Surgery Frequently Asked Questions

​Will I automatically go through menopause if I have a hysterectomy?

Definitely not! Depending on your reason for a hysterectomy, the ovaries can often be preserved. If you haven’t already gone through menopause, then by keeping at least one ovary, you shouldn’t go through menopause until around the time you would naturally go through menopause. Generally, this happens around 51 or 52, although your family history also plays a role as to when this happens. If you have already gone through menopause before your surgery, even if your ovaries are removed, you won’t go through menopause a second time.

Are there other surgical options to help with heavy bleeding?

An endometrial ablation may offer relief of heavy bleeding for many patients, with most women having either lighter or no menstrual cycles following the procedure. That being said, not every woman is a candidate for an ablation. Some factors that can influence whether or not a patient is a good candidate are her suspected cause of bleeding, her previous surgical history, and her uterine size among other considerations.

Is a tubal a permanent procedure?

Tubal ligation is meant to be a permanent sterilization procedure. While tubal ligation reversals are possible, even if the procedure is successful, it may not result in
pregnancy or may result in ectopic (tubal) pregnancy. Alternatively, in vitro fertilization (IVF) may also be done after a tubal ligation. However, neither of these procedures are typically covered by insurance, and both can be rather expensive without a guarantee of successful pregnancy with either treatment. The bottom line is that it is advisable to be as certain as possible that you’re done having children before undergoing a tubal ligation.

Will a tubal ligation affect my hormones or my menstrual cycle?

A tubal ligation works by blocking the path (fallopian tube) through which the egg travels on its way to be fertilized and implant in the uterus. This is generally done either by clips that block/close this pathway or by removal of a portion or all of the fallopian tube. The tube acts as a road to the ovary and has no role in hormone production. The ovaries remain intact with this procedure, so hormone production is unaffected; however, for women who have been on hormonal birth control prior to their procedure, they may notice a difference in menstrual flow for several reasons. First, hormonal birth control tends to make a menstrual cycle lighter, and second, for women who are used to having a portion of their menstrual cycle flow back through the tube into their abdominal cavity, they will now see this additional blood pass out of the body through the cervix and vagina. Both of these factors can contribute to heavier menstrual cycles.

If I have fibroids, can these be removed without doing a hysterectomy?

Depending on where the fibroids are located and also whether there is a desire for future pregnancy, myomectomy (removal of fibroids) may be a reasonable option. For instance, if the fibroid is located entirely in the cavity of the uterus, removal with a hysteroscope (a scope that doesn’t require incisions and is passed from the vagina into the uterus) is often an option. For fibroids either embedded in the wall of the uterus or on the outside of the uterus, removal via laparoscopy (small incisions and a scope placed into the abdomen) may be reasonable for those looking for future pregnancy; however, as there is often more bleeding with this procedure in comparison to hysterectomy and there is also potential for both persistent heavy menstrual bleeding as well as recurrence of fibroids even with successful removal, the optimal treatment option should be discussed with your medical provider.