Heavy Bleeding, Fibroids & Pelvic Pain: When Do Women Need A Hysterectomy?

Last Updated:January 17, 2026, 18:37 IST

With awareness and careful guidance, most women can achieve relief from heavy bleeding, pelvic pain, and fibroids without resorting to hysterectomy unnecessarily.

A hysterectomy is a surgery to remove a woman’s uterus.

Prolonged periods, heavy bleeding, pelvic pain, or fibroids are common problems affecting many women today. In most cases, they are advised to undergo a hysterectomy as the only option left. But these symptoms can be easily treated sometimes with medication, hormonal treatments, or very delicate surgeries. Hysterectomy is usually the first option recommended, but it has the potential to cause the patient to lose her uterus unnecessarily and undergo long-term physical and emotional impact.

We speak to Dr Gayathri Kamath, Additional Director, Obstetrics & Gynaecology, Fortis Hospital, Bannerghatta Road, Bengaluru, to understand what a hysterectomy is and what other options are available for women.

A hysterectomy is a surgery to remove a woman’s uterus, the organ where a baby grows during pregnancy. Doctors often do it to treat heavy bleeding, fibroids, endometriosis, or cancer. Sometimes they also remove the cervix, ovaries, or fallopian tubes. After this operation, periods stop, and pregnancy is no longer possible. Recovery takes a few weeks

Common symptoms such as heavy menstrual bleeding, spotting between periods, pelvic discomfort, and bloating can often be addressed without removing the uterus. In fact, fibroids are non-cancerous tumours that sometimes do not need surgical excisions at all. The chance of fibroids turning malignant is less than 1%. Many patients are unaware that modern gynaecology now offers several uterus-preserving treatments that can effectively control symptoms while keeping the uterus intact.

Hormonal intrauterine devices (IUDs) like Mirena, for instance, are the ones that release small quantities of progesterone gradually inside the uterus. This helps reduce bleeding. In case the fibroids become troublesome, one can opt for a minimally invasive process such as laparoscopic or robotic myomectomy, where the fibroids are removed, but the uterus continues to function.

Another alternative is Uterine Artery Embolisation (UAE), a non-surgical method that cuts off the blood supply to fibroids, causing them to shrink away and thus reduce the bleeding without involving any major surgery.

The advantage of this stepwise treatment approach is that it prioritises safety and fertility preservation, reserving hysterectomy only for cases where conservative measures have failed or where malignancy is suspected. Jumping directly to surgery exposes women to risks such as surgical complications, loss of fertility, and long-term effects on cardiovascular and bone health that occur only when ovaries are removed.

If none of these options are feasible, one may then resort to a hysterectomy. With minimally invasive laparoscopic and robotic technology nowadays, recovery after hysterectomy has been very gratifying.

Before consenting to a hysterectomy, women should feel confident to ask questions: Are there minimally invasive options available? Could a hormonal IUD or UAE help my symptoms? What are the short- and long-term risks of removing my uterus? How will surgery impact my hormonal balance and overall health? Understanding all available options helps women make informed decisions that are tailored to their health and lifestyle.

The objective is to get rid of the symptoms in the most effective way possible while still keeping the uterus whenever possible. With awareness and careful guidance, most women can achieve relief from heavy bleeding, pelvic pain, and fibroids without resorting to hysterectomy unnecessarily.