uterus through an opening in the abdomen. In the vaginal approach, the uterus is removed through a small opening created within the vagina.

Laparoscopic hysterectomies are considered less invasive than open and involve a small lighted tube and surgical tools being inserted through small openings in your abdomen. This can be performed with traditional instruments, via single-incision surgery, or with robotic assistance.

Who decides which type of hysterectomy I need?

“The decision to move forward with any specific type of hysterectomy is a shared decision between physician and patient,” said Dr. Saraf. “In some cases, open or laparotomy hysterectomy may be the only available and safest option.”

Is hysterectomy safe?

Thanks to the adoption of minimally invasive surgery options, the safety of the procedure has increased drastically over the past few decades. Laparoscopic and vaginal hysterectomies show excellent outcomes for those who receive them overall.

Before undergoing the procedure, your provider will do everything they can to prioritize your safety and well-being when deciding what type of surgery you need.

What should I expect after having a hysterectomy?

“Most patients leave the hospital either the same day, as part of an outpatient procedure, or the day after the surgery,” said Dr. Saraf. “We generally expect the patient to return to full physical function within a few weeks afterward.”

Dr. Saraf offered the following advice for those who are preparing for a hysterectomy:

• Schedule time off from work for recovery
• Plan to get some rest and stay in a comfortable spot in your home
• Don’t lift anything heavy for six weeks or so after your surgery
• Arrange for a friend or family member to stay with you, so that they can help you with driving, standing or moving around while you recover

These are very general recommendations, and your doctor will speak with you in greater detail on what to expect and the best advice for your own recovery period.

After the surgery, you may experience some common discomforts, including vaginal bleeding, abdominal pain or cramping, urinary urgency or frequency or anesthesia complications. Most of these should resolve on their own.

After a hysterectomy, you will no longer have periods or get pregnant.

Do I still need to get a Pap smear after having a hysterectomy?

“A hysterectomy doesn’t always involve the full removal of the ovaries and cervix,” said Dr. Saraf. “Ovaries, tubes and the cervix may be retained, so it’s important to follow up with your OB/GYN during the post-operative period and to continue seeing them regularly afterward.”

When it comes to Pap smears- those who receive a partial hysterectomy, or whose hysterectomy was performed due to precancerous or cancerous cells, will likely need to continue receiving Pap smears. Those who received a total hysterectomy for noncancerous reasons may be able to skip Pap smears from then on.

Will I have hot flashes and menopause symptoms after a hysterectomy?

Symptoms like hot flashes, chills, night sweats and other discomforts are possible if the ovaries are removed and are caused by changes in hormone levels within the body. However, ovaries are no longer universally removed during hysterectomies.

For most patients, these symptoms don’t happen because of hysterectomy, but only when they go through natural menopause, typically after the age of 50.

Will having a hysterectomy affect my sex life?

“Sexual activity is an interplay of a lot of factors, including hormones, lubrication, mental health and sexual desire,” said Dr. Saraf. “Undergoing any surgical procedure or a major medical condition can affect your sex life in a short- or long-term manner.”

Most patients who undergo a hysterectomy are able to enjoy unrestricted sexual activity and return to their regular sex life after a few weeks. If you have specific concerns about this, speak with your physician. There are treatments or counseling available that can help with issues that might arise.