A diagnosis of problematic fibroids, endometriosis or abnormal bleeding could lead your doctor to recommend a hysterectomy. But before you get rolled into the OR, ask questions. "Patients who regret the procedure usually aren't presented with all their options," says Lauren Streicher, M.D., author of The Essential Guide to Hysterectomy. Avoid resentment later by inquiring now.
Q. Is there an alternative I can consider?
A. With fibroids, some women are candidates for uterine artery embolization (UAE) or MR-guided focused ultrasound (MRgFUS); both shrink tumors with no incision. "There are almost always alternatives," affirms Dr. Streicher, who surveyed women nationwide about their hysterectomy experiences.
Q. Do you operate on a regular basis?
A. "Most expert surgeons do at least 10 to 20 hysterectomies a year," says Dr. Streicher. She notes that doctors who don't operate as frequently may not be as skilled or even familiar with minimally invasive techniques (such as laparoscopy). Get a recommendation through a professional organization, such as AAGL (for gynecologic laparoscopists) or ACOG (for ob-gyns), or by calling a teaching hospital.
Q. Can I keep my ovaries?
A. If they're still functioning, removal will send you into menopause, which may lead to hot flashes, lowered libido and even a decline in memory and thinking skills, according to a new study. Only 2 percent of women who had their ovaries removed during a hysterectomy were at high risk for ovarian cancer, so make sure taking them out is truly necessary.
Q. Should I get estrogen therapy?
A. If you require ovary removal, be sure to discuss the possible benefits of hormone therapy with your doctor. "There's so much misinformation about its dangers, but estrogen may actually decrease menopausal symptoms and the risk of heart disease," says Dr. Streicher, who is also an associate clinical professor of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine.
How Heavy Periods Ruin Your Day
50% of you won't wear a bathing suit.
33% of you skip an outdoor activity.
22% of you pass on going out with friends.
20% of you miss work.
Originally published in the February 2014 issue of Family Circle magazine.