Do you need a hysterectomy? It’s more common than you may think — in fact, 500,000 American women have this surgical procedure annually. If you’re one of the many women who may need a hysterectomy, take a look at the top reasons to have this type of reproductive surgery.


This reproductive system disorder happens when the normal uterine tissue lining grows outside of the uterus. The tissue can grow in the pelvic lining, fallopian tubes, or ovaries. In some (rare) cases, the tissue spreads past the pelvic organs to other parts of the abdomen.

Symptoms of endometriosis include painful periods, pain during intercourse, pain with urination or bowel movements, increased menstrual bleeding, and infertility. Even though these symptoms may point to endometriosis, pain and excessive menstrual bleeding are also signs of other reproductive conditions. This makes a doctor’s diagnosis a necessary first step before treatment.

The medical provider may suggest a conservative treatment (such as pain medication or hormonal therapy) as treatment before scheduling surgery. Some women may find relief from a conservative surgical approach. Instead of removing the uterus, the surgeon laparoscopically removes the overgrown tissue.

If these types of treatments don’t work or the doctor feels the endometriosis is advanced/severe, you may need a hysterectomy. The surgeon will remove the uterus and ovaries. This stops the overgrowth of endometrial tissue and results in early menopause and infertility. If you want to start a family, talk to your doctor about pre-surgery options or alternatives.

Uterine Fibroids

Fibroids are noncancerous growths in the uterus. Some women with fibroids experience no or very few symptoms. In these types of cases, hysterectomy is not necessary. But multiple, large, or extremely fibroids that don’t resolve with other treatments may require a surgery.

Symptoms of fibroids may include unusually heavy periods, long periods, pelvic pain, pelvic pressure, urination issues, constipation, or backache/unexplained leg pains. Like endometriosis, uterine fibroids symptoms can mimic signs of other reproductive disorders. Again, this makes a medical diagnosis necessary.

While these tumors aren’t cancerous, they can interfere with daily life. Painful fibroids or fibroids with other troublesome symptoms may respond to conservative treatments, such as gonadotropin-releasing hormone agonist medications, a progestin-releasing IUD, MRI-guided ultrasound surgery, radiofrequency ablation surgery, uterine artery embolization, or endometrial ablation.

Uterine fibroids that don’t respond to other treatments or are severe may require hysterectomy. Your doctor will evaluate your individual needs and discuss your options before scheduling this type of reproductive surgery. Like any hysterectomy, this procedure will cause infertility.

Uterine Prolapse

Most women don’t notice their uterus. But if the muscles and ligaments that support this reproductive organ weaken or fail, the uterus can prolapse (or fall) into the vagina. Some women experience incomplete prolapse. This is a partial prolapse where only some of the organ slips into the vaginal canal. In complete prolapse, the entire uterus sags and may fall out of the vagina.

Symptoms of uterine prolapse may include vaginal bleeding, intercourse issues, a heavy feeling in the pelvis, or constipation. You may also feel/see the uterus in or outside of the vaginal canal.

The doctor may recommend first-step nonsurgical treatments such as weight loss, Kegel exercises, or a pessary (a vaginal device that pushes up and into the cervix to hold the uterus in place). If these treatments don’t work or you have serious symptoms, the doctor may suggest surgery.

The two primary surgical options are uterine suspension (reattaching pelvic ligaments or surgically suspending the uterus) or removal (hysterectomy). Hysterectomy will permanently correct this issue. If you’re not sure which option is right for your needs, discuss the alternatives with your doctor.

Do you need a hysterectomy? Contact Rappahannock Women’s Health Center for more information.