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The physical, emotional and psychological impacts of a hysterectomy

Question: I'm 48 and have been suffering from very heavy bleeding, which is inconvenient and draining. I've been told that I have fibroids and my gynaecologist has recommended that I have a hysterectomy. As I have finished having kids, and there is no need to remove my ovaries, I was pretty comfortable about having this procedure until my mother-in-law said, "How will you feel about no longer being fully a woman?" I don't feel I'm defined by my reproductive organs, but I wonder if I will feel differently later.

Answer: Although having a hysterectomy is often an elective procedure, it is still major surgery and the recovery period can be accompanied by depression. You can find more information about the medical aspects of hysterectomy at Jean Hailes for Women’s Health.

A hysterectomy involves the removal of the uterus (womb). If the cervix is also taken, this is called a total hysterectomy. In some circumstances, the fallopian tubes might also be removed.

If the underlying condition means that the ovaries also have to be taken, this has greater physical repercussions. The ovaries produce female hormones, and when they are gone menopause will occur (if you have not gone through it), and ongoing hormone treatment can be necessary.

When cancer is involved, having surgery is a matter of urgency – but in your case you can take a little time to get a second opinion, get informed, ask questions, and prepare yourself psychologically.

Research has shown that women who understand what is going on, get their questions answered and generally feel consulted and respected through this process have more positive outcomes in recovery than those who feel their bodies were hijacked by a medical machine. You know your own body and your input is valuable.

Maureen MatthewsCredit:Craig Sillitoe

Very few people feel a deep emotional, spiritual or existential connection to their appendix or tonsils, but it is different with one's reproductive organs. Some religions forbid medical procedures that render a fertile woman sterile, which can add shame to the equation. Other groups promote an extreme modesty that makes them reluctant to even get examined by a gynaecologist. Even if you do not hold these beliefs you might encounter them in others.

It is important to keep your partner in the loop as well. Having support is helpful, and this impacts on the partner too. A lot of people are ignorant about female anatomy, and can be fearful about what hysterectomy involves. They can have strange misconceptions, and irrational beliefs, such as those expressed by your mother-in-law. If they feel excluded, or not given information, or a chance to ask questions, it can negatively affect how they feel about sex.

Once you are declared to be physically fit to go home, your ongoing recovery can involve a number of issues. When the ovaries have been removed, menopause symptoms will begin. This can be particularly challenging, psychologically, if the woman has not had the children she wanted. The physical repercussions might be less severe when the ovaries remain but other issues can arise, both emotional and sexual, so be kind to yourself.

There can be a period of grieving for the loss of the womb, even if you do not want more children, and some women feel that their femininity has been compromised. This might not be rational, but it must be acknowledged, and addressed. Be prepared to seek counselling if you are struggling.

In many cases, taking away the symptoms that have been plaguing the woman can give her a new lease of life, sexually. However, their symptoms can have been so disruptive and traumatising over time that their interest in sex can have been destroyed. It can take time, patience, and ongoing communication to rebuild intimacy, which can be confusing and disappointing for the partner.

Talking to others who have had similar experiences can be very helpful. Your doctor might know of a support group in your area. They can also refer you to appropriate counselling services that can aid your recovery. If you and your partner find that you are struggling to resume a pleasurable sex life, you might also find it useful to consult a sex therapist.

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