Hysterectomy (womb removal)
An operation to remove the womb, used for several conditions; it permanently ends periods and the ability to carry a pregnancy.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A hysterectomy removes the womb and permanently ends periods and the ability to carry a pregnancy.
- It is major surgery, so for benign conditions less invasive, reversible options are usually considered first.
- There are three main approaches — vaginal, keyhole and abdominal — which differ in scars and recovery.
- Whether to also remove the cervix, ovaries or tubes is a separate decision; removing the ovaries before the menopause causes an immediate menopause.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Can permanently stop heavy or painful periods when other treatments have not worked
If you may want a pregnancy in future, a hysterectomy is not the right choice for benign disease — fertility-sparing options should be explored.
You will be helped to get up and walk early to reduce clot risk. You may have a catheter and drip for a short time. Pain relief is given, and the team...
Clear written instructions on wound care, activity, driving and when sex is safe.
You will be helped to get up and walk early to reduce clot risk. You may have a catheter and drip for a short...
Expect tiredness, some pain and period-like bleeding. Do gentle activity and short walks, avoid heavy lifting, and...
Energy gradually returns. Many people resume light activities and driving once comfortable and able to do an...
Most people having abdominal surgery are recovering well by now; recovery is often quicker after vaginal or...
What is a hysterectomy?
A hysterectomy is an operation to remove the womb (uterus). It is used for conditions such as heavy or painful periods, fibroids, prolapse, severe endometriosis or adenomyosis, and for some cancers. Removing the womb permanently stops periods and means you can no longer carry a pregnancy.
It is major surgery and the change is permanent, so for benign (non-cancer) conditions it is usually considered only after less invasive, reversible options — such as a hormonal coil, other medicines, or smaller procedures — have been tried or carefully discussed. For cancer, the decision is different and is made by a specialist team.
There are different types. The womb can be removed through the vagina, by keyhole (laparoscopic) surgery, or through a cut in the tummy (abdominal). Sometimes the cervix, and occasionally the ovaries and tubes, are removed too — each of these is a separate decision with its own effects. If the ovaries are removed before the menopause, this brings on the menopause straight away.
This guide explains the types, what to expect and the risks, so you can have a fuller conversation with your surgeon. It does not replace that personal discussion.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Comparing the three approaches
| Approach | Scars | Typical recovery |
|---|---|---|
| Vaginal | No external scar | Often the quickest |
| Laparoscopic (keyhole) | A few small (0.5–1 cm) scars | Usually quicker than open |
| Abdominal (open) | One larger lower-tummy scar | About 6–8 weeks |
The best approach depends on the reason for surgery, the size of the womb and your anatomy — not just preference.
Preparing for your surgery
- Make sure you understand why a hysterectomy is being recommended and that less invasive options have been discussed, if your condition is benign.
- Discuss which approach (vaginal, keyhole or abdominal) is planned and why, and whether the cervix, ovaries and tubes will be removed.
- If your ovaries may be removed before the menopause, ask about HRT and the effects of an immediate menopause.
- Stop smoking beforehand if you can, as it slows healing and raises complication risk.
- Tell the team about all medicines, especially blood thinners, and about any health conditions.
- Arrange time off work (often several weeks), help at home, and a lift home, as you cannot drive for a while.
- Ask about measures to prevent blood clots, such as stockings, injections and early walking.
What happens
A hysterectomy is usually done under general anaesthetic, so you are asleep; sometimes a spinal or epidural is used. The operation takes around one to two hours depending on the approach.
Depending on the type, the surgeon removes the womb through the vagina, through a few small keyhole cuts, or through a cut in the lower tummy. The cervix, ovaries and tubes are removed or left according to the agreed plan. The top of the vagina is closed with stitches that dissolve.
