The Facts of Life: Examining Reproductive Health

Female Anatomy

Facts of a Hysterectomy

• Hysterectomy is second only to cesarean sections as the most frequently performed major operation in the United States.
• Data from the National Hospital Discharge Survey indicate that approximately 600,000 hysterectomies are performed annually.
• By the age of 60, over one third of U.S. women have undergone hysterectomy.
• The annual hospital costs in the U.S. for the operation currently exceed $5 billion.
• Hysterectomy is performed more frequently in African American women than on any other women.
• Hysterectomy rates vary sixfold among Western countries and are highest in the United States and lowest in Norway, Sweden, and England.
• Within the United States, hysterectomy rates vary regionally (with the highest in the South and the Midwest), and between small areas within states.

When is Hysterectomy Necessary?
A number of life-threatening conditions require hysterectomy, including:

• invasive cancer of the uterus, cervix, vagina, fallopian tubes and/or ovaries (8 to 12 percent of hysterectomies are performed to treat cancer)
• severe, uncontrollable infection (PID);
• severe, uncontrollable bleeding;
• life-threatening blockage of the bladder or intestines by the uterus or growth in the uterus;
• conditions associated with rare but serious complications during childbirth, including rupture of the uterus.

If you have any of these conditions, hysterectomy may not only save your life but free you from significant pain and discomfort.

Some conditions which are not life-threatening but may justify hysterectomy include:

• precancerous changes of the endometrium (hyperplasia);
• severe, recurring pelvic infections;
• extensive endometriosis, causing debilitating pain and/or involving other organs;
• fibroid tumors which are extensive, large, involve other organs or cause debilitating bleeding;
• pelvic relaxation (uterine prolapse).

Depending on their severity, many of these conditions can be treated without resorting to major surgery. Fortunately, new diagnostic techniques, such as sonography, Pap smears and laparoscopy, make it possible to avoid or delay many hysterectomies that might have been done in the past.

Hysterectomies are sometimes performed unnecessarily for the following reasons:

• small fibroids which are not causing problems;
• abortion (during the first and second trimesters);
• sterilization;
• cervicitis;
• mild dysfunctional uterine bleeding;
• pelvic congestion (menstrual irregularities and low back pain).

These problems can usually be treated with alternative therapies.

Used with permission from The New Our Bodies, Ourselves: A Book By and For Women. By the Boston Women's Health Book Collective. Page 512, copyright 1984.