What effects does it have?

What is it?

Permanent surgical removal of the uterus (womb).

It's also known as Hysto.

How long does it last?

The effects are permanent and cannot be reversed.

More information

Warning

Hysterectomy results in permanent destruction of the uterus (womb) and is irreversible. After hysterectomy you will be unable to become pregnant or give birth.

Warning

Not all types of hysterectomy remove the risk of cervical cancer. The cervix is only removed as part of an operation called a “total hysterectomy”. Ask your surgeon whether you will still need to be regularly tested for cervical cancer if you are unsure.

Hysterectomies are usually carried out because of cancer or other tumours of the uterus, cervix, fallopian tubes or ovaries. They are also sometimes carried out on people with very heavy periods.

In the UK, current guidelines recommend that people taking testosterone long-term should have a hysterectomy, usually within a maximum of 4-5 years after starting testosterone 1.

This is because testosterone suppresses menstruation (periods), and some medical professionals have theorised that this could lead to endometrial hyperplasia (thickening of the lining of the womb), which might increase the risk of cancer. However, most studies have indicated that endometrial hyperplasia either does not occur, or happens only in a small minority of people, and that the risk of endometrial cancer is low with only one known case 2.

Hysterectomy for people taking testosterone is optional and you may feel the risks involved in a major operation are unnecessary considering the extremely small probability of cancer. If you decide not to undergo hysterectomy it is recommended to have scans to check for thickening of the endometrium every two years to reduce this risk 2.

There several types of hysterectomy, which may or may not include removing the cervix or removing the ovaries and fallopian tubes (also known as salpingo-oophorectomy). If your hysterectomy does not involve salpingo-oophorectomy, you are still at risk of ovarian cancer 2.

Hysterectomy does not usually involve removal of the vagina, which is called a vaginectomy.

Hysterectomy is a major surgery and has a significant recovery time. You should expect to spend at least 4-6 weeks time recovering before you are ready to resume work or study. When you are discharged from hospital, your surgeon should provide you with a sick note to give to your employer.

You can read more about hysterectomy on the NHS Choices website.

Costs and funding

The NHS will normally fund total hysterectomy and salpingo-oophorectomy for patients who are undergoing testosterone therapy.

You will normally need to meet the following conditions:

  • persistent and well-documented gender dysphoria
  • capacity to make fully informed decisions and to consent to treatment
  • if significant medical or mental health concerns are present, they must be reasonably well controlled
  • two medical opinions, usually at least one from a gender clinic, that surgery is appropriate
  • 12 months’ continuous endocrine treatment as appropriate to the patient’s goals (unless the patient has medical contraindications or is otherwise unable to take hormones) 1.

Hysterectomy for other medical reasons is not subject to these requirements.

References

  1. 1 Royal College of Psychiatrists (2013) “Good practice guidelines for the assessment and treatment of adults with gender dysphoria.” [online] Available from: www.rcpsych.ac.uk/usefulresources/publications/collegereports/cr/cr181.aspx
  2. 2 Seal, Leighton J (2017) “Hormone Treatment for Transgender Adults,” in Bouman, W. P. and Arcelus, J. (eds.), The Transgender Handbook: A Guide for Transgender People, Their Families and Professionals, Nova Science Publishers Inc, pp. 227–249.

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Page last updated: September 2017