Hysterectomy in Chicago — When It Helps, and What to Try First
A hysterectomy removes the uterus. Once it is done, you will no longer have periods and you cannot become pregnant. It is one of the most common surgeries performed on women in the United States, and for the right problem it can end years of bleeding, pain, or pressure that nothing else has touched.
It is also a surgery that is offered more readily than it should be. Most of the conditions that lead women to a hysterectomy consultation have treatments that keep the uterus. You are entitled to hear about those options before you agree to remove an organ. At the Women's Health Center of Chicago, that conversation happens first.
Why a hysterectomy is done
The reasons fall into two groups: conditions that are benign but genuinely disabling, and conditions where removing the uterus is the treatment.
Benign conditions that may lead to hysterectomy:
- Uterine fibroids causing heavy bleeding, anemia, pelvic pressure, or urinary frequency
- Adenomyosis, where endometrial tissue grows into the muscular wall of the uterus, causing heavy, painful periods
- Abnormal uterine bleeding that has not responded to medication or to less invasive procedures
- Endometriosis with severe pain that has failed medical and conservative surgical management
- Uterine prolapse, where the uterus descends into the vaginal canal
- Chronic pelvic pain clearly localized to the uterus after a thorough workup
Conditions where hysterectomy is the primary treatment:
- Cancer or pre-cancer of the uterus, cervix, or ovaries
- Uncontrollable bleeding after childbirth or surgery, as a life-saving measure
If your reason falls in the first group, an alternative almost certainly exists. Read the section below before you schedule anything.
The alternatives you should hear about first
Ask directly: what happens if I keep my uterus? A good answer covers these.
The levonorgestrel IUD. A hormonal IUD dramatically reduces menstrual bleeding for most women who use it, and for heavy bleeding without a large structural cause it is a reasonable first-line treatment. It is reversible, placed in the office, and lasts years. For many women considering hysterectomy for bleeding alone, this is the option that ends the discussion. See birth control for how placement works.
Medication. Tranexamic acid during your period, NSAIDs, combined hormonal contraceptives, or progestin therapy can each meaningfully reduce bleeding. Newer oral medications can shrink fibroid-related bleeding as well.
Endometrial ablation. A short procedure that destroys the uterine lining, reducing or stopping periods. It suits women who have completed childbearing and whose uterine cavity is not distorted by large fibroids. It is not contraception, and pregnancy after ablation is dangerous, so reliable birth control is still required.
Uterine artery embolization (UAE). An interventional radiology procedure that cuts the blood supply to fibroids so they shrink. No abdominal incision, shorter recovery than surgery. Effects on future fertility are not fully defined, so it is generally offered to women not planning pregnancy.
**Myomectomy.** Removal of fibroids while the uterus stays in place. The right choice if fibroids are the problem and you want to preserve fertility, or simply want to keep your uterus.
**Hysteroscopy.** For polyps or fibroids that sit inside the uterine cavity, removal through the cervix — no incision at all — can resolve the bleeding entirely.
If none of these fits your situation, or you have already tried them, hysterectomy becomes a reasonable and often excellent choice. The point is that it should be a decision, not a default.
The surgical approaches
How the uterus is removed matters more to your recovery than almost anything else about the operation.
Vaginal hysterectomy. The uterus is removed through the vagina, with no abdominal incision. Where anatomy allows it, this is the preferred approach — the least pain, the shortest hospital stay, the fastest return to normal life.
Laparoscopic hysterectomy. Performed through several small abdominal incisions using a camera and narrow instruments. Recovery is close to that of the vaginal approach. Often used when adhesions, endometriosis, or a larger uterus make the vaginal route difficult. See laparoscopy for what minimally invasive surgery involves.
Robotic-assisted laparoscopic hysterectomy. A variation of laparoscopy in which the surgeon operates instruments through a console. Useful for complex anatomy; recovery is broadly similar to standard laparoscopy.
Abdominal hysterectomy. Through a single larger incision, usually along the bikini line. Reserved for a very large uterus, extensive scarring, or suspected cancer. Recovery is longer and post-operative pain is greater, so it is chosen when there is a reason, not by habit.
ACOG's position is clear: minimally invasive approaches should be used whenever they are feasible and safe. If an abdominal hysterectomy is recommended to you, ask why the other routes are not suitable.
Total, supracervical, and what happens to your ovaries
Total hysterectomy removes the uterus and the cervix. Supracervical (partial) hysterectomy leaves the cervix in place — you will still need cervical cancer screening. Neither has been shown to be better for sexual function.
Your ovaries are a separate decision. Removing the uterus does not require removing the ovaries. If you have not reached menopause, keeping healthy ovaries is usually the better choice — see oophorectomy for why this matters more than most women are told. Fallopian tubes are often removed at the same time, which appears to lower ovarian cancer risk without affecting hormones.
What to expect
Before. Blood work, imaging, and often a biopsy of the uterine lining to rule out cancer. You will be asked to stop certain medications, particularly blood thinners and some anti-inflammatories. Nothing to eat or drink after midnight before surgery.
During. General anesthesia. Most hysterectomies take one to three hours depending on approach and anatomy.
After. Vaginal and laparoscopic patients often go home the same day or after one night. Abdominal hysterectomy usually means one to two nights in hospital. You will have some vaginal bleeding and discharge for several weeks — this is expected. Nothing in the vagina for about six weeks so the vaginal cuff can heal: no tampons, no douching, no intercourse.
Recovery timeline
- Week 1: fatigue, soreness, short walks several times a day. Prescription pain relief for a few days, then over-the-counter is usually enough after minimally invasive surgery.
- Weeks 2–3: most women who had vaginal or laparoscopic surgery are driving and doing light activity. Desk work is often possible.
- Weeks 4–6: gradually returning to normal routines. No lifting over about ten pounds until cleared.
- Week 6: post-operative visit. Intercourse and full exercise are usually cleared here after minimally invasive surgery.
- Weeks 6–8+: abdominal hysterectomy recovery runs longer, commonly six to eight weeks before full activity.
Everyone heals at a different pace. Fatigue that lingers a couple of months is common and not a sign that something is wrong.
Risks, honestly
Hysterectomy is a major operation and carries real risk:
- Bleeding, sometimes requiring transfusion
- Infection of the incision, vaginal cuff, or urinary tract
- Injury to the bladder, ureters, or bowel — uncommon, but serious when it happens
- Blood clots in the legs or lungs
- Anesthesia complications
- Vaginal cuff separation, a rare late complication
- Early menopause even with ovaries retained, in a minority of women
- Permanent loss of fertility, in every case
Call us urgently for heavy bleeding, fever over 100.4°F, worsening rather than improving pain, redness or drainage at an incision, chest pain, difficulty breathing, or calf pain and swelling.
Book a consultation
Dr. Adeeb Alshahrour, MD, FACOG, is a board-certified obstetrician-gynecologist at the Women's Health Center of Chicago, 4009 W Fullerton Ave. A hysterectomy consultation here starts with the diagnosis and the full range of options — including the ones that keep your uterus — so the decision you make is genuinely yours.
Bring your imaging, a record of what you have already tried, and your questions. Second opinions are welcome.
Book a consultation or see our locations. Learn more about Dr. Alshahrour and our gynecological surgery services.
Medical disclaimer
This page is for general education and does not replace individual medical advice. Surgical recommendations depend on your diagnosis, anatomy, medical history, and goals. Only a licensed physician who has evaluated you can advise on whether hysterectomy is appropriate. If you have severe bleeding, severe pain, fever, chest pain, or trouble breathing, seek emergency care immediately.