A total hysterectomy is a surgical procedure that involves the removal of the uterus and cervix. It is one of the most common gynecologic surgeries and is performed to treat various medical conditions affecting the female reproductive system. After a total hysterectomy, a woman will no longer have menstrual periods and cannot become pregnant. Understanding why this procedure is done, how it’s performed, and what to expect afterward can help patients make informed decisions and prepare for recovery.
Doctors may recommend a total hysterectomy when other treatments haven’t been successful or when a condition is serious. Common medical reasons include:
Uterine fibroids causing pain, heavy bleeding, or pressure
Endometriosis (tissue like the uterine lining growing outside the uterus)
Uterine, cervical, or ovarian cancer
Chronic pelvic pain
Abnormal or heavy menstrual bleeding
Adenomyosis (uterine lining growing into the muscle wall of the uterus)
Prolapsed uterus (uterus falling into the vaginal canal)
Though a total hysterectomy always removes both the uterus and cervix, the surgical approach can vary:
Before surgery, your provider will review your health, order necessary labs or imaging, and give instructions about eating, medications, and activity. The procedure is done under general or spinal anesthesia and usually takes 1–3 hours. After surgery:
Some women experience emotional changes, especially if the hysterectomy affects their sense of identity or fertility. Support groups or counseling can be helpful during this time.
If the ovaries are not removed, hormone levels may stay the same, and you won’t experience immediate menopause.
If both ovaries are removed (a total hysterectomy with bilateral salpingo-oophorectomy), menopause begins right away, possibly with symptoms like hot flashes or mood changes. Hormone replacement therapy (HRT) may be considered in some cases.
A total hysterectomy can provide lasting relief from chronic pain, bleeding, or serious health conditions. While it is a major decision, many women find improved quality of life afterward. Talk openly with your healthcare provider about the benefits, risks, and recovery process to ensure the best possible outcome.
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