500,000 women get hysterectomies in the U.S. every year. Here’s why some say it was the ‘best’ decision.

By the age of 60, one in three women in the U.S. will have had their uterus removed. This procedure, called a hysterectomy, is most common in women between the ages of 40 and 44, Dr. Joyce Gottesfeld, an ob-gyn at Kaiser Permanente in Denver, tells Yahoo Life.

Dr. Hugh Taylor, Yale Medicine chair of obstetrics, gynecology and reproductive sciences, tells Yahoo Life that there are approximately 500,000 hysterectomies performed in the U.S. each year. It’s the second-most-common surgery for women, after cesarean sections.

Women get hysterectomies for a variety of reasons, notes Gottesfeld. Sometimes the surgery is performed in a life-threatening situation, such as when bleeding can’t be managed by other methods during childbirth. But Gottesfeld says the most common reasons that women choose to get hysterectomies are heavy periods or irregular bleeding that can’t be controlled through other means; gynecological cancers; and conditions that cause chronic pelvic pain.

Although some women experience grief or face decisional regret after having the procedure, others say that having a hysterectomy significantly improved in their lives.

‘I would not stop bleeding’

Sabrina H. Lonzo had large, painful uterine fibroid tumors. She often slept on the floor of her living room because she was up all night tossing and turning and didn’t want to disturb her husband. Twice the pain from her fibroids sent her to the emergency room.

Lonzo “bled for about six months straight” because of the fibroids, she tells Yahoo Life. Her bleeding was so heavy that it led to a drop in her iron and hemoglobin levels. She needed five iron infusions as a result. She tried progesterone birth control pills to stop the bleeding, but they didn’t work. “I would not stop bleeding,” she says.

Eventually, Lonzo’s ob-gyn suggested a hysterectomy to help with the fibroids. “After bleeding for so long and in chronic pain every day, the decision was easy,” she says. Her recovery has had its ups and downs. She says she was “very uncomfortable” for weeks after the surgery. A year later, her surgery scar is still tender and some days she says she can’t walk very far or bend over.

But, Lonzo says, “I no longer have chronic pain. That's a beautiful feeling.” She adds: “Would I do it all over again? Yes.”

‘I want this organ out’

Alexandria Mooney started having irregular and heavy periods after she stopped breastfeeding her fourth child. Instead of her periods returning to normal as they had when she stopped nursing in the past, they became unpredictable and very heavy. Sometimes the flow was so intense that Mooney would stand in the shower and let the blood run down her legs.

Her periods also became very painful. “I'd never had cramps or any period issues in the past, and now all of a sudden it was this relentless beast,” she tells Yahoo Life.

Because of how heavy her periods were and the “horrible” cramps she was experiencing, Mooney had to rearrange her schedule to stay close to home when she had her period. “I just wanted to lie in my bed with a heating pad and have everyone leave me alone,” she says. “But having four young kiddos and my own business to run, well, that was impossible. I was just grumpy and ragey.”

She eventually went to her ob-gyn and told her, “I want this organ out. I am done with it.” Her ob-gyn eventually diagnosed her with adenomyosis, a condition in which the tissue that lines the uterus grows into the muscular wall of the uterus instead. Hysterectomies are the only way to fully stop adenomyosis, according to Johns Hopkins Medicine.

Mooney, who had a robotic laparoscopic hysterectomy that left her with five small incisions, describes her surgery as “a complete walk in the park.” She says she had “no pain” and that it was “the easiest surgery and recovery” she has ever had. Mooney, who is a photographer, was back at work three days later documenting a 10-hour birth.

Who is at risk of needing a hysterectomy?

Because the health conditions that lead to hysterectomy are very common, Taylor says that “no one is risk-free” when it comes to who will need the surgery.

He explains that most women will develop fibroids at some point during their reproductive years and that fibroids are “by far the most common reason for hysterectomy.” Endometriosis, a condition in which uterine tissue grows outside the uterus, causing severe pelvic pain and heavy bleeding, is the second-most-common reason. This condition will affect 10% of reproductive-age women at some point, he says.

Additionally, “Black women are at higher risk of having fibroids and bleeding related to fibroids,” Taylor says. “These conditions also have some genetic component, so having fibroids or endometriosis in your family increases your risk.”

Not all hysterectomies are the same

The type of hysterectomy a woman needs and how the procedure is performed are highly dependent on each woman’s individual circumstances, notes Gottesfeld.

Most hysterectomies are “total,” meaning the uterus and the cervix are removed. However, some are “partial,” in which case the cervix remains intact. Gottesfeld explains that sometimes a woman’s ovaries and fallopian tubes are removed at the same time she has a hysterectomy in order to reduce the risk of ovarian cancer later in life, although these are separate procedures.

There are also different ways hysterectomies can be performed, including open abdominal surgery, which usually requires an overnight stay in the hospital and a six-week recovery, explains Taylor. Hysterectomies can also be done vaginally; those have a shorter and less painful recovery period than abdominal surgery, according to the Mayo Clinic.

There are also less invasive laparoscopic and robotic approaches, which “make the hysterectomy and recovery easier on the patient,” Taylor says. These types of hysterectomies can usually be performed without an overnight stay in the hospital, and recovery takes about two weeks. Although less invasive hysterectomies are usually preferable, large uterine fibroids like the ones Lonzo had and other conditions may require open abdominal surgery.

What is life like after a hysterectomy?

Gottesfeld says that women’s lives usually improve after a hysterectomy because it fixes the underlying problem that led to the need for surgery. She adds that many women feel relieved that they no longer have to deal with menstruation or think about getting pregnant. “A lot of women feel much better being sexually active after surgery,” she says.

While premenopausal women are often concerned that a hysterectomy will put them into menopause, Gottesfeld explains that “a hysterectomy by itself does not affect your hormones” and will not cause menopause. However, having the ovaries removed at the same time as a hysterectomy will trigger menopause due to the sudden drop in estrogen, she explains. For women who get this procedure, hormone replacement therapy can help alleviate the symptoms of menopause, including hot flashes.

Despite the benefits of hysterectomies in treating certain health conditions, Gottesfeld says that some women “feel a sense of loss” after the surgery.

Lonzo says she sees this in her hysterectomy support groups. “I think that a lot of women want to hold on to their uterus because they feel like it makes them a woman,” she says. “They feel loyal to it.”

But for those with debilitating health conditions that can be treated with the surgery, Lonzo asks, “Why feel loyal to a body part that is trying to hurt you?” She adds, “I still feel like a woman, even though I don't have a uterus.”

For Mooney, having a hysterectomy made a big difference. “All of my issues vanished after my hysterectomy,” she says. “It truly has changed my life for the better. It was one of the best 'for me' decisions I've ever made in my life.”

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