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What are the Pros and Cons of Hysterectomy for Endometriosis?

By Lori Smith
Updated May 17, 2024
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A hysterectomy for endometriosis is often a personal decision between a patient and her doctor. For some, the procedure may result in a renewed zest for life because debilitating pain from the condition is eliminated. For others, menopausal symptoms are bothersome and surgery risks may pose additional problems for the patient. Once a woman's reproductive organs are removed, she will no longer be able to have children. For this reason, hysterectomy for endometriosis is usually a last resort.

The pain and suffering caused by endometriosis can be excruciating. Women with the disease may experience it at varying degrees. Some also experience pain during intercourse and find that their personal relationships suffer as a result. A hysterectomy for endometriosis can potentially end the monthly, or in some cases, daily discomfort. It may also improve a couple’s sex life because the condition that caused the pain is virtually eliminated. In many cases, hysterectomy for endometriosis is a cure for the syndrome.

Once the uterus is removed, a woman will no longer have a monthly menstrual period. There is no longer a need to worry about birth control for unwanted pregnancies. When the cervix and ovaries are also removed, as in most cases, the risk of developing cervical, uterine, and ovarian cancers is also virtually non-existent. Women may face other risks, however.

The microscopic implants of endometriosis sometimes migrate to other areas within the pelvic cavity, such as the bladder, abdominal wall, and intestines. During the surgical procedure, a surgeon will usually try to ablate these tissue implants, but sometimes, not all of them are easily seen. In this case, pain may return even when the reproductive organs are removed.

Menopausal symptoms are usually apparent immediately following a hysterectomy for endometriosis. Vasomotor flushes — also known as hot flashes — night sweats, and mood swings are usually the most troublesome signs of surgical menopause that women experience. Over time, other symptoms may present, such as skin changes, weight gain, and vaginal dryness. Many times, especially for younger women, hormone replacement therapy (HRT) is prescribed to make them more comfortable and slow-down the natural aging process that can occur following hysterectomy for endometriosis.

While HRT may help with symptoms of surgical menopause, it can also cause the pain to return, especially if endometrial implants remain within the abdominal or pelvic cavity. This occurs because endometriosis feeds off estrogen. HRT can provoke a flare-up of any of the existing implants that may have been left behind.

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