Hysterectomy for PCOS: Pros, Cons & Hidden Dangers

For many women, a PCOS cure would be life-changing. And here's where you might have heard about hysterectomy as a potential remedy for polycystic ovary syndrome and other gynecological problems. But this is a lie.

A hysterectomy is a surgical procedure in which a woman's uterus (womb) is removed. While a partial hysterectomy involves the removal of only a part of the uterus and not the cervix, the uterus and cervix are removed during a total hysterectomy.  In some cases, during a hysterectomy, a woman's ovaries may be removed along with the uterus. However, in other cases, the ovaries may be left intact. The consequences of this type of surgery are life-changing.

Of course, any conversation about PCOS and hysterectomy must cover how women’s health has been poorly researched and understood. For example, PCOS is often misdiagnosed and experts don’t even fully understand the side-effects of birth control medication. Additionally, research shows that having a hysterectomy often comes with its own set of complications and shouldn't be labelled a PCOS cure. Ever.

Consensus is that a hysterectomy shouldn't be on the table when you're speaking through treatment options for PCOS. And if it is, it's time to get a second opinion. 

That being said, below we'll review the pros and cons of hysterectomy surgery for PCOS.

Pros of PCOS hysterectomy

Advocates say a hysterectomy can be a beneficial procedure for some of the symptoms that may accompany PCOS. Specifically, a PCOS hysterectomy may alleviate heavy bleeding. Ahead, we look at a few of the advantages of having a hysterectomy, according to scientific research. (Full disclaimer: there aren't many pros.)

Relief from heavy bleeding

According to the Care Clinic, one of the benefits of a PCOS hysterectomy is that it eases heavy bleeding and irregular periods. 

However, many women may still experience other symptoms, like acne and excess hair growth. Reddit comments around PCOS and hysterectomy aligns with this. Most women who’ve had the procedure agree that while they no longer have heavy bleeding, they still have to manage other symptoms through diet and other lifestyle changes.

Plus, one research article finds that most causes of heavy bleeding are benign:

"...hysterectomy is generally reserved as a final, definitive treatment for HMB when medical and uterine sparing surgical options have failed or are contra-indicated."

Reduced risk of ovarian cancer

A hysterectomy can lower the risk of ovarian cancer. 

It's worth noting that PCOS patients have a elevated cancer risk. Case in point: one study of 14 764 women suggests that PCOS increases cancer risk. 

However, Tatnai Burnett, M.D. writes in this Mayo Clinic article that while the ovarian cancer risk may drop off after the surgery, it's still possible to get ovarian cancer even after a hysterectomy.

Cons of PCOS hysterectomy

The drawbacks of a PCOS hysterectomy far outweigh any pros.

Now a growing movement is calling on women and medical experts to reconsider guidelines for hysterectomy. In this article, one woman shares her experience with hysterectomy surgery, discussing the reasons such an invasive and life-altering surgery remains so common - even when it's medically unnecessary. The writer, who has chosen to remain anonymous, appealed for a “conservative” approach similar to the one usually adopted in prostate cancer cases.  

“...at play are the prevalent myths in medicine (and society more broadly) that the uterus is disposable after childbearing and the ovaries shut down at menopause. These myths stem from the misogynistic idea that women’s primary function is childbearing and their lives are of little value once fertility ends. Additionally, there are prevailing views that women are not supposed to be sexual. 

“Tellingly, the word “hysteria” originates from medical professionals defining a neurotic condition peculiar to women, thought to be caused by uterine dysfunction. Hysterectomy was the cure for this “madness.” I, as well as many other women, can certainly attest to the fact that hysterectomy has a marked effect on personality and emotions, to the point we never feel like ourselves.”

As we’ll learn below, the effects of a hysterectomy extend well beyond permanent sterility.

Hormonal imbalance

‍

The ovaries play a key role in hormone production throughout our lives.

This is exactly why organisations like The Ovaries for Life stress the role of ovaries in hormone balance, even after you’re done having - or choose not to have -  children.

“Our ovaries are not just reproductive organs that can be thrown away if we don't want or are finished having children (and your uterus shouldn't be, either) - ovaries are both exocrine and endocrine glands. Though the exocrine part (releasing eggs) ends at menopause, the inner, endocrine part keeps making hormones that we need for our entire lives…They form a connection to our brains called the HPG axis, and make hormones that keep us healthy for our entire lives.

