A hysterectomy isn’t the only treatment option for uterine fibroids—but it’s often the only one presented. Information on fibroids, whether in books, on the internet, or from medical professionals, can be confusing and contradictory. In fact, a 2017 survey showed that one in every 5 women (20%) believe that hysterectomies are the only available fibroids treatment.
Moreover, many women don’t feel like they can or should speak up after being given a first opinion. Treatments that do not require having a hysterectomy, however, are available, and it’s both important and normal to want and ask for a second opinion about your fibroids in order to get a treatment plan that works best for you, your body, and your life.
What are the potential risks of a hysterectomy?
A hysterectomy (surgical removal of the uterus) is often the go-to treatment for women with uterine fibroids (UF). Largely, this is because it’s a permanent solution to getting rid of fibroids. Having a hysterectomy means that you will no longer be able to get pregnant; without the uterus, a successful pregnancy isn’t possible.
There are different types of hysterectomies, but no matter what type is chosen, it’s a major surgery that includes, but is not limited to:
A hospital stay
For a laparoscopic or vaginal hysterectomy, you’ll be in the hospital for one to two days post-op. For an abdominal hysterectomy, you’ll be in the hospital for three to five days after surgery.
Minor complications are habitual and include urinary tract infections (UTIs), mild pain, and light vaginal bleeding. Potential serious complications can include blood clots, infection, and/or injury to other nearby organs. Other complications can include pelvic floor disorders, sexual dysfunction, and an increased long-term risk of cardiovascular and metabolic conditions.
Recovery time ranges from two weeks to six weeks. Some women, however, report not feeling back to normal for up to a year.
In cases where both ovaries are also removed, you will likely have to start hormone replacement therapy (HRT) to regulate your estrogen levels. Even with removing the uterus alone, you will stop menstruating, or having a period—even if you are not menopausal. Moreover, on average, women who have had a hysterectomy go into menopause one to three years earlier than women who have not.
As U.S. News & World Report reported, “More than 400,000 hysterectomies are performed annually in the United States, according to research published in the American Journal of Obstetrics and Gynecology in March 2015. Overutilization of hysterectomy has been estimated to range from 16 to 70 percent, according to the study.”
Why don’t most women don’t ask for a second opinion?
The Center for Menstrual Disorders cites a number of reasons women may not ask for a second opinion about their fibroids, such as:
- “I don’t want to offend my doctor.”
- “I trust my doctor. Another doctor is just going to tell me the same thing anyway.”
- “It may cost some extra money to get a second opinion.”
- “A second opinion may mean that I have to delay my surgery. I can’t live with my symptoms any longer.”
- “My friend had the same problem. She had a hysterectomy, and she’s happy.”
- “My mother had a hysterectomy, so I knew I would eventually have one anyway.”
- “I just want it out!”
- “I did my research online, and a hysterectomy seems the best way to go.”
Finding a fibroids treatment that’s right for your body
A hysterectomy is often a viable option for some women, such as women who have finished childbearing and/or have issues with severe menstrual cramps, uterine prolapse, or urinary incontinence. That doesn’t mean, however, that it’s the right treatment option for everyone. Your needs and concerns are important, and you deserve to be treated with respect and understanding.
Your gynecologist is there to help you and listen to you, and you should never be given a single answer or solution. No two fibroid cases are alike, and the best treatment option for you will depend on multiple factors, such as:
- your age,
- your desire for fertility, and
- the size and location of your fibroids.
How can I ask for a second opinion on fibroids?
If your gynecologist only suggests a hysterectomy and you’re unsure that is the right option for you, you need and deserve to get a second opinion about your fibroids.
Here is a list of things you can do to understand your treatment options and get a second opinion:
- Find a new gynecologist who specializes in fibroids and understands all available treatment options, presents them all to you equally, and helps you find the best option for you. Even if you choose a form of treatment that they don’t specialize in, they will refer you to another specialist who does.
- Take your test results with you, so tests are not repeated unnecessarily. These can include your latest Pap smear results, ultrasound report, and notes from the last two to three years of office visits—especially anything that details fibroid growth.
- You can ask your doctor, “If I was your family member (sister, wife, daughter, aunt, mother, etc.), friend, or loved one, would you recommend this surgery?”
- Consider seeing a radiologist. Talk to your gynecologist and ask for a referral to an interventional radiologist to discuss uterine fibroid embolization (UFE).
- Find a specialist in myomectomy (surgical removal of fibroids). It is a minimally invasive procedure that is outpatient, has a quick recovery, and is highly effective.
- Make an appointment to learn about endometrial ablation. This procedure burns the interior lining of the uterus and can help decrease heavy bleeding caused by fibroids. It’s a good option for those whose fibroids are located under this lining. It’s often combined with a myomectomy.
What if I decide a hysterectomy is right for me?
After weighing all of your options, a hysterectomy may still be the right treatment option for you. You know you’ve done your research. You have the information you need to comfortably decide on a hysterectomy as your preferred form of treatment. You can rest assured that you’ve been thorough and listened to yourself and what you need. You’ve made a knowledgeable choice about what is best for your body.
Stay informed and in charge
Ultimately, there are two main things you must keep in mind when deciding what fibroids treatment is best for you:
- There is no shame in wanting to have as much information as possible about any and all possible treatment options. Knowledge is power.
- It’s your body–you get to take as much time as you need. Read as much information as you want, talk to as many doctors as you want, and get as much advice as you want from other women with fibroids. This will all help you confidently make an informed decision that feels good to you.