Hysterectomy Alternatives

Doctor filling in gynaecological chart, close-up, mid section, elevated view
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Each year, in the United States, over a half million women undergo hysterectomy. In most cases, hysterectomy also includes oophorectomy or ovarian removal. In no other part of the world is hysterectomy performed this often. By age 60, at least 33 percent of women have already undergone hysterectomy. Amazingly, 90 percent of these surgeries are classified as 'elective' surgery or surgery performed by choice and not as a lifesaving procedure.

Reasons for Hysterectomy

Because hysterectomy has such long-term effects on a woman's health, longevity, and sexuality it is vital that women understand all possible consequences. You must understand when hysterectomy is elective and when it is necessary to save your life.

Non-elective reasons for hysterectomy:

  • Invasive cancer of the reproductive system including the uterus, cervix, ovaries, fallopian tubes, vagina
  • Severe infection (PID) that does not respond to treatment.
  • Severe and uncontrollable uterine bleeding.
  • Serious complications during childbirth such as a ruptured uterus.

Elective reasons for hysterectomy:

All of the above reasons for elective hysterectomy are based on your personal medical condition.

Before choosing hysterectomy you should carefully explore hysterectomy alternatives that may be available to you so that you make an informed decision about what is best for you.

Many times, conditions for which your healthcare provider suggests hysterectomy are successfully treated with alternatives to hysterectomy that include less invasive surgeries, pharmacological treatments, and observation.

Sadly, many physicians see the uterus only necessary for women wishing to have children.

This often leaves women alone to explore potential alternatives to hysterectomy. Today, many insurance providers require a second opinion prior to approval of hysterectomy in an effort to reduce the number of unnecessary hysterectomies. If your doctor insists on hysterectomy and it is not for a life-threatening situation, seek another opinion and explore your options before making your decision.

Treatment of Uterine Fibroid Tumors

Surgical Hysterectomy Alternatives

Hormonal Pharmacological Hysterectomy Alternatives

Non-Hormonal Pharmacological Hysterectomy Alternatives

  • NSAIDs - Non-Steroidal Anti-Inflammatory Drugs

Other Options

  • Observation

Treatment of Endometriosis

Surgical Hysterectomy Alternatives

  • Excision of endometrial ablation
  • Resection of cul-de-sac obliteration
  • Nerve blocks
  • Uterosacral nerve ablation

Hormonal Pharmacological Hysterectomy Alternatives

  • GnRH agonists with add-back therapy
  • Danazol
  • Progestins
  • Oral Contraceptives
  • Tamoxifen
  • RU-486

Non-Hormonal Pharmacological Hysterectomy Alternatives

  • NSAIDs
  • Analgesics
  • Anxiolytics

Other Options

Treatment of Uterine Prolapse

Surgical Hysterectomy Alternatives

  • Anterior or posterior colporrhaphy (vaginal wall repair)
  • Laparoscopic or vaginal suspension

Hormonal Pharmacological Hysterectomy Alternatives

  • Estrogen

Non-Hormonal Pharmacological Hysterectomy Alternatives

  • None

Other Options

  • Observation
  • Kegels
  • Pessaries
  • Electrical stimulation
  • Urethral beads
  • Periurethral injections of GAX, collagen, fat, or silicon

Treatment of Abnormal Uterine Bleeding

Surgical Hysterectomy Alternatives

Hormonal Pharmacological Hysterectomy Alternatives

  • Progestins
  • Estrogen
  • Oral contraceptives
  • Danazol
  • Prostaglandin inhibitors
  • GnRH agonists
  • Antifibrinolytic agents
  • Luteinizing hormone agonists

Non-Hormonal Pharmacological Hysterectomy Alternatives

  • None

Other Options

  • Observation
  • Antidepressants

Treatment of Chronic Pelvic Pain

Surgical Hysterectomy Alternatives

  • Adhesiolysis
  • Nerve blocks
  • Denervation procedure
  • Uterosacral nerve ablation

Hormonal Pharmacological Hysterectomy Alternatives

  • Danazol
  • GnRH agonists with add-back therapy
  • Oral Contraceptives
  • Medroxyprogesterone acetate

Non-Hormonal Pharmacological Hysterectomy Alternatives

  • NSAIDs
  • Analgesics
  • Nerve blocks
  • Narcotics

Other Options

  • Observation
  • Counseling
  • Biofeedback
  • Relaxation
  • Trigger point injections
  • Acupuncture
  • Psychotropic drugs
  • Antidepressants
  • Physical therapy

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