The emotional impact of hysterectomy

For the majority of women, hysterectomy is elective surgery. However, it seldom feels that way. As our post bag testifies, in many cases from the moment a woman presents at the doctors’ surgery with a gynaecological disorder, she “feels as if she’s on a conveyor belt with little information, choice or support”. Post-operatively, after a few days in hospital, she is passed medically fit and discharged to contemplate how this piece of elective surgery may affect the rest of her life and her relationships.

Removal of the uterus may be undertaken for a number of medical reasons although it is only performed to save life in relatively few cases. Whatever the primary indication, hysterectomy may be accompanied by alterations in sexuality that may occur for a variety of biological and psychological reasons. For instance, some research has shown the important role that the cervix plays in the experience of orgasm. This organ is routinely removed during total hysterectomy in the UK even when it is healthy. In other instances the symptoms necessitating hysterectomy may have disturbed the closeness of the relationship to such an extent that the couple find resumption of intimacy difficult when the physical problem has disappeared.

For some women, however, sexual problems occurring after the operation may be a continuation or further evolution of previously existing difficulties. Some women, who may have experienced years of pain or discomfort through their condition, may be so negatively conditioned towards sexual activity that they abstain or avoid sexual activity post-operatively.

However, for many women, the opposite reaction occurs. Freed of the symptoms as a result of surgery, a woman may find her sexual responsiveness reawakened. With myriad different reactions possible, it is perhaps not surprising that post-operatively there is an increased incidence of depression when compared with the after effects of other major surgery.

The success of the operation then depends upon two things, each as important as the surgeon’s skill; the woman’s self esteem and the partners reaction.

Research has shown a crucial link between information giving and the perception of being cared for by health professionals. Women who present their bodies to medics without knowledge or understanding of the what, why and after effects, suffer considerably more post-operative complications than the woman who insists on knowing as much as possible and feels in control at all times [except whilst under the anaesthetic of course!] After all, a woman is the greatest expert in the world on herself.

The woman’s husband or sexual partner is the second most important factor in determining the success of surgery. Most men (and quite a few women) don’t understand the nature of the female anatomy or the functional results of hysterectomy, and may harbour many misconceptions regarding sexuality after the operation. If the man equates removal of the uterus with loss of libido or diminished femininity, he may inadvertently avoid sexual interaction with her. Men who appear indifferent to uterine removal, may actually feel anxious or guilty about subsequent sexual activity with their partner.

A hysterectomy can be seen as a unifying experience, one that the couple face together, talking and listening to each others needs, communicating their feelings as they change day by day.

With the right support network in place, which should include her partner as well as medical staff, there is no reason why a woman’s sexual function cannot improve following recuperation from the operation. If health-care professionals take the time that is necessary to assuage fears and doubts regarding such operations and provide a reasonable amount of factual information to both the woman and her sexual partner, few sexual difficulties will ensue postoperatively. However, whilst counselling is routine prior to sterilisation or vasectomy, no such norm exists for hysterectomies. As with all types of surgery that may have an impact on sexuality, such counselling ought to be a routine part of the care for a hysterectomy patient.

Recommended Reading:

star buy Losing the Woman Within – £5.50. is essential reading for everyone who feels they are alone and emotional following a hysterectomy.

Recommended Resources:

32 thoughts on “The emotional impact of hysterectomy

  1. Kathy Grile

    I’m 2 years post op TAH…this was not elective…ovarian cancer.
    I had the typical depression issues as a teen. This is absolutely crazy. Since my TAH, I have no energy…to even get out of bed, no sex drive, I could actually care less what goes on outside my front door. I can’t ever remember, as a teen, being this depressed!! I didn’t really have a strong support system before, during out after my TAH. My husband has all but given up on our marriage and in my present state of mind, I couldn’t care less. I’m about 20% sure I don’t mean that but if this is another “side effect” of my surgery…I guess it was meant to be (or wasn’t meant to be…)

    1. Linda Parkinson-Hardman Post author

      It may not be a side effect of the surgery, but is almost certainly the menopause kicking in. It would be worth chatting with your GP about the things you can do – there are non-oestrogen HRT’s available you could try. Alternatively, you get hold of Marilyn Glenvilles book, The New Natural Alternatives to HRT as that will give lots of hints and tips about getting your verve back.