Afterwards you wake up in recovery. You may have a drip, a catheter to drain urine for a short time, and some vaginal bleeding like a period. Pain relief, anti-clot measures and early gentle walking are part of the recovery. Most people stay in hospital for one to a few days, longer after an abdominal operation. The team will explain wound care and what to expect before you go home.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- If you may want a pregnancy in future, a hysterectomy is not the right choice for benign disease — fertility-sparing options should be explored.
- For benign conditions, surgery is usually not appropriate until less invasive, reversible treatments have been tried or fully discussed.
- It will not help symptoms that are not actually coming from the womb, such as some bladder, bowel or nerve pain.
- Some people are at high surgical risk because of other health conditions, where the risks may outweigh the benefits.
Delay surgery if…
- There is any chance you are pregnant.
- You have an active infection that should be treated first.
- Your anaemia or other medical problems need optimising before major surgery.
- You have not yet had a full discussion of alternatives, the approach, and whether your ovaries will be kept, or you feel unsure or rushed.
Alternatives to discuss
- A hormonal coil (LNG-IUS) or other medicines for heavy or painful periods
- Smaller procedures such as endometrial ablation, fibroid removal (myomectomy) or uterine artery embolisation
- A pessary or prolapse repair instead of hysterectomy for some prolapse
- Watchful waiting, especially if symptoms are mild or the menopause is near
- A second opinion before committing to permanent surgery
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Can permanently stop heavy or painful periods when other treatments have not worked
- Can relieve symptoms from large fibroids, prolapse or severe endometriosis or adenomyosis
- Removes the womb as a source of certain cancers, when that is the reason for surgery
- For the right person, can greatly improve quality of life
- Removes the need for ongoing treatments aimed at controlling those symptoms
Risks & complications
- Pain, tiredness and bruising for the first weeks
- Vaginal bleeding or discharge for a few weeks
- Temporary bladder or bowel upset, including constipation and urinary infections
- Wound discomfort, and a scar after abdominal or keyhole surgery
- Wound or pelvic infection needing antibiotics
- Heavier bleeding, sometimes needing a blood transfusion
- A collection of blood or fluid at the top of the vagina
- Keyhole or vaginal surgery occasionally needing to be changed to an open operation
- Damage to the bladder, bowel or the tubes between kidney and bladder (ureters), sometimes needing further surgery
- Blood clots in the legs or lungs
- The top of the vagina later weakening or prolapsing
- Serious complications and, very rarely, life-threatening problems, as with any major surgery
The biggest things to weigh are that this is major surgery and that it is permanent — there is no going back on losing periods and fertility. Serious complications are uncommon but real, and include injury to the bladder, bowel or ureters and blood clots. Ask your surgeon about their planned approach and why, your personal risk, whether your ovaries will be kept or removed, and what the realistic recovery looks like for you.
Published figures to discuss
Risk depends strongly on the route (abdominal, laparoscopic or vaginal), the reason for surgery, previous surgery, endometriosis or fibroids, and general health. RCOG consent materials quote different risks by route; use the figures below as discussion prompts, not a personal prediction.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Overall serious complications after abdominal hysterectomy | About 4 in 100 in RCOG consent advice | Risk is higher with obesity, significant pathology, previous surgery and other medical problems. | RCOG — Recovering well after laparoscopic hysterectomyrcog.org.ukSource-linked context |
| Bladder or ureter injury | Around 2–7 in 1,000, depending on route and complexity | May need repair during the operation, a catheter for longer, a stent, or further treatment. | NHS — Hysterectomynhs.ukSource-linked context |
| Bowel injury | Low single digits per 1,000 in consent materials, higher in complex pelvic surgery | Previous surgery, severe endometriosis or adhesions can increase the risk. | NHS — Hysterectomynhs.ukPublished figure |
| Bleeding needing transfusion or return to theatre | Up to around 2 in 100 in some RCOG route-specific consent advice | Bleeding risk depends on route, uterine size, pathology and medicines. | RCOG — Recovering well after laparoscopic hysterectomyrcog.org.ukSource-linked context |
| Later vaginal vault prolapse | Reported around 1.8% after hysterectomy for non-prolapse benign disease and 11.6% after hysterectomy for prolapse | RCOG notes wide historical ranges; pelvic-floor risk should be discussed before surgery. | RCOG — Recovering well after laparoscopic hysterectomyrcog.org.ukPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery from a hysterectomy takes weeks, and longer after an abdominal (open) operation than after vaginal or keyhole surgery. Building back gradually, while avoiding heavy lifting and straining, helps healing.
