When it comes to determining which hysterectomies are elective and which are necessary, it is often up to the physician and the insurance company to decide. What one doctor may feel is necessary for a woman to live a happy life, another may feel that it is an unnecessary risk. The elective hysterectomy becoming ever more popular nonetheless, and more and more insurance companies are opting to pay for them in certain situations.
The Difference between Necessary and Elective
According to data from multiple hospitals and insurance providers across the country, hysterectomy is the second most common major operation performed on women in the United States. Progressive doctors feel that 90% of these hysterectomies are unnecessary, and conservative physicians put that number at somewhere between 20% and 30%. An elective procedure is one that is not medically necessary, even though it may improve a patient’s quality of life.
Reason #1 – Heavy Bleeding
The term “dysfunctional uterine bleeding” is being used more and more often these days to describe heavy menstrual bleeding without any apparent clinical cause. There are several treatments for heavy uterine bleeding, including the surgical removal of the uterine lining, or uterine ablation, which essentially destroys the lining and prevents future heavy periods. However, some women opt for an elective hysterectomy, especially if they do not want more children and uterine ablation did not provide them with permanent results.
Reason #2 – Fibroids
According to hospitals and insurance companies across the country, about 40% of all women who choose an elective hysterectomy do so to combat uterine fibroids. One in five women over the age of 35 has uterine fibroids, whether or not she is aware of them. While most cases do not cause any symptoms or irregular bleeding, other cases cause significant pain and discomfort. When other treatment methods fail, or when fibroids continue to recur despite the doctors’ efforts, a hysterectomy can provide relief.
Reason #3 – Endometriosis
Endometriosis has two main symptoms that concern women – pain and infertility. Women who have endometriosis may experience severe cramping during their periods, significant pain during sexual intercourse, and abnormally heavy bleeding during their periods, which are often longer than normal. Women who have severe endometriosis often describe their pain as unbearable. Even in this case, a hysterectomy is considered an elective procedure since endometriosis often presents very little if any threat to a woman’s health.
Reason #4 – Postmenopausal Bleeding
Finally, there are cases in which women who have gone through menopause begin to bleed again months or even years later. This is always a cause for concern, and women who experience it should seek medical attention. Many women who have postmenopausal bleeding opt for an elective hysterectomy to stop the bleeding, but many doctors disagree on this. Some believe that the removal of the uterus improves the patients’ well-being; others feel that hysterectomy is unnecessarily invasive, even in this case.
If you are considering an elective hysterectomy for any reason, be sure to speak to your doctor about the scope of your procedure and whether your ovaries will be left behind. If not, you may want to consider bioidentical hormone replacement therapy and lifestyle changes to help you ward off some of the symptoms of menopause.