  2. amanda

    Hi
    I am a 45 year old woman and I had my abdominal hysterectomy 5 weeks ago, i have one ovary left as other had a cyst and i had the beginnings of cancerous cells taken from my cervix …. all went well and glad it is gone and i have no pain or bleeding fab!!! but …. i am so emotional to the point of nearly breaking up with my partner as i’m so needy at the moment ,can sob not cry my heart out for no reason at all and to be honest i was told i would get emotional but not like this it is so unlike me but i hate it
    i am hoping it is going to settle soon , but i think because my job is an active one and i am on the go all the time to sit around and not being able to do much is not helping. So am hoping i feel better when i get back to work .

  3. neketia

    Hey it s been 4months seens I had surgery they took it all out but my problem is that I didn’t have kids at all I am 33 years old what can I do to control my emotions an feeling the way I do am at my breaking point an I don’t know what to do

  4. Kim E.

    Hi. I am 8 weeks out from a vaginal hysterectomy, removed everything but ovaries. My Right ovarie was attached to my organs and when they cut it loose they couldn’t tell me if it would function normally. I expected to be back to normal by this point but It seems like every weeks I’ve slipped a little farther down emotionally. I have started having anxiety attacks for the first time ever and am being treated with medication for those and with an anti depressant. I just feel so bad physically and emotionally. I don’t feel like I’m being a good mother yo my 3 children all still small.. 8 down to 3, because I just feel so bad but in all reality I am giving 100% of me to them even if it is lacking and saving nothing for myself or my husband. I found this site last night and I can’t tell you what a relief it is to know the emotions, the physical pain in muscles and just all over body achea, lack of energy and severe fatigue and insomnia is actually a “norm” for other people and not just me. I honestly felt like I was crazy, that I should be better by now. It helps to know there are other people out there and I’m not alone! Thank you for that!!!

    1. Linda Parkinson-Hardman Post author

      You are very welcome Kim and I’m glad we’ve helped. You may also be starting to experience the menopause too .. it’s worth bearing that in mind as that would give you similar emotional reactions on top of those you get during recovery.

  5. heidi

    I had a complete/radical hysterectomy coming up on 8 years next month. I was 30 when I was diagnosed with uterine cancer. Its still devastating to me that I won’t be able to have more babies. It definitely left a hole in my life. On a good note though,I don’t miss the non stop periods. Mine would last for months,the doctors never did find a reason. My sister who’s now in her mid thirties has the same problems unfortunately she has never had the joy of pregnant or motherhood something she tried so hard to have but hasn’t happened. I’m very lucky to have my beautiful daughter,the doctors told me that I probably wouldn’t get pregnant. I ran into a cashier today who told me she thought she was pregnant even though her tubes were tied”it happens” she was not happy about a possible pregnancy. Me on the other hand I’d be thrilled to be pregnant again. It must be nice for women to choose when their done having babies,rather then hoping and praying that it happens and being told you can’t. 8 years latter and I still have a hard time

  6. rose

    since last February 2013 i have put mine back because i am scared of the mental and physical effects,i have gone from diagnosis to having marine coil fitted and is still having periods for ten days along with headaches,pain in hips and legs, putting on weight like no tomorrow, also tiredness,moodiness is killing me, reading all your experience is helping me rethink for the summer hols,as it wont effect my work as a s.n.a,however , how long is the the recovery period overall, do you ever feel normal and comfortable in your own body

  7. Betty

    I was informed yesterday during a routine annual exam, that ended up lasting 4 hours and a uterine biopsy later. That I would need to have a hysterectomy done. They did the biopsy because he said there were polyps. No medication at all for this procedure, I really didn’t think that it would be too painful but sure enough I was surprised by the pain all evening. That was the least of my worries, sitting there alone is when the doctor said That I needed a hysterectomy. I am 34 with 2 children, I really did not plan on having more children, never did I think that I would have to have a hysterectomy. My uterus is tilted and because of the difficult childbirth I had it is prolapsed also. I feel so lost and I cant stop crying. I feel like I am loosing part of my womanhood. My boyfriend is treating me as if I have the plague, which is just making things worse emotionally for me. He is 50 and had a vasectomy many years ago so I ruled out him being upset about no more children. I feel so alone.

    1. Linda Parkinson-Hardman Post author

      Your reaction is all too common and it’s OK to feel as you do Betty. It’s a big shock and you will naturally feel that a part of life has ended. However, it might be worth talking with the boyfriend in more detail because it may be that he’s just worried or frightened himself.

    2. Latrice

      I’m 10 days post surgery my cervix and uterus was removed, I’m 36 yrs old. and like yourself it was a total shock for me when I was told I felt the same feelings you are feeling and it’s perfectly understandable. Maybe your boyfriend is afraid and don’t understand enough about the surgery, maybe going to the doctors with you and have the doctor explain to him about the procedure and even try therapy. I hope all goes well with you and your family. On a brighter note I feel much better now that it’s over there’s always a light at the end of the tunnel.

