Hysterectomy About 20% of women in the UK end up having a hysterectomy, the most common major surgery performed. This should be greatly beneficial to the woman if the indications are appropriate, the operation done well, with adequate long-term hormone replacement. If the ovaries are removed replacement androgens are also required. Although there are now 20 prospective studies showing that such women have an improvement in libido, sexuality, depression, general health scores, anxiety scores, there is still a belief supported by the Press which tell women that the consequences of hysterectomy are marital breakdown, depression, loss of sex drive etc. This is the opposite of the truth and one can only wonder at the motivation of the journalists who continue to write reports which are manifestly untrue. Women may be troubled with heavy, painful periods, premenstrual syndrome, menstrual headaches, exhaustion, depression, and may only have seven good days a month regardless of medical therapy. It is these women who will request - or even demand - a hysterectomy because they are aware that their ill health is cyclical related to the periods, the ovaries and the uterus. We should not regard this as an extreme last choice treatment or even a confession of failure as it does relieve the appropriate symptoms once and for all. Hormone replacement should be effective either by oestrogen tablets, patches or gel or, if androgens are needed, by the insertion of an oestradiol and testosterone implant. . www.studd.co.uk . Khastgir, G., Studd J. (2000) Patient's outlook, experience and satisfaction with hysterectomy, bilateral oophorectomy, and subsequent continuation of hormone replacement therapy. Am.J.Obstet.Gynecol. 183 (6) 1427-33 . Khastgir, G., Studd JWW (1998) Hysterectomy, hormones and depression. The Yearbook of Obstetrics and Gynaecology. Ed. PMS O'Brien. RCOG Press 402-413 Back to top