In the past, hysterectomy was sometimes used to cure complaints, which now can often be treated successfully with drugs, for example in cases of heavy bleeding. Ancient Greeks believed that a woman’s emotions were made womb, for which the Greek name was “hysteros”. From this origin came the word, hysterical. of course it has long been known that emotions originate in the brain but if the frustration or unhappiness remains for long enough, it can cause heavy periods .At one time the only known remedy was hysterectomy, which cured the heavy periods, but left the disturbed emotions unaltered. Now drugs and a sympathetic understanding of the problem usually are adequate to deal with the condition. However there are some conditions for the only successful answer is hysterectomy. Apart from such obvious reasons as cancer of the uterus or cervix, muscle tumors or fibroids are the most common conditions for which a hysterectomy is the only really complete answer. Fibroids begin with the over development of one or more of the muscle fibres which make up the wall of the uterus. They grow into pea-sized tumors deep in the muscle wall , and continue to grow slowly until they reach the size of a golf ball, a tennis ball or even a grape fruit. They may be few or many and can grow outward or inward. If they grow inward and distort the shape of the uterine cavity, menstrual periods may be heavy or irregular. In rare cases, fibroids can cause pain during sexual intercourse. The medical terms for this painful coitus is dyspareunia. Other frequent indications for hysterectomy are “adenomyosis” and the related “endometriosis” both non malignant disturbances of the glandular uterine lining.

No doctor will remove a women’s ovaries before her menopause unless it is absolutely essential. Sometimes it is necessary to remove one ovary, but if both are diseased, every effort will made to leave some ovarian tissue to carry on its work of producing the female sex hormone oestrogen if the disease is non-cancerous it is necessary to remove both ovaries and the patient is not past the menopause, the gynecologist will make sure his patient is given oestrogen tablets to replace the hormone and minimize “change of life” symptoms which would otherwise follow the operation. In certain cases of cancer however oestrogen is not used.

The after-effects of hysterectomy will be that menstruation ceases, and that pregnancy cannot possibly occur. Hysterectomy or removal of the womb, is one of the most common surgical operations performed on women. Unfortunately it is also one of the most maligned by those who do not understand it.

Questions you may ask …

Q	Will hysterectomy affect my sex life?
A	No. Hysterectomy does not make a women sexually mutilated and undesirable it does not shorten her Vagina so that sexual intercourse is impossible or potentially dangerous. In most cases when the womb is removed the vagina is cut at its uppermost end, and the cervix no longer projects into it so if anything the vagina is a little longer after the operation. In rare cases the cervix is left when the surgeon removes the section of the womb above it. In such a case there is no alternation at all to the vagina.
Q	Must I take some medication for the rest of my life?
A	No, unless both ovaries are removed. Then you will need to take only the oestrogen tablets, to replace natural hormones – and these only for a limited time.
Q	Will suffer a personality change?
A	This is really up to you. If you convince yourself you will be changed nothing will prevent you from becoming a chronic neurotic. But the operation will not cause it
Q	How soon will I be able to return to normal duties?
A	As with any other major surgery It is advisable to take things quietly for 2 weeks and gradually Increase activity rather than rush into it. Your doctor will advice about the length of time needed for convalescence – usually 3-4 weeks.
Q	Will be semi –invalid for the rest of my life?
A	No you will no doubt feel healthier than before the operation as the complaint for which it has been advised will be cured.
Q	Would an outsider know I had a hysterectomy?
A	There will be no visible signs. Many of the women you pass daily in the street, or work with have had the same kind of operation. If you or your husband have any further questions or fears you would like to allay, talk it over with your doctor. He – not an uninformed relative or friend – is qualified to advice.
Q	But will sex be as satisfying to me after the operation?
A	There will be no difference in sexual desire or satisfaction after the hysterectomy. In fact where there has been some fear of pregnancy, when all possibility of pregnancy has been removed a woman’s sexual desire or satisfaction after the hysterectomy. In fact where there has been some fear of pregnancy when allpossibility of pregnancy has been removed a woman’s sexual desires and reponse may increase.
Q	will still be able to reach an orgasm or “climax” during intercourse?
A	Yes removal of the womb has no effect on this.
Q	Will my husband be able to feel to any physical change in my body, when we have sexual intercourse?
A	No unless he was told a man would not know a woman had undergone this type of surgery.
Q	How soon after the operation should my husband and I resume normal sexual relations?
A	Once the top of the vagina has healed strongly, which takes about six weeks sexual intercourse can be resumed safely and with normal satisfaction.
Q	Will I become fat?
A	Only if you sit about and eat too much instead of carrying on normal activities. Woman who grows fat after any surgery usually do so because during convalescence a pattern of over eating and under exercising is set and this begins a habit difficult to break.
Q	Will I become hairy or develop male characteristics?
A	No the womb does not produce any hormones – the ovaries do this – so removal of the womb will make no difference to hormone balance.
Q	Will I go through an immediate “change of life”?
A	Only if both ovaries are completely removed in which case the oestrogen tablets you will be given will minimize or completely relieve symptoms.