  8. Tesse

    I had a hysterectomy 4 weeks ago and still have waves of nausea and have had similar emotion responses. I don’t think I understood how hard this would be emotionally.

    1. teen

      i am the same will be 5 weeks today for mine,i have good days and bad days ,where i think am just about to start to feel ok then the next day will be pain again nausea and just feeling exhausted xx

  9. Renée

    Hi, I am 37, two weeks ago today, I just had an abdominal hysterectomy, both ovaries and tubes were removed-I had large cysts on both ovaries and suffered from terrible periods. I am moving around pretty good. One of my main problems is that I feel sick a lot of the time-does anyone else feel sick after having this surgery? My other problem is that my emotions are all over the place. I am single, my Mom has been a God send during this ordeal but I feel so very alone. I have concerns/fears about having sex with someone new after having this surgery. I’m not dating or have anyone in mind so it might be silly to worry about this now but I worry none the less….will I work “down there”,’will I need lubricant? Who will want to be with me? So forth…
    I had my tubes tied after my second son was born 11years ago-BIGGEST MISTAKE OF MY LIFE, I had always hoped to have the reversal done…but now…I know that I will never have more children. No one seems to understand how badly this is affecting me. I see a newborn at the store and all I want to do is blaw my eyes out. I am so tired all the time, I feel alone and empty. Is this normal? And sick, I feel sick. I don’t get sick very often and brush it off when I do, so why do I feel sick now?

    1. Linda Parkinson-Hardman Post author

      It’s perfectly normal to have an emotional reaction to the surgery – it may be driven by how you feel or by things like the anaesthetic, but it is common. If it is purely about your emotions and coping with the sense of loss then it may be worth talking with a counsellor who could help you deal with that.

      1. Kathy

        I don’t understand why no one has brought up fact the that your hormones are no longer being produced by your ovaries and that is what causes the emotions you are feeling. Once your body adjusts to the lack of hormones and/or your doctor prescribes hormone replacement, you should be feeling better. I will possibly be having my uterus removed but not my ovaries; also I am post menopausal and 59 years old, so I’ve known for a long time I won’t have more children. My question is, will my emotions be affected with the uterus removal?

        1. Linda Parkinson-Hardman Post author

          For some women the removal of the ovaries can cause emotional upset, mostly because of the testosterone that is no longer being produced. However, it’s by no mean universal and many women seem to have no noticeable effect whatsoever. It’s also important to understand that surgery of any type can cause emotional upset as it’s one way the body has of coping with the trauma as well as the effect of anaesthesia. Your hormone balance will be affected by the surgery – this may be a temporary thing or it may be more permanent as in 50% of women their ovaries fail much earlier than expected.

          1. SHELLEY

            > I had a hysterectomy two weeks ago and left the ovaries. Why are my emotions all over the place? I am worried about it. I am also having trouble sleeping. Any help is much appreciated.

          2. Linda Parkinson-Hardman Post author

            All sorts of things affect your emotional state after a hysterectomy Shelley including the anaesthetic which can cause the post surgical blues, your hormones because they will be in a bit of disarray until they settle down and your body’s reaction to the surgery itself. All of these should settle down by themselves in time.

  10. Del

    I’m in my early 40s and had premature ovarian failure (early menopause) when i was in my late 20s after a myomectomy my periods stopped. However, i had an abdominal hysterectomy 7 weeks ago but the cervics was left intact due to adhesions it was decided during surgery, that was the best option othetwise it may have left me incontinent had they removed it. My surgeon said i had gross adhesions my organs were stuck together ie bowels, bladder, womb, cervics etc so they had to divide everything to remove the womb, tubes and ovaries. I’ve had the best care from my consultant and the hrt team who’ve looked after me two years after my premature menopause. But before that i had to deal with everything myself never had conselling and it’s been tough for me. Sometimes i felt like giving up. Now after the hysterectomy 7 weeks ago i am feeling so low, teary all the time i just keep thinking of what happened during the myomectomy years ago, am having flash backs and feel sad about the whole thing. I feel emotionally drained. I accepted years ago that i would never have children the day they told me that my ovaries had ceased. Because they say when you’ve gone through menopause before having hystetectomy you do not feel anything so why am i feeling like this? I’ve also got joint pains and i feel tired with no energy all the time. Thank you!

