Woman’s Weekly Living Series – July 2019

PHOTOs: GETTY (POsED BY MODELs)

HealtH spotligHt

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our womb (uterus)

sits low in your pelvis

between your bladder

and back passage. It’s linked

by your cervix (neck of the

womb) to your vagina (front

passage), and each ovary

by a Fallopian tube, and

supported by ligaments and

your pelvic-floor muscles. Its

lining builds up each month,

but falls away as a period if

pregnancy doesn’t occur.

Tell your GP if you

have unexpected bleeding

(between periods, after

lovemaking, or the

menopause) or persistent

pain; you may need scans,

blood tests and/or a telescope

examination to look and

take samples/biopsies inside

the womb (hysteroscopy) or

pelvis (laparoscopy).

Why have one?

Some women opt for surgery

when other treatments for

heavy periods haven’t worked

(see box) or for fibroids

(benign tumours in the

womb’s muscle wall). These

can grow large, exert pressure

and make periods heavy,

although small ones may be

removable (myomectomy) or

have their blood supply cut off

(endometrial artery embolism).

In endometriosis, womb

lining cells appear around

the pelvis; their monthly

cycle can cause severe pain,

bleeding, ovarian cysts,

and/or scarring which can

be helped by removing the

uterus, and other affected

tissues. Hysterectomy is also

performed for uterus/cervix

cancer, some precancerous

changes, or for ovarian

cancer. The womb may

also be removed (vaginal

hysterectomy) during surgery

for womb/vaginal prolapse.

What’s involved?

Abdominal hysterectomies

are the most common type,

either as a full or keyhole

(laparoscopic) operation.

If your cervix is left for

technical reasons (sub-total

hysterectomy), you’ll still need

cervical screening (‘smears’).

Ovaries and/or other internal

tissues may also be removed.

Hysterectomy carries a

small risk of bleeding, deep

vein thrombosis (blood clots),

infection and anaesthetic

problems. You’ll be in

hospital for a few days and

will be advised on exercise

to aid recovery, but strong

healing takes at least two

months, so avoid heavy lifting

and strenuous exercise.

Things to consider

Is it convenient to have

a hysterectomy now or do

you wait? The surgery ends

childbearing – might you

want a(nother) baby? If you’re

approaching the menopause,

could you manage with

short-term medication or

other treatment? If you’re

facing years of symptoms,

it could be ‘good value’.

Should you also have your

ovaries removed, to reduce

ovarian cancer risks? If you’re

premenopausal, this surgery

will trigger an immediate

menopause. Recent research

says removal may increase

heart disease/cancer risks

and reduce life expectancy.

Discuss all the pros and

cons with your gynaecologist.

Do you need a

Dr Melanie

Wynne-Jones

reveals the

latest on this op...

hysTerecTomy?

1

Non-steroidal anti-

inflammatory drugs, eg,^

ibuprofen, can reduce pain^

and flow. Check with your^

pharmacist first if you have^

other medical problems or

take other medication.

2

Tranexamic acid, taken^

at period time, or^

progesterone (a hormone^

taken three weeks out of^

four), can reduce flow.

3

The Mirena coil^

(levonorgestrel-

releasing intrauterine^

system; lNG-Ius for

short) can eventually stop^

periods. It’s also an^

effective contraceptive.

4

The oral contraceptive^

pill (and in severe cases,^

gonadotropin-releasing^

hormone – GnRH –

injections) switch off your^

hormones and reduce flow,^

but can have side effects.

5

Endometrial ablation^

(destroying the womb^

lining using microwaves

or a heated balloon) can^

reduce period flow but may

fail. Future pregnancies

are not recommended.

5 alternative^

treatments for^

heavy periods