A hysterectomy is an irrevocable change in a woman’s life. It involves the removal of at least the uterus, and sometimes the pelvic lymph nodes and cervix as well. Occasionally, a salpingo-oophorectomy (the surgical removal of one or both of the fallopian tubes and ovaries) will additionally be necessary.
For a woman who has already gone through menopause, the biological, hormonal, and physical changes will be very similar; for one who hasn’t, it may be a hard choice to make. While it may be a solution to many gynecological issues, it also means a woman no longer has her period or can get pregnant. Sometimes, a hysterectomy is the only option. But, depending on why it’s being done, there may be other alternatives.
Fibroid Alternative Treatments
Fibroids are tumors that grow on the uterus. In some cases, you barely even know they’re there. In others, they can be problematic, causing bleeding and anemia or pain and pressure. A hysterectomy is the only surefire way to solve them, because tiny bits of the tumor may remain undetected. However, if they aren’t extremely terrible, dealing with them symptomatically may be an alternative. Intrauterine devices that release progesterone may help with excessive bleeding.
A myomectomy removes the fibroids but leaves the uterus intact. Other procedures used include uterine artery embolization, which blocks the blood flow to the fibroids, hopefully stopping their growth until they die off. Myolysis uses an electric current to stop blood flow and destroy the fibroid, and cryomyolysis freezes them. Gonadotropin-releasing hormone (Gn-RH) agonists are a medication taken to essentially induce menopause, but only temporarily. These may shrink the fibroids, but they won’t make them go away. Doctors generally use them to make the tumors smaller before surgery.
Uterine Prolapse Alternative Treatments
Uterine prolapse occurs when the tissues that hold the uterus in place lose strength and the uterus falls (prolapses). Sometimes no treatment at all may be necessary, if there is only minimal discomfort or problems. However, a pessary may help; this is a small device that is placed inside the vagina and then holds the uterus up, so it doesn’t press on the vaginal area. It can be removed and replaced easily, so you needn’t wear it all the time.
Surgeries to repair and replace the tissue are also an alternative, although not for women who still plan to have children, as the strain of childbirth can undo the surgery. Pelvic floor exercises (like kegel exercises) and physical therapy may be sufficient for those with mild symptoms.
Endometriosis Alternative Treatments
The endometrium is the lining of the uterus; when it begins to grow where it isn’t supposed to, this is known as endometriosis. While a hysterectomy is the best and most thorough treatment for this as well, it is possible to try surgery to remove only the excess tissue. Hormone therapy (using birth controls, Danazol, or Gn-RH agonists and antagonists) may also help, but it is geared more toward reducing the pain of the condition, as symptoms may resume after the therapy is finished.
Cancer Alternative Treatments
In the case of gynecological cancers, a hysterectomy is usual the best option, because it (ideally) removes all traces of the cancer without the sickness of other cancer treatments. However, radiation and chemotherapy are an option, although these may affect fertility, if pregnancy is your main concern about having a hysterectomy. Each cancer is different, and must be treated differently, as are all issues involving the reproductive organs. Talk to your doctor about the best option for you.