    1. Linda Parkinson-Hardman Post author

      HI Del, firstly it’s perfectly normal to feel the way you do so don’t be hard on yourself. Firstly you’ll be having a reaction to the surgery itself this, then the fact that your ovaries and womb have removed will have an impact on your hormone levels – which will be all out of kilter too. Finally, you’ve just had major surgery. Give yourself some time and things will improve.

  11. joy

    so relieved my syptoms are normal, why is there not councelling post op as standard. I spoke to my doctor, my husband and i have relationship problems so part of me has been putting the lack of self-esteem and mood swings to the fact that we are still not getting along.

    So i made a appointment with my doctor who put me in touch with steps to wellbeing dorset. I had appointment today as a refferal . It is not a councelling referal for post -op, i am dissappointed. The lady was very nice and has made an appoint.ment for me to group discussion. But it isnt , i feel the way forward.

    Will i have to pay privatley to get the councelling i need post-op/?Ive been feeling really low in myself for 3 months, i hate my body because of the scarring, i dont want my husband to touch me without my clothes on.

    My thoughts are about leaving him because he would be better off without me.

    1. Linda Parkinson-Hardman Post author

      Hi Joy, you may be able to access counselling for yourself through your GP free of charge. There are often NHS counsellors attached to surgeries. However, if it’s relationship counselling you are after you will need to contact Relate. They have an offices in Dorchester, Bridport, Shaftesbury, Yeovil and Blandford.

    2. Joanne

      I often think this way, about my husband and children being better off, but it’s not true. If you look deep down inside, you ll feel that love for him and if you talk or try something new, date nights, meals out and cosy night in, spark might happen to get the conservation flowing. If you don t talk about how you feel, you may never find happiness. It may not be with your husband but you owe it to yourself to try.
      I m sure you ve fought for a long time to be well. That fight never stops, it’s life. And living requires talking and trying. If you feel you can t do that anymore, you need to speak to a doctor or a close friend, even a stranger, to find a way forward. Your light at the end of the tunnel is waiting for you, just like mine is, sometimes it takes a lot of digging to find it.
      I d love to know how you re getting on now. :)

      1. Aby

        I was 42 and married 6yrs trying for a child . I was diagnosed with endromitiis cancer in April 2013 and in end of May 2013 I had the full hysterectomy . I was given no Pre counselling .
        After the operation I was ill and on bed for 6 months due to infection wound opening and other problems.
        Prior to the operation my husband and I were a very close couple , after the op he started to change .
        He works long hrs as a taxi driver he used to go at 4pm and return at 5am and days off go and sit with mates till same time
        I come from a big famy and before the operation mum and sisters said they would support me through everything but a day after I came back they all stopped talking and contacting me . I fell so alone I used to sit up all night till hubby came back and when he used to come back he used to be too tired to talk. In the day all he did was watch TV or sit playing candy crush
        Then in January 2014 mum died . In a space of 8 months I lost my exsistance and my future .
        I had to move in too mums to look after my teenage brothers
        Things still haven’t changed i put on my face infront of everyone . All dolled up but inside I’m dying . I feel alone and scared , I have panic attacks sometimes after the panic attacks I call my husband just to talk because I’m scared but he is always to busy talking to his friends . I once checked his FONE 2 weeks ago and in 24 hrs that he had worked he is talking to his friends for upto 18 hours
        Every 2 hours the mobile stops the he rings again.
        I have tried so hard to talk to him and tell him what I am going through but he doesn’t understand
        I’m at breaking point he’s leaving he’s told his family back in Pakistan she’s not good to me ,she suspects me , she checks my fone
        All I want is for someone to care for me to hold me I feel dead from inside
        He objects to the fact that why don’t I feel like this with the boys . Why don’t he understand the boys are orphans I dont want them to feel as bad as they already do after loosing mum if Im all depressed it will kill them seeing me like this
        Sometimes I just ..

  12. Hayley Martin

    i had a abdominal hysterectomy and bso nearly 3 weeks ago.I was so focused on relieving the chronic pain of adenomyosis that i never realised the emotional havoc it causes. I have been so terarful snd thinking so illogically that i am slipping down a slope into depression. I commenced HRT pre op but consultant is going to change it at 8 weeks post op,are my feelings normal?

    with Thanks
    Hayley

      1. suzanne

        Hi Joanne

        I am also feeling exactly the same and have a couple of good days then tearful days….. one person told me for every negative thought you have, try and think of 3 positives. Im working on that now. Have you tried any natural remedies?

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