“If any part of our endocrine system is acting up, we get sick. Our ovaries are no exception. If they’re gone entirely? We get really sick. Because this system affects every single cell in our bodies, women who lose their ovaries are proven to age throughout their whole bodies much more quickly."

‍

When the uterus is removed, the ovaries may continue to produce hormones, but at a far lower level. And it’s this reduction of hormones can lead to imbalances, which can cause a range of symptoms. For example, hot flashes, mood swings, and vaginal dryness.

Early menopause

Hysterectomy can trigger early menopause.  Early menopause is when you stop having a period before the age of 40. 

‍

Similarly to hormone imbalance, early menopause may present as hot flashes, night sweats, and vaginal dryness. This premature menopause can also increase the risk of osteoporosis and other health problems.

Infertility

‍

Having a hysterectomy will mark the end of your ability to fall pregnant. 

‍

The ovaries are also responsible for producing eggs. When her ovaries are removed, a woman will no longer be able to conceive naturally.  

‍

Depending on where you’re at with family planning, this may or may not be a serious deal-breaker.

Higher risk of cardiovascular diseases and some cancers

Hormones play a crucial role in cardiovascular health. When hormone levels are out of balance, it can bump up the risk of cardiovascular diseases, including heart disease and stroke. 

‍

A 2021 systematic review published in the Journal of Clinical Medicine analysed 29 studies and found that a hysterectomy was associated with a higher risk of cardiovascular diseases. 

‍

In another study of 730 women, researchers found a link between having a hysterectomy and an increased risk of thyroid cancer. 

Frequently asked questions about PCOS and hysterectomy

‍

We answer the most common questions about PCOS and hysterectomy. 

Does a hysterectomy help with PCOS?

No, a hysterectomy is not a direct treatment for PCOS.

Hysterectomy involves the removal of the uterus and may or may not involve removal of the ovaries. Since PCOS is primarily related to ovarian function and hormone levels, a hysterectomy alone wouldn’t fix the underlying hormonal imbalances associated with PCOS.

Hysterectomies are major surgeries with a long recovery period, and should only be considered as a last resort. PCOS is a condition that can be managed with lifestyle changes, such as diet and exercise, as well as medications. 

‍

If you're considering a hysterectomy, ask your doctor questions about potential risks and benefits. Additionally, it's important to get a second (and third) opinion if your doctor recommends a hysterectomy.

‍

What are the downsides to a hysterectomy?

‍

While hysterectomy can provide relief from certain medical conditions, it is a major surgical procedure. And, as such, it comes along with the usual potential risks and drawbacks.

‍

Like with most operations, bleeding, infection, and damage to surrounding organs are common risks.  Recovery from hysterectomy can also be lengthy and you’ll require significant post-surgery care.

Depending on the type of hysterectomy (partial, total, or radical), removal of the uterus and/or ovaries holds implications for hormonal balance, sexual function, and pelvic support. 

‍

For example, if the ovaries are removed, menopause can occur earlier than expected. Shortly after the operation, you’ll likely experience poor sleep, night sweats, and hot flashes.

Is it easier to lose weight after a hysterectomy?

Weight loss after a hysterectomy can vary from person to person. In other words, weight loss depends on your personal circumstances.

‍

Some of these factors include hormone levels, activity levels, diet, and individual metabolism. In other words, a hysterectomy can’t guarantee weight loss.

‍

If you're struggling with your weight, get an evaluation from a healthcare professional or registered dietitian.

‍

Demand better forms of PCOS treatment

‍

In the majority of cases, a PCOS hysterectomy is a bad idea. 

‍

A hysterectomy won't cure the underlying cause of a woman’s health issues, and it comes with a mountain of immediate and long-term risks.

‍

There are far more appropriate forms of treatment to help you manage PCOS. In fact, most researchers agree: non-surgical options should be the first line of treatment. 

‍

Lifestyle changes, such as regular exercise and a healthy diet, can restore hormone balance. Many of these interventions aim to reduce insulin resistance. In addition, commonly used PCOS medications, such as birth control pills and metformin, can also be effective for some women. 

‍

‍