Reasons for Hysterectomy

Reasons for Hysterectomy

Understanding your options, starts with understanding the “why”

A Smart, Informed Decision

A hysterectomy is one of the most common and effective operations in women’s health. Around one in five women will have one by their mid-50s. It can be life-changing for those living with pain, pressure, or unpredictable bleeding that affects daily life.

Knowing why it’s being recommended helps you make sense of your treatment plan and recovery expectations.

Common Medical Reasons

1. Fibroids

Fibroids are benign growths in the muscle wall of the uterus. Depending on their size and location, they can cause:

  • Heavy or prolonged bleeding

  • Pelvic pressure or bloating

  • Pain during periods or sex

  • Bladder urgency

When medication, hormonal devices (like the Mirena IUS), or other procedures don’t control symptoms, hysterectomy can provide a permanent solution.

2. Endometriosis or Adenomyosis

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, while adenomyosis happens when it grows within the uterine muscle wall. Both can cause severe pelvic pain, heavy bleeding, and fatigue.

For some, removing the uterus, particularly in adenomyosis, brings long-term relief when conservative treatments haven’t helped.

3. Pelvic Organ Prolapse

Prolapse happens when the uterus and vaginal tissues lose support and descend into the vaginal space. You might feel:

  • A heaviness or dragging in the pelvis

  • A bulge at the vaginal opening

  • Difficulty emptying your bladder or bowel

Hysterectomy can form part of prolapse repair, often combined with pelvic floor or ligament support procedures to restore anatomy and function.

4. Abnormal or Heavy Bleeding

Persistent or unpredictable bleeding can significantly affect quality of life. Causes include fibroids, hormonal imbalance, and endometrial thickening.

When investigations rule out malignancy and conservative measures (like hormonal therapy or endometrial ablation) aren’t effective, hysterectomy provides a definitive solution.

5. Cancer or Cancer Prevention

Hysterectomy may be recommended for cancers of the uterus, cervix, or ovaries, or in women with genetic risks (such as BRCA or Lynch syndrome).

In these cases, the surgery is preventative or curative, forming part of a carefully coordinated care plan led by your specialist team.

6. Emergency Situations

Occasionally, hysterectomy is performed as an emergency procedure, often during childbirth or following trauma.

This can happen:

  • During a Caesarean section, if uncontrollable bleeding occurs and removing the uterus is the safest way to save the mother’s life

  • After a complicated pregnancy, such as a uterine rupture or placenta accreta

  • Following severe pelvic trauma, such as from an accident or injury

These situations are rare, but when they occur, surgery is immediate and life-saving. Because there’s no time to prepare physically or emotionally, recovery can be especially complex, both physically and psychologically.

In some cases, this kind of emergency may also involve the loss of a baby, as well as loss of future fertility. That is a unique and profound grief, and it deserves space and specialist care.

If your hysterectomy was unplanned or emergent, it’s important to speak with your GP, consultant, and a trauma- or grief-informed counsellor before beginning any new activity or rehabilitation plan. Your body and mind have been through an acute event, and recovery should be guided with additional medical and emotional support.

There is no “one-size-fits-all” here, this is a different type of recovery that needs time, understanding, and professional guidance at every step.

Understanding Your “Why”

Knowing the medical reason behind your surgery also helps you understand your recovery path.

  • Prolapse repairs often require a slower return to lifting.

  • Laparoscopic removal for fibroids might mean faster recovery.

  • Cancer or emergency surgeries may need longer rest and emotional support.

Different reasons mean different timelines, but every recovery can be optimised with the right movement, nutrition, and professional guidance.

Making the Decision

A good decision comes from clear information, not pressure. Talk with your consultant about:

  • What’s causing your symptoms

  • Which structures need to be removed (uterus, cervix, ovaries)

  • What that means for hormones and recovery

  • What alternatives exist

Understanding these details helps you feel in control and prepared for the next step.

What’s Next

If hysterectomy is your next step, Preparing for Surgery will guide you through how to get your body and mind ready for a smooth recovery.
If you’re still exploring, visit Alternatives to Surgery to learn about other treatment options that may be appropriate before or instead of surgery.