Pelvic Pain: Weighing The Risks of Endometriosis and Hysterectomy

A significant number of women suffer from endometriosis – some with symptoms so severe that they turn to hysterectomy as a solution for their pain. While hysterectomy may be appropriate in some cases, it does not always cure the underlying problem. There are other less drastic procedures that a woman may want to explore before deciding to have a hysterectomy.

Endometriosis occurs when the tissue (endometrium) that lines the uterus thickens and grows in places other than the uterus. The condition can be extremely painful as well as highly inconvenient. It may cause heavy vaginal bleeding at any time during the month, not just during the menstrual cycle. In addition, endometriosis can lead to uterine adhesions, in which the uterus itself becomes stuck to other organs such as the ovaries and/or fallopian tubes. Untreated endometriosis can eventually lead to problems with the entire reproductive system, including infertility.

Symptoms of endometriosis vary widely both in type and severity. They occur primarily before the start of a woman’s period but may rear their heads at any time. While vaginal bleeding outside of the normal period is one indication of endometriosis, blood in the stool and/or blood after sexual intercourse may also be symptom. Symptoms of pelvic pain, low back pain, and pain in the upper legs and thighs may also point toward endometriosis. A woman should also report pain during bowel movements and painful intercourse to her physician.

The symptoms of endometriosis may ebb and flow. Often they diminish during pregnancy and may stop altogether after menopause. This is because the production of the errant cells is related to the body’s production of hormones. However, endometriosis is a chronic disease that very rarely disappears completely of its own accord.

Before opting for a hysterectomy, a woman may want to consider other less invasive treatments. These may include hormone therapy and laparoscopy. Still, it is important to remember that the side effects from continued endometriosis can be as damaging as the malady itself and, in some cases, even more traumatic than the initial disease. Not only can endometriosis lead to infertility, the uterus can also adhere to the bowels. Cancer of the reproductive organs is also higher among women who suffer from endometriosis.

Therefore, in consultation with your doctor, you may decide to have a hysterectomy. You and your doctor may choose a total hysterectomy in which the uterus and cervix are removed, a sub-total hysterectomy in which the uterus only is removed, or a total hysterectomy plus removal of the fallopian tubes and one or both ovaries. Many women choose to remove only the uterus since the removal of the ovaries can lead to surgical menopause. Leaving one or both ovaries allows the body to continue producing hormones, which may delay menopausal symptoms. While taking out the uterus only may end the signs of endometriosis for some women, unfortunately, it is treating the symptoms only and not the cause of the disease. The ovaries may still signal the body to produce endometrial tissue in places outside of the uterus. As a result, pain, bleeding, and other side effects may continue and additional surgery may be required.

The pain and inconvenience of endometriosis may be bearable and controllable for some women. Ultimately though, a woman will have to weigh the risks inherent in lesser therapies against the negative factors which may be associated with a hysterectomy. After a careful analysis, many women may choose a hysterectomy to eradicate the pain, emotional trauma, and possibilities of further health damage caused by unchecked endometriosis.

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