Going Back to Work after a Hysterectomy

the impact of a hysterectomy

The impact of having a hysterectomy for a woman is huge. From the debilitating symptoms that lead up to it, to the excruciatingly emotional journey of the diagnosis of whatever condition is behind the symptoms. Then the physical recovery and the much-underreported emotional impact.

Imagine for example the usual pressures of a busy day at work. Now, imagine those same pressures while recovering from major surgery. Now add to that the shame, anxiety and pressure you’d feel if you’d tried to hide the very symptoms you’re hoping to get relief from for years because you’re worried about the impact on your career. You want to get back to work quickly, like it never happened and get on with the rest of your life because that’s what you’ve been trying to achieve for years (it currently takes around 8 years to get a diagnosis of endometriosis, for example, then the treatment process before it’s deemed a hysterectomy is needed can be another 3 or 4 years).

In this blog, we look more at the mechanics of hysterectomies, recovery needs and why this should matter to employers.

types of hysterectomy

A hysterectomy is the surgical removal of the uterus and it comes in many shapes and forms.

There is the total hysterectomy which is the removal of the uterus and cervix. The subtotal (partial) hysterectomy which removes the uterus while leaving the cervix intact. There is also the total hysterectomy with bilateral dalpingo-oophorectomy which removes the uterus, cervix, both ovaries, and fallopian tubes.

All of these options are life-changing and can bring about significant physical and emotional challenges. Women may experience fluctuating hormones, intense emotions and physical pain, all while trying to get their life back to normal (better than “normal” in many cases) and effectively manage their return to their responsibilities at work.

This is the reality for many women who undergo this procedure each year. And there are approximately 55,000 hysterectomies performed in the UK annually – that's a lot of women who are going through this intense journey – how many of your employees are included in that statistic?

employees have hysterectomies - fact

The fact is that employees undergo medical procedures, including hysterectomies, all the time. They face recovery periods, they deal with potential complications and they manage their emotional wellbeing, most of the time without any support of their employers over and above the usual sickness policies.

Many workplaces overlook these experiences, hoping (or assuming) they will resolve themselves swifty in the allotted sickness policy recovery period and supporting with phased returns and temporary adjustments until the staff member is back up and running. And that all works just fine.

But hysterectomies aren’t like key-hole knee ops or wisdom teeth removal.

Most women go through with the operation because they are told that it is the only remaining option – I was in that very same situation myself with my own endometriosis but chose not to listen to my doctors. That was around 25 years ago and, to date, I haven’t needed any type of surgery and have managed my own symptoms with only 2 flare-ups in that time. Had I listened to the doctors, I would have had my womb removed, pushing me into a permanent, early menopause at the age of 25. The impact this would have had on the rest of my life cannot be exaggerated. And chances are that my endometriosis symptoms would have returned anyway – studies argue different statistics, with the most commonly-cited probability of returning endo at 15% of women undergoing hysterectomy, but some studies show percentages as high as 65% return rate.

Of course, I write from a place of privilege. I had people in my life at that point who were able to help me look for alternatives. But most women don’t have that. I’ve worked with and talked to many women who have faced this “choice” and bar none, their viewpoint has been “the pain is unbearable, please just whip it all out - I can’t take it any more”.

So let me be very clear here, if they had a choice all of the women I know would reject a hysterectomy in favour of less invasive and life-altering alternatives. The scary thing is that most simply aren’t offered that choice. They go into hysterectomies, often knowing that their symptoms may well return, because they believe it is the only route left open to them. They are desperate.

Of course, not all conditions are like endometriosis and a hysterectomy is the only viable way of curing what they are going through, but this doesn't necessarily alter the emotional impact behind the surgery.

common reasons for hysterectomies

The main medical conditions leading to hysterectomies include:

Uterine fibroids (non-cancerous growths in the uterus)
Endometriosis (a condition where tissue similar to the lining inside the uterus grows outside it)
Prolapsed uterus (when the uterus slips from its normal position into the vaginal canal)
Persistent vaginal bleeding
Chronic pelvic pain
Cancer of the uterus, cervix, or ovaries

But I also want to reiterate here that a hysterectomy doesn’t actually give long-term resolution of symptoms in a lot of these cases. The medical conditions behind the operation are often not the real reason for the hysterectomy – the reality is that women have them because they feel there is no other option. They go into them often knowing that chances are their symptoms will come back and, even if they don’t, they will have a whole host of other things to deal with. But they are so desperate that they are willing to face or risk all of that for some respite from what they have been going through.

hysterectomy procedures and recovery time

Hysterectomies are most commonly performed on women between the ages of 40 and 50, though I faced the option in my mid-twenties and I’ve worked with many women who go through this much younger than 40. (Essentially, where a hysterectomy isn’t going to save a life, doctors will try to postpone it until the patient has had children or isn’t considering childbirth. This gives some indication of the emotional impact this life-changing surgery can have.)

Approximately 54% of hysterectomies are performed through an abdominal incision. Around 20% are done vaginally, which is less invasive and often has a quicker (physical) recovery time. Laparoscopic hysterectomy accounts for the remaining percentage and is performed using keyhole surgery techniques.

Physical recovery from a hysterectomy can vary, but generally, women are advised to take about 6 to 8 weeks off work for an abdominal hysterectomy, and about 3 to 4 weeks for a vaginal or laparoscopic hysterectomy.

That may be the physical recovery time from the operation itself, but in practice a hysterectomy can take months, if not years to recovery from fully, especially when you take into account the additional physical issues that often return (like endometriosis) and the emotional impact that can follow.

mental health and recovery following a hysterectomy

Women recovering from a hysterectomy often face mental health challenges such as anxiety and depression. Concerns about their physical recovery, the impact on their work, and their future can dominate their thoughts. Physical symptoms like pain and fatigue can further affect their mental wellbeing – these are the symptoms that they opted for the hysterectomy to resolve, and every shooting pain, every burning sensation, every twinge, pull or flinch brings worry that their symptoms may be returning already.

Plus we have the rollercoaster of emotions that surgery that disrupts hormones can create. Women’s hormones are delicately balanced. When we enter menopause naturally our bodies are preparing for it ahead of the transition; our hormones shift gradually towards the cessation of our periods and respond to each other to gradually move through this time. With a hysterectomy, however, overnight women can suddenly be dealing with menopause symptoms on top of the recovery from a major operation. In many cases, doctors prescribe HRT to mitigate the impact of this sudden menopause, but the unfortune downside of that is that the conditions / cases of the underlying conditions being exacerbated by oestrogen can see a resurgence in the original symptoms returning, and potentially returning quite quickly. The fear of this, let alone the impact of it actually happening, can have a devastating emotional impact.

Following a hysterectomy, emotions such as grief and intense feelings of loss are often felt as the possibility to have children is suddenly taken away. Grief and loss are difficult emotions to face at the best of times but when combined with physical discomfort and sudden rapid hormonal changes, they can really take their toll. Some women are offered counselling but not all, and the waiting times for this support are very varied depending on where you are. I’ve worked with many women who truly believed, at the time they consented to the surgery, that they didn’t want children, only to be hit with the grief and loss of having that option removed from them years later.

A hysterectomy in many cases isn’t fixing a broken piece of the body. It’s removing a massively important part of a women’s identity. It’s not like removing a gall bladder or tonsils or even a kidney, where your body readjusts and carries on pretty much as normal. It fundamentally changes the female body and we just don’t talk about it enough in these terms.

the stigma of hysterectomies

In the UK, many medical conditions, especially those affecting women's reproductive health, are unfortunately often surrounded by stigma. Most women feel the need to keep their menstrual health issues private, making up excuses for doctor visits or time off work because they don’t feel able to talk freely about their periods to their line manager.

Imagine how supported they would feel if they knew there was someone confidential to talk to about any issues impacting their work. Especially if that person was able to offer effective support to reduce symptoms, educate their colleagues and break down the stigma that is currently surrounding their symptoms.

Halcyon Women's Health® can provide that confidential support, offering a safe space for employees to discuss their fears and challenges about their hysterectomies with the objective of achieving a healthy, supported and motivated workforce. We can also help reduce the symptoms and minimise their impact, meaning less time off work and increased likelihood of a smoother and happier return to work.
After all, as an employer, supporting your employees' overall happiness and wellbeing can lead to increased loyalty and productivity so it really is a win-win.

addressing women’s health in the workplace and why it matters

Issues such as hysterectomies, menstrual problems, and fertility challenges can significantly affect a woman's professional life. In the UK, women have legal protections concerning their health, but employers must actively support these rights in the workplace.

HR managers need to be aware of their legal responsibilities and frameworks. If you need more confidence in this area, Halcyon Women's Health® can provide guidance and support.
Supporting women through their recovery from a hysterectomy can have a significant impact on your workplace. Flexible policies around hospital appointments and recovery times can prevent unnecessary days off work. By working together, we can break the taboo around these issues and create a more efficient and supportive work environment.

Imagine the productivity impact if all your female employees felt supported, understood, and able to manage their health effectively. And as we know, working in a place that ‘gets you’, has a real draw for new staff and makes existing staff more likely to stay.

As an HR manager, you can directly influence your organisation's bottom line by fostering a supportive work environment.

A motivated and supported workforce adds value to your bottom line. Employees who feel cared for during challenging times are more likely to be loyal and productive. It's time to address these tough topics with compassion and support.

what can HR Managers do to support employees through their menopause journey?

Employers need to be patient; recovery from hysterectomy doesn't often fit nicely into the usual sickness processes. As an HR manager, fostering open communication and reducing the stigma around hysterectomies is crucial. Start by creating an environment where employees feel comfortable discussing their health openly.
As an HR manager, you can:

Create an Open Environment: Encourage open discussions about women's health issues.
Offer Support Services: Engage with external specialists (like us!) who can provide information, support and guidance.
Implement Flexible Policies: Allow flexible working arrangements and time off for medical appointments.

By taking these steps, you can create a supportive and engaged workforce.

need help?

Halcyon Women’s Health® is here to help organisations address women's health issues effectively. Our award-winning training and support workshops and programmes help you create a supportive work environment, enhancing both employee wellbeing and organisational productivity.

From a free women’s health audit to onsite training and support, we can help.

about Sarah

Sarah Darwen is passionate about women's health. Diagnosed with endometriosis in her mid-20s and undergoing a chemically-induced (temporary ) menopause that didn’t provide long-standing relief for her symptoms, Sarah faced the possibility of a hysterectomy. She wasn’t ready to take such a drastic step and found alternative ways to manage her condition. She has successfully managed her symptoms for over 20 years and now offers training and support to organisations on reproductive, hormonal, and menstrual health as well as working directly with women to help them get their lives back and find happiness beyond their symptoms.
For more information on how Halcyon Women’s Health® can help your organization, please book a free Discovery Call here: Halcyon Women's Health® or email.

references

Sage Journals: https://journals.sagepub.com/doi/pdf/10.1177/2055102919860635#:~:text=There%20is%20lit%2D%20tle%20research,The%20Hysterectomy%20Association%2C%20n.d.).

Royal College of Obstetricians and Gynaecologists (RCOG). https://www.rcog.org.uk/media/dlafmg2l/pi-morcellation-for-myomectomy-or-hysterectomy.pdf

National Institute for Health and Care Excellence (NICE). "Hysterectomy for Heavy Menstrual Bleeding." https://www.ncbi.nlm.nih.gov/books/NBK569015/

Office for National Statistics (ONS). Healthcare Procedures Data. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem