The removal of the uterus can be one of the greatest traumas in a woman’s life, especially for those who have not yet become mothers and still have this dream. This removal procedure is called a hysterectomy and is indicated for various health factors and complications such as cervical cancer.

Uterus removal surgery is performed by a gynecologist, and it is a procedure currently used not only due to the presence of cancer, but also as a method for preventing disease. It has even been performed by some television stars, as was the case with Angelina Jolie who, after having her breasts removed as a breast cancer prevention measure, chose to have her uterus removed as well. After undergoing oncogenetic testing that detected a defective gene and indicated a high risk of developing cancer—just as her mother and grandmother, who had both passed away—the movie star decided to go through with the procedure.

Medically, the uterus removal procedure is recommended in cases of advanced cancer of the ovaries or myometrium, uterine fibroids, uterine prolapse, severe endometriosis, and pelvic infections as well as constant hemorrhaging. However, hysterectomy surgery is only performed after it is confirmed that other treatments have not been successful. There are three types of uterus removal procedures, each indicated for specific cases, which are:

  • Total uterus removal or total hysterectomy – This is when both the uterus and the cervix are removed.
  • Subtotal uterus removal or subtotal hysterectomy – This is when the uterus is removed, but the cervix is left intact.
  • Radical uterus removal or radical hysterectomy – This is when the uterus, cervix, part of the tissues surrounding these organs, and the upper part of the vagina are removed.

In more extreme cases, the procedure may extend to the removal of the fallopian tubes and ovaries, which is normally indicated for patients with very advanced cancer or severe endometriosis. The method for removing the uterus was once considered aggressive surgery that required an abdominal incision similar to the old cesarean section, but with advances in medicine, it is possible to perform the procedure via laparoscopy or robotic removal where machines perform the surgery, as well as through the vagina. However, many doctors still opt for the abdominal incision method, as it provides a better and broader view for identifying each tissue and organ.

What Changes After Uterus Removal?

A question practically all women have when undergoing this procedure or being recommended it is about the changes after uterus removal. Loss of libido, mood, hormone levels, menstruation—after all, what will change in a woman’s life after this procedure?

The first major change in women’s lives after this procedure is the disappearance of menstrual bleeding. The menstrual cycle will continue, but since there is no more uterine tissue, there is no shedding through bleeding. For women whose ovaries have also been removed, hormone replacement therapy may be recommended to control menopause symptoms, since their ovaries will no longer be producing the necessary hormones.

Loss of libido, which is also a frequent concern for women, is not a very common symptom after the procedure, especially for those who had surgery for cancer and normally experienced pain during sex. It is actually quite common for women to report that their sexual desire increased after the surgery since they no longer feel any discomfort. For women who have their uterus removed before menopause, there may be a slight loss of lubrication, which can cause pain during intercourse, but this can easily be managed with the use of lubricants.

Emotional and psychological aspects can also be affected, as a mix of emotions may arise. The feeling of having resolved the problem brings relief, but knowing that the organ representing femininity is no longer there can be emotionally challenging for some. After uterus removal, the doctor may refer the patient for psychological support to help manage these emotions and prevent future disorders or depression.

See also: What Is the Role of the Fallopian Tubes in Fertility?

Photos: Andreiandrade