- Tiredness that improves week by week
- Period-like vaginal bleeding or discharge for a few weeks
- Some wound soreness, and numbness or tingling near an abdominal scar
- Mild emotional ups and downs as you recover
- A temporarily unsettled bladder or bowel
Aftercare
- Take pain relief as advised and keep mobile with short, regular walks to lower clot risk.
- Avoid heavy lifting, straining and strenuous activity for several weeks.
- Keep wounds clean and dry, and follow advice on stitches or dressings.
- Avoid sex until at least 6 weeks and your team says internal healing is complete.
- Do not drive until you are comfortable, off strong painkillers, and can do an emergency stop.
- Eat well and stay hydrated, and treat constipation early to avoid straining.
- Keep follow-up appointments, and continue cervical screening if your cervix was left in place.
- Several weeks off work arranged, with help at home for the first days
- A lift home and someone to help in the first days
- Loose, comfortable clothing and sanitary pads (not tampons) for bleeding
- Pain relief and any anti-clot medicines or stockings ready
- A plan for HRT discussed if the ovaries are being removed before the menopause
- The clinic's contact details and out-of-hours number saved
Scars and how they heal
The scar depends on the approach. A vaginal hysterectomy leaves no external scar; the only stitches are inside the vagina and dissolve. A laparoscopic (keyhole) hysterectomy leaves a few small scars about 0.5–1 cm long on the tummy, which usually fade well. An abdominal hysterectomy leaves one larger scar in the lower tummy, most often along the bikini line, occasionally up-and-down for a large womb or some cancers; this scar is firm and pink at first and fades over months, and the skin near it may feel numb for a while. Sun protection and good wound care help scars settle.
⚠ Get urgent help if…
- A hot, swollen, painful calf, or sudden breathlessness or chest pain (possible blood clot — call 999)
- Heavy vaginal bleeding, or bleeding that soaks pads quickly
- A high temperature, feeling very unwell, or a wound that is red, hot or leaking (possible infection)
- Severe or worsening tummy pain not eased by your painkillers
- Being unable to pass urine, or pain and burning when passing urine
- A swollen tummy with vomiting or being unable to open your bowels
- Offensive vaginal discharge
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
For the right person, a hysterectomy can permanently relieve heavy or painful periods, fibroid symptoms, prolapse or other problems that have not responded to other treatments, and can greatly improve quality of life. Periods stop straight away and permanently.
What it cannot do is be undone, and it does not treat problems that are not coming from the womb. It is major surgery with a real, if uncommon, risk of serious complications. A good surgeon is clear about why it is being recommended, what else could be tried for benign disease, and what recovery and risks are realistic for you.
The effect on periods is permanent and immediate. If the ovaries are kept, they usually keep working until your natural menopause; if they are removed before the menopause, the menopause begins straight away and HRT is often discussed. Over the longer term, the top of the vagina can occasionally weaken or prolapse, which may rarely need further treatment. If a subtotal hysterectomy leaves the cervix, you still need cervical screening.
Combining with other procedures
A hysterectomy is sometimes combined with other procedures, such as a prolapse repair or removal of the ovaries and tubes, when this is clinically appropriate. Whether to remove the ovaries is a balance between any benefit (such as reducing some cancer risks) and the effects of an early menopause, and should be discussed specifically rather than assumed.
Follow-up & long-term care
You will usually have a check-up after surgery to review healing and discuss the results, including anything found on the removed tissue when relevant. If your ovaries were removed before the menopause, follow-up includes managing menopausal symptoms and HRT. Report bleeding, pain or discharge that is not settling, and continue cervical screening if your cervix was kept.
- Continue cervical screening if a subtotal hysterectomy left your cervix in place.
- Review HRT and menopausal symptoms if the ovaries were removed before the menopause.
- Keep up pelvic-floor exercises to help support the top of the vagina.
- Seek review if new bulging, bladder or bowel symptoms appear later.
Revision and secondary surgery reality
- Keyhole or vaginal surgery occasionally has to be changed to an open operation during the procedure.
- If the bladder, bowel or ureters are injured, further surgery may be needed to repair them.
- The top of the vagina can later weaken or prolapse, sometimes needing treatment.
- Removing the ovaries cannot be reversed, so the decision to keep or remove them should be made carefully beforehand.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Clear written instructions on wound care, activity, driving and when sex is safe.
- Active measures to prevent blood clots, with advice on warning signs.
- A named contact and out-of-hours route for problems such as bleeding or infection.
- A plan for HRT and menopause symptoms if the ovaries were removed before the menopause.
- Follow-up to review healing and any tissue results, and advice on continuing cervical screening if the cervix was kept.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The surgeon's fee and the complexity of your case
- The anaesthetic and the anaesthetist's fee
- The approach used (vaginal, keyhole or abdominal) and theatre time
- The length of hospital stay
- Tests before surgery and analysis of the removed tissue
- Follow-up appointments and aftercare
- How any complications or readmissions are covered
- The surgeon's and anaesthetist's fees
- The hospital/theatre fee and expected length of stay
- What is included if you stay longer or are readmitted
- The cost of pre-operative tests and analysis of removed tissue
- Follow-up appointments and aftercare
- What happens, and what it costs, if a complication occurs
- The cancellation policy
On the NHS? Hysterectomy is commonly available on the NHS when clinically needed; private care is sometimes used for a quicker appointment, choice of surgeon, or a second opinion.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Agreeing to surgery for benign disease without a clear discussion of less invasive, reversible options.
- Not understanding that periods and fertility end permanently.
- Not realising that removing the ovaries before the menopause causes an immediate menopause.
- Being unclear whether the cervix is being kept (and so whether you still need cervical screening).
- No clear plan for emergency symptoms such as signs of a blood clot or serious bleeding.
Marketing red flags
- Presenting hysterectomy as a quick or simple 'fix' for benign period problems.
- Promoting one approach without explaining which is actually right for your anatomy and condition.
- Downplaying that the operation is major and permanent.
- Not discussing the effects of removing the ovaries, or the need for HRT.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Why is a hysterectomy being recommended, and what less invasive options could I try first?
- Which approach (vaginal, keyhole or abdominal) do you recommend for me, and why?
- Will my cervix, ovaries and tubes be removed or kept, and what are the effects of each?
- What is my personal risk of serious complications such as bladder, bowel or clot problems?
- If my ovaries are removed, will I need HRT, and how will menopause symptoms be managed?
- What does recovery realistically look like for me, and when can I return to work and normal life?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will I definitely lose my periods and fertility?
Will I go through the menopause after a hysterectomy?
Which type of hysterectomy will I have?
How long is the recovery?
Do I still need cervical screening?
Can I get a hysterectomy on the NHS?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Hysterectomy NHS — Hysterectomy recovery RCOG — Recovering well after laparoscopic hysterectomy RCOG — Recovering well after vaginal hysterectomy NICE NG88 — Heavy menstrual bleeding (alternatives before surgery) RCOG — Consent advice for abdominal hysterectomy (PDF) RCOG — Consent advice for vaginal hysterectomy (PDF) RCOG — Post-hysterectomy vaginal vault prolapse
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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