Hysterectomy Types and Menopausal Hormone Therapy

4
 minutes
Aug 21, 2021
Medically reviewed by: 

Hysterectomies: Understanding Your Procedure

About 20 million American women have had a hysterectomy. However, not every hysterectomy is the same. Some include removal of ovaries and/or the cervix, while others remove just the uterus. As you explore hormone therapy for menopause, it's important to know what kind of hysterectomy you've had—which organs were removed and which remain—because these details are necessary for you to get appropriate treatment.

Here are the main types of hysterectomies and pelvic procedures common to women in midlife along with their technical, surgical name, which is the one your medical chart should reflect:

Name of procedure (short-form)

Organ(s) removed

Organs left inside you

Total abdominal hysterectomy (TAH)

Uterus including cervix

Both right and left ovaries

Total abdominal hysterectomy (TAH-BSO)

Uterus including cervix and both ovaries

No reproductive organs remain

Total abdominal hysterectomy with unilateral salpingoophorectomy (TAH-R or L SO)

Uterus including cervix and: Right ovary (RSO), Left ovary (LSO)

One of your ovaries and it’s important to know which one

Total laparoscopic hysterectomy (TLH)

Uterus including cervix

Both right and left ovaries

Subtotal laparoscopic hysterectomy (SubTLH)

Uterus (not cervix)

Cervix remains (Pap tests needed)

Radical hysterectomy with bilateral salpingoophorectomy

Uterus including cervix and both ovaries and both fallopian tubes

No reproductive organs remain (usually for precancer or cancer diagnosis)

Other Pelvic Surgery

   

Salpingectomy (R or LSO)

One or both fallopian tubes

Ovaries, unless specified, are still inside you

Oophorectomy

One or both ovaries

Fallopian Tubes, unless specified, are still inside you

Bilateral salpingoophorectomy (BSO)

Both ovaries AND tubes

Uterus, unless specified, is still inside you

This may seem complicated, but knowing which organs were removed, which remain, and which need ongoing surveillance or screening is an important way to advocate for your own health. If you don’t know or you're not sure, call the office of the doctor who performed your procedure and get that information.

Here's just one example of why an accurate surgical history is important: If your cervix has not been removed as part of your hysterectomy, you’ll need to continue to have occasional pap smears to screen for cervical cancer. Similarly, if you still have your fallopian tubes and/or ovaries, you’ll need to continue having pelvic exams to screen for ovarian cysts, ovarian cancer, or fallopian tube problems.

Hormone Therapy After Hysterectomy

If you've had your uterus removed, only estrogen is needed and not progesterone. Studies to date reveal that estrogen, taken alone, has the lowest risks and may actually have a lower risk for breast cancer than post-menopausal women who don’t take any hormones at all.

The bottom line

Understanding your body and being educated about past surgeries is key to maintaining your health. Whether you are taking menopausal hormone therapy or not, maintaining an accurate record of surgeries and procedures will help you and your doctor ensure you get the most appropriate treatment.