Hysterectomy is a surgical operation that involves the removal of the uterus and, in some cases, of other surrounding genital parts: the cervix, ovaries, tubes. Here is what it is and what is the correlation with the AVV.
In this post we will talk about:
- What is hysterectomy
- When is hysterectomy recommended?
- Consequences after hysterectomy
- Hysterectomy and menopause
- Hysterectomy, sexuality and Vulvo Vaginal Atrophy
What is hysterectomy
It is an invasive surgery that is only recommended when it is really necessary for the psychological consequences that it can entail. This intervention concerns about 20% of women before the age of 60 (according to the data reported by Prof. Alessandra Graziottin on her website)
This operation in fact involves the removal of the uterus and, in some cases, also of the ovaries and fallopian tubes.
It can be decisive in case of serious pathologies (tumors, severe endometriosis, prolapses of various degrees) and the women for whom this intervention is indicated find themselves dealing with a path that can lead to premature menopause .
When is hysterectomy recommended?
The conditions that could lead the gynecologist to recommend a hysterectomy can be different:
- Cancer of the uterus, cervix or ovaries which is the best known cause of medical hysterectomy
- Severe endometriosis when it is severely disabling for a woman’s life
- Severe pelvic infections with complications affecting other systems and other districts
- Painful fibroids, even if in recent years less invasive therapies are preferred if they are benign events.
Consequences after hysterectomy
First of all, it is necessary to clarify that the techniques for performing the hysterectomy are linked to the pathology that the woman must treat through this intervention.
Generally one can resort to:
- Total hysterectomy : when the uterus and cervix are removed
- Subtotal hysterectomy : when the cervix is preserved
- Hysterectomy with bilateral adnexectomy : when the ovaries and tubes are removed besides the uterus and cervix
- Radical hysterectomy : when the upper vagina and pelvic lymph glands are also removed
In any case, the most important consequence is the impossibility of a pregnancy considering that there is no longer the site in which the egg can be implanted. At the same time, the menstrual cycle will disappear even if it is not certain that you will necessarily enter menopause: only in the case of removal of the ovaries will you enter menopause.
If the ovaries remain , they continue to produce female hormones and eggs therefore the typical disorders of menopause do not occur.
Even if there was no removal of the ovaries, however, menopause could come sooner than expected as the normal balance of the reproductive system has been altered by the operation.
Hysterectomy and menopause
As mentioned, a woman who undergoes a hysterectomy does not always go through menopause . However, the processes of cessation of estrogen and testosterone production accelerate and some ailments that can be considered typical of the near end of fertile life take over more quickly : heat, insomnia, dancing mood, decreased desire and tendency to gain weight.
The case in which you enter surgical menopause is different, which instead intervenes when the removal of the ovaries is necessary .
Hysterectomy, sexuality and Vulvo Vaginal Atrophy
Women who have undergone a hysterectomy without ovary removal can expect menopause in generally physiological times (although often a few years in advance) and the manifestation of normal related disorders, although in many cases they can present themselves more intensely.
Reading forums and social media, it turns out that many women associate the difficulties of having intimate relationships with a previous hysterectomy . In reality, except in special cases, vaginal dryness and the relative difficulty of natural hydration, pain in intercourse (dyspareunia) , decreased desire, small blood losses , are not dependent on the surgical operation undergone but can instead be dependent on Vulvo Vaginal Atrophy , a pathological condition that affects about 50% of menopausal women and that involves some disorders similar to those described.
If these are your symptoms and you are going through these difficulties, you can contact your gynecologist for more information on how to deal with them and how to take a path that allows you to get better.