H is for Hysterectomy - a podcast by Dr. Lori Beth Bisbey - A to Z of Sex

 
Hi everyone!  Welcome to the A to Z of Sex.  I’m Dr Lori Beth Bisbey and I am your host.  We are working our way through the erotic alphabet one letter at a time.  Just a reminder this podcast deals with adult content, so if you don’t have total privacy, you might want to put on your headphones.  Today the letter is H and H is for Hysterectomy. 
Recently, I had an hysterectomy.   I decided to do this show because of my experience and the stories I have been told by other women in the lead up to my operation and since. 
I’ll start with definitions:Hysterectomy is a surgical operation to remove all or part of the uterus.
Partial hysterectomy involves leaving in part of the uterus and/or the cervix.Total hysterectomy involves removing all the uterus including the cervix.
Total hysterectomy with bilateral salpingo-oophorectomy is when the uterus, fallopian tubes and ovaries are all removed.Radical hysterectomy includes removing everything plus the tissue surrounding the womb, fatty tissue, part of the vagina and lymph glands.
 I had a total hysterectomy with bilateral salpingo-oophorectomy.
 Reasons for hysterectomy:
The reasons are often different depending upon whether you are pre or post menopause. 
Pre-menopausal reasons for hysterectomy:Emergency ones can be done during child birth as a result of hemmorhaging.
Heavy periods:  This is only when the bleeding has a significant impact on the woman’s life and other treatments have not worked and no further children are desired.  I don’t know any women who had a hysterectomy for this reason and when we talk about it, none of us can figure out what a significant impact might look like for heavy periods.  Many of the women I spoke with had significant life impacts as a result of their periods full stop – due to changing emotions, exhaustion, and pain.  
Pelvic pain:  This can be due to fibroids, endometriosis (cells from the uterus are found outside the uterus), unsuccessfully treated pelvic inflammatory disease, adenomyosis (cells from the uterus push through the uterine wall and are found on the outside of the wall).  PID when not treated causes chronic pain from damage to the uterus and the fallopian tubes. 
Fibroids: Non-cancerous tumours that grow in the uterus and can cause pain, pain during sex, frequent urination and urinary incontinence, constipation,  heavy pain.  Hysterectomy is only recommended for fibroids if they are very large and attempts to shrink them has not worked, if there is severe bleeding and if no further children are desired.  
Prolapse of the uterus – where it falls from it’s usual position and protrudes into the vagina – symptoms include back pain, urinary incontinence, difficulty having sex and the feeling something is coming out of your vagina.  It can occur as the result of childbirth.  It is only recommended in this case when the tissues that support the uterus are so weak that there is no other way to resolve the issue. 
Cancer:  Hysterectomy can be recommended in cervical cancer, endometrial cancer, cancer of the womb, ovarian cancer and cancer of the fallopian tubes.  If cancer has spread or reached an advanced stage, this may be the only treatment option. 
Reasons for hysterectomy after menopause:Fibroids – I had mine as a result of very large and relatively fast growing fibroids.
ProlapseCancer
Pelvic pain – endometriosis etc. 
Hysterectomies can be done laproscopically (through small incisions), vaginally or as open operations.   Ideally, you want laproscopic or vaginal as the surgery is less stressful on the body.  In my case, there was no choice but to do it as open surgery.  This means that it is a far more major operation and you can expect your body to take longer to recover. 
What happens when you have an hysterectomy?  What everyone talks about is that you will go through menopause immediately if your ovaries are removed. 
What they don’t...

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