A hysterectomy is an operation to remove the womb. Done by keyhole surgery — laparoscopically — it involves several small incisions rather than one large one, with less pain and a faster recovery than open surgery.

It is a permanent step, so it is worth understanding both the operation and the alternatives before deciding.

Before you decide: what else could be tried?

Hysterectomy is usually considered when other treatments have not worked. Depending on your problem, the options that generally come first are:

  • Medical treatment — tablets to reduce heavy bleeding or pain
  • The hormonal coil (LNG-IUS) — often highly effective for heavy periods, and it avoids surgery entirely. See our guide to the hormonal coil
  • Endometrial ablation — treating the womb lining rather than removing the womb
  • Myomectomy — removing fibroids while keeping the womb, if fibroids are the problem. See our guide to laparoscopic myomectomy

If none of these has worked, or if they are not appropriate for your condition, hysterectomy becomes a reasonable and often very effective option.

The different types

  • Total laparoscopic hysterectomy (TLH) — the womb and cervix are removed entirely by keyhole surgery. See our detailed guide to TLH.
  • Laparoscopic-assisted vaginal hysterectomy (LAVH) — the womb is removed through the vagina, with keyhole instruments assisting from above.
  • Laparoscopic supracervical (subtotal) hysterectomy — the body of the womb is removed and the cervix is left in place.

What keeping the cervix means in practice: if your cervix is left behind, you will still need cervical screening, and a small number of women continue to have light monthly bleeding. Your surgeon will explain which type suits your situation and why.

What about my ovaries?

This is the question women worry about most, and the answer is usually reassuring.

Your ovaries are normally left in place. Removing the womb alone does not bring on the menopause — your ovaries carry on producing hormones as before. You will stop having periods and you will not be able to become pregnant, but you will not go through menopause as a result of the operation itself.

If there is a specific reason to remove your ovaries as well, it will be discussed with you beforehand and never done without your agreement.

Before the operation

You will have a physical examination, blood tests, an ultrasound scan and usually an ECG. Your surgeon will go through the procedure, the risks and the alternatives, and you will have the opportunity to ask questions before consenting.

The operation itself

Under general anaesthesia, a small incision is made near the navel and a laparoscope — a thin telescope with a camera — is passed into the abdomen, which is gently inflated with gas to give a clear view. Around three further small incisions allow the surgical instruments through. The womb is detached and removed, and the top of the vagina is closed with stitches that dissolve.

Hospital stay and recovery

Most women stay overnight and go home the following day.

A realistic recovery timeline:

  • Day of surgery — you will be encouraged to get up, walk a little and eat. Early movement reduces the risk of clots.
  • First week — tiredness and soreness are normal; pain is usually controlled with simple painkillers. Shoulder-tip discomfort from the gas settles within a few days.
  • Weeks 2–4 — gradually increasing light activity. No heavy lifting.
  • Weeks 4–6 — most women return to normal activities, including work, exercise and sex, though this varies.

Light vaginal bleeding or discharge for a few weeks is normal. Do not use tampons, and follow your surgeon's advice on when to resume sex.

Contact your doctor if you have heavy bleeding, offensive discharge, fever, worsening pain, or pain and swelling in a leg.

Risks

Laparoscopic hysterectomy is a safe, well-established operation, but as with any surgery there are risks: bleeding, infection, injury to the bladder, bowel or ureters, blood clots, and anaesthetic complications. Occasionally keyhole surgery has to be converted to open surgery. Serious complications are uncommon, and your surgeon will discuss them with you before you consent.

How it might feel

Deciding to have your womb removed can carry real emotional weight, even when the medical case is clear and even when you have finished having children. Relief and a sense of loss are both common, sometimes together. Talk to us about it, and to someone you trust.

The bottom line

Laparoscopic hysterectomy removes the womb with less pain and faster recovery than open surgery, and most women go home after one night. Your ovaries usually stay, so it does not cause menopause. Because it is permanent, make sure the alternatives have been properly discussed first.

References

  1. National Health Service. Hysterectomy [Internet]. NHS; [cited 2026 Jul 22]. Available from: https://www.nhs.uk/conditions/hysterectomy/
  2. National Institute for Health