8 hysterectomy myths and facts

Hysterectomies, which are surgeries to remove the uterus, are very common in the United States. After cesarean sections, they’re the most frequently-performed surgical procedure for people who have a uterus and are of reproductive age. You may have heard, though, about certain myths surrounding the procedure.

It’s true that hysterectomies can be major, invasive surgeries with long recovery times. But medicine has advanced a long way in the last 30 years and minimally invasive surgical techniques can greatly shorten recovery time. Today, the procedure may be appropriate for those with conditions such as uterine fibroids, endometriosis, heavy menstrual bleeding, and uterine, cervical, and ovarian cancers.

Whether you’re weighing your treatment options or about to have surgery, clearing up some of these persistent hysterectomy myths can help you make an informed decision.

Fact: Many people find that it does not fundamentally change who they are.

“There’s a strong identity associated with the uterus, and some people may think removing it is going to change their life dramatically,” says David Forschner, MD, an OBGYN with Presbyterian/St. Luke's Medical Center in Denver, Colorado.

It’s true that the uterus sheds its lining each month during menstruation, and helps carry the fetus during pregnancy. But removing it won't affect your hormones and many people find that it does not fundamentally change who they are, explains Dr. Forschner. After a hysterectomy, it can take time to adjust to no longer being able to have children. Reaching out to a counselor or support group can help. Your healthcare provider (HCP) can point you in the direction of helpful resources, too.

Fact: Unless your ovaries are removed, a hysterectomy won’t trigger menopause.

Natural menopause is a process marked by going a full year without having a menstrual period. Beginning in your late 30s and into your 40s, your ovaries produce the hormone estrogen less regularly than when you were younger. During menopause, which typically occurs in your early 50s, your ovaries no longer produce much estrogen.

Sometimes, ovaries are removed during a hysterectomy (a procedure called an oophorectomy), which can start menopause immediately. But since a hysterectomy typically only involves the removal of the uterus, it doesn’t automatically result in menopause. “The ovaries can be removed at the same time as a hysterectomy, but often they’re left in place,” explains Forschner. “You would only start menopause after a hysterectomy if both ovaries are removed.”

Even though your periods will stop after a hysterectomy, that doesn’t mean menopause has arrived. Your body will likely keep making estrogen until around the time your hormone levels naturally begin to decrease.

Fact: You’ll still be able to have sex and orgasms may feel even better.

You might have heard that a hysterectomy will lower your sex drive. But a hysterectomy would only affect your sex hormones—estrogen and testosterone—if you also have your ovaries removed along with the procedure. That said, in most cases, you’ll want to wait at least six weeks after a hysterectomy before having sex to give your body time to recover. Once your HCP gives you the all-clear, you can start having intercourse again.

Sex might feel a little different since you won’t have contractions in your uterus during orgasms anymore, but you can still have orgasms. Many people actually find that sex after a hysterectomy is better, since the procedure can resolve issues like bleeding or pain that may have interfered with pleasure.

“Whatever led to the hysterectomy may have made you uncomfortable during sex,” says Forschner. “After surgery, you’ll be able to appreciate how much better sex can be.”

Fact: The recovery time varies based on the type of hysterectomy.

There are different kinds of hysterectomies, but recovery time usually doesn’t exceed six weeks, depending on the type you get.

The quickest recovery is with a vaginal hysterectomy, says Forschner. This procedure involves taking out the uterus through your vagina. It’s recommended as the first option whenever possible. You’ll spend the day and maybe one night in the hospital. Upon returning home, you’ll want to take it easy for two to four weeks as you recover. The recovery time is similar for a laparoscopic hysterectomy, during which a surgeon makes small cuts in your lower abdomen, then inserts a tiny camera and tools for surgery through the incisions to remove your uterus. The uterus may be removed either in small pieces through the incisions or through the vagina, which is known as a laparoscopic assisted vaginal hysterectomy.

An abdominal hysterectomy, also known as a traditional hysterectomy, involves surgical removal of the uterus through a larger incision made in the lower part of the abdomen. This is usually a last-resort option and is typically only recommended if your uterus is large or if there are adhesions or scar tissue. Since it is an open surgery, this type of hysterectomy does require more time in the hospital, and full recovery usually takes about six weeks. No matter what type of surgery you have, your HCP will guide you through the recovery process.

Fact: Moving around after surgery is better for your health.

After surgery, you may have heard that you should take it easy. Instead, your HCP may encourage you to get out of bed that same day.

“We recommend not exerting yourself too much,” says Forschner, “but we want you up and moving around the day of the surgery. Walking around will prevent blood clots, not to mention improve your healing by getting good blood flow to your wounds.”

Ask for help before getting out of bed. Start slowly and try to increase your walking distance a little bit every day. Also be sure to avoid heavy lifting. With your HCP’s approval, you can usually get back to your regular exercise routine within six weeks post-surgery.

Fact: It can actually treat or help prevent vaginal prolapse.

Vaginal prolapse is when the muscles and tissues around your vagina get weak or tear, causing your vagina to descend from its usual position. In some cases, the uterus may drop into the vagina or through its opening. Vaginal childbirth (especially multiple births), obesity, and menopause can increase your chances of prolapse.

Prolapse may actually be the reason you have a hysterectomy in the first place, says Forschner. While it’s possible to have a prolapse after a hysterectomy, surgeons take extra steps to suspend, or tie up, the vagina during surgery to keep that from happening.

Fact: It depends on the type of procedure, but laparoscopic and vaginal hysterectomies leave minimal scars.

Since vaginal hysterectomies are done through the vagina, the scarring that occurs is usually internal and not noticeable. Laparoscopic hysterectomies do involve very small incisions, so you may have some scarring in those areas, but not a lot. If you need an abdominal hysterectomy, however, you’re likely to have a scar post-surgery where the incision was made. Sometimes surgeons make a vertical incision, while other times they’ll use a horizontal, or “bikini line,” incision. 

No matter which type of scar you have, there are treatment options, both dermatological and natural, to try to minimize the appearance of scarring.

Fact: It depends on your individual health circumstances.

“Very rarely are there no alternatives,” says Forschner. For example, if your uterus has prolapsed, or fallen down, physical therapy may be able to help. So can using a pessary, a device you wear in the vagina to support the uterus. For other conditions, like endometriosis, your HCP might be able to suggest other surgeries or medications.

People who have uterine cancer or experience excessive bleeding may need a hysterectomy right away. But even in these cases, your HCP may be able to recommend other treatments to try first. “Removing the uterus should be the last resort in many cases,” emphasizes Forschner.

You and your healthcare team can talk through your options. You should also do your own research and ask any questions you have. Remember: Even if you do need a hysterectomy, there may be fewer drawbacks to the procedure than you might realize.