Hysterectomy: When does it become a necessity

Hysterectomy means the surgical removal of the uterus. In some cases, other accompanying organs such as the fallopian tubes, ovaries and cervix are often removed too, depending on the type of hysterectomy being performed. The procedure terminates menstruation and the ability to have a pregnancy. 

Hysterectomy is one of the most common types of elective surgeries for women. It is essential for women to be educated about it and that a hysterectomy is not a minor surgery and should not inevitably be chosen as the only treatment and only option for heavy menstrual bleeding. A hysterectomy should be reserved for cases only when conservative treatment options have not worked.

For years critics have questioned the need for hysterectomies. They have campaigned strongly against the commonness of the practice, via television and writing articles and books like ''The Hysterectomy Hoax'' and ''No More Hysterectomies.'' They have articulated that doctors are too quick to take out the uterus at the slightest sign of trouble, predominantly with middle-aged women for whom the organ is purportedly past its purpose in any case. 

Not all hysterectomies are even required. A good number of them are used to remove a fibroid uterus, but even in cases of benign tumors, a hysterectomy is not at all times the best option. In fact, uterine fibroids time and again need no treatment at all unless the pelvic pain and heavy bleeding that are now and again associated with the condition become too cruel.

When does it become a necessity?

Very few would disagree with the efficacy of removing the uterus for cervical, uterine, or ovarian cancer, where hysterectomy can be life-saving. However, loads of other women have symptoms that, while not life-threatening, do have an effect on their general physical and emotional health and their capability to perform normal activities.

Other common reasons are continued heavy bleeding, hormonal imbalances, endometriosis -- the abnormal and from time to time painful growth of uterine lining tissue outside the uterus -- and pelvic discomfort. A hysterectomy is a woman’s lone option in cases of cervical, uterine, or ovarian cancer. An emergency hysterectomy may also be compulsory if there’s an uncontrolled uterine hemorrhage or infection.

Nevertheless, in the huge majority of other cases, alternatives to a hysterectomy should be presented to women but over and over again, aren't.  One of the reasons that they’re so swiftly offered as a choice is straightforward. Hysterectomies are a huge source of income for many hospitals and physicians. Still, there are other options that need to be explored, like hormonal therapy or fibroid embolization, which is a non-surgical method that cuts off the blood supply feeding the tumors. Both treatment methods have demonstrated to be tremendously effective and often negate the need for hysterectomies.

When a hysterectomy has been suggested for a non-cancerous situation without the prior proposition of more conventional treatment, women are advised to seek a second medical opinion to make sure all treatment options have been completely considered.

The choice to have a hysterectomy should not be taken flippantly. There are medical conditions that necessitate treatment - cancer, prolonged heavy bleeding causing severe anemia, or debilitating pain. Nonetheless, as we said above, all medical conditions have more than one alternative for treatment. There are potential side effects of hysterectomy, none of which are entirely predictable for each individual. But, for some women, hysterectomy will be the right treatment.

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Neha Ramneek Kapoor

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