Endo Crossroads: 4 Questions to Guide Your Hysterectomy Decision

Deciding On Treating Endometriosis

Impacting thousands of American women, endometriosis is a common reproductive condition. With endometriosis, parts of the uterine lining can deposit in other areas of the reproductive organs or pelvic area. For instance, endometrial tissue can form near the fallopian tubes, ovaries, connective tissue, and even the abdomen. Symptoms can include pain, scarring, irregular periods, and even infertility. For some women, endometriosis is mild or even undetectable, but for others, the symptoms can be severe. There are multiple treatments, including medication and surgery, with hysterectomy considered the most extreme option. Undergoing a hysterectomy is an important decision as the repercussions go far beyond improving endometriosis symptoms.

Surgery pros and cons

Hysterectomy is the surgical removal of the uterus. In some cases, the ovaries are also removed, thereby making the woman sterile and causing surgical menopause. Hysterectomies are often performed on women who have a medical condition that may impact long-term health or quality of life. These reasons include severe abnormal uterine bleeding (AUB), cancers, uterine prolapse, and, yes, endometriosis. In some cases, women use a hysterectomy for family planning purposes. The biggest advantage is improving overall health, but the procedure is a major surgery that requires extensive recovery time. Ask the 4 questions before moving forward with the procedure.

1. How severe is my endometriosis?

Some women will have mild endometriosis symptoms, while other individuals will experience chronic pain, abnormal bleeding, and general discomfort. Uncontrolled symptoms can impact work and relationships. In some cases, endometriosis can lead to dangerous medical complications like blood clots, organ damage, and bowel or bladder problems. Endometriosis also leads to depression and anxiety and impacts social relationships. If the condition continues to impact the quality of life, some women will consider hysterectomy.

2. Is a hysterectomy the only option?

Endometriosis can respond well to pain and hormone medication to relieve discomfort and regulate ovulation, respectively. In some cases, laparoscopic surgery can remove bands of scar tissue or deposits of endometrial tissue causing these symptoms. If these fail to improve symptoms, the next step is to remove the uterus. A hysterectomy is a surgical procedure that requires several weeks of recovery. Weighing the benefits and risks of this surgery can help people make the best possible decision.

3. What are my reproductive goals?

A hysterectomy means that having a natural pregnancy is no longer possible. Doctors take the procedure seriously and will not recommend a hysterectomy if family planning is in the future. Women at an advanced reproductive age who no longer intend on getting pregnant are more suitable candidates for the procedure. Those looking to start or grow a family should consider other options. For instance, non-surgical treatment for endometriosis followed by in vitro fertilization (IVF) is a recommended course of action. If pregnancy is not in the cards, an earlier hysterectomy may be considered.

4. Am I emotionally ready?

Hysterectomy goes beyond treating endometriosis, as there are other risks, complications, and considerations. The removal of the uterus and ovaries can trigger menopause, regardless of age. Menopause symptoms can be overwhelming and add another layer of complication to hysterectomy recovery and quality of life. Hormone replacement therapy (HRT) may be necessary after surgery. There’s also an emotional impact for women after removing the uterus. Continuous support may be needed from family, friends, and healthcare providers.

It’s Not The Endo The Road

For some women, endometriosis symptoms can be severe and require extensive treatment. Hysterectomy is the option when conventional treatment fails to improve the condition. The surgery has advantages and disadvantages that women must review and consider before making this decision. With a hysterectomy, women can address endometriosis and finally control symptoms negatively impacting the quality of life.


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