Hysterectomy: 6 Super-Important Things You Must Know (That Doctors Rarely Mention)
From pelvic floor therapy and strength training to preventive medicine and health outcomes, these are the top 6 tips I wish someone had shared with me before my surgery.
When I first faced my hysterectomy decision, I sought FIVE medical opinions. Some might say that’s overkill, but I wanted to be absolutely certain. But even with that, there’s so much I wasn’t aware of or prepared for prior to my surgery. All the doctors and surgeons I spoke with made it seem as if life would just resume after six weeks and that I’d feel instantly better with minimal effort. The truth is it’s not that simple for everyone. Recovery and life after a hysterectomy can vary greatly from person to person, so it’s extra important to be proactive and do what we can to help improve the experience. From pelvic floor therapy and strength training to preventive medicine and possible health outcomes, these are the top 6 tips I wish someone had shared with me before my hysterectomy surgery.
#1
Know what type of hysterectomy surgery you’re getting along with the benefits and risks associated with it.
I cannot stress this enough, especially if you’re getting an elective hysterectomy for a benign condition. Will it be laparoscopic or open abdominal? How many incisions? Will it be a keyhole technique or removed vaginally? And last but certainly not least, are you getting a supracervical hysterectomy, total hysterectomy, or radical hysterectomy? You owe it to yourself (and your body) to know every detail beforehand. For example, if you’re opting for a total hysterectomy, that means both your uterus and cervix will be removed and a vaginal cuff will be created in place of your cervix. There are pros and cons to removing the cervix. Please, do your research in advance, so you can make an informed decision. Although extremely rare, if you opt for a total or radial hysterectomy, cuff tears can happen.
Learn more about the different types of hysterectomies here and about the incidence of cuff tears here. Also, if you have endometriosis, ensure the surgeon performs excision as well. A hysterectomy does NOT address endometriosis.
#2
Start pelvic floor therapy BEFORE surgery.
If you can, start pelvic floor therapy before your hysterectomy. It can make a world of difference! If you can’t start it beforehand, make sure to prioritize it after surgery. Some people get weirded out by the internal manual part of pelvic PT, but that piece is totally optional. Although manual techniques can be super helpful, you can still benefit from pelvic therapy even without it. If you’re interested in trying pelvic PT but unsure where to start, check out Dr. Jocelyn Wallace and Dr. Janelle Howell. Good pelvic PT addresses the whole body, including posture, breathing, and much more. So, do yourself a favor and get thee to PT stat.
#3
Know your baseline and pre-existing conditions.
Do you have hypertonic pelvic floor muscles? Are you hypermobile? What about digestive issues or autoimmune conditions? Is anxiety or depression an issue for you? It’s crucial that you fully know where your mind and body are prior to surgery. Pre-existing conditions or even just a lack of exercise can often dictate your recovery experience. Don’t go by the women who claim they felt instantly better right after surgery. That might not be the case for you. It certainly wasn’t for me. Prep accordingly and get all the proper assessments you need beforehand.
#4
You may be at higher risk for cardiovascular conditions, even if you keep your ovaries.
The jury is still out on this, but preliminary data, as reported by the American Heart Association, seems to point in this direction. According to this 2018 Mayo Clinic study, the risk increases the younger one is at the time of the hysterectomy. Make sure to discuss these risks and your family history with your doctor. This all points back to knowing your body’s baseline. If you decide to move forward with a hysterectomy, you should strongly consider prioritizing diet, exercise, and other healthy lifestyle practices for the rest of your life to help mitigate the increased risks. And, of course, make sure you’re getting your medical check-ups regularly. You might even want to add a cardiologist to your medical team to stay ahead of any potential issues. Again, know the pros and cons. Many women feel the above risks are well worth it if it means the hysterectomy can improve their quality of life now.
#5
Yes, you CAN strength train after a hysterectomy.
However, you must wait until you’ve received clearance from your surgeon. Even then, you should probably proceed cautiously at first. If you want some inspiration, Melanie Durrette of Female Fitness Systems speaks about her journey back to strength training here. I also highly recommend following Dr. Jocelyn Wallace’s recovery journey on her Instagram.
#6
You might end up with SIBO.
If you’re struggling with digestive issues, consider taking a 3-gas breath test to rule out SIBO (small intestinal bacterial overgrowth) or IMO (intestinal methanogen overgrowth). If you can take one before surgery, even better. The more you can do to know your baseline prior to surgery, the better. Many doctors still debate SIBO, but I can assure you it’s a very real condition and it’s a pain to have. For all the latest on SIBO and IMO, follow Dr. Mark Pimentel and the MAST program.
If you’d like to see a post covering my own hysterectomy experience, let me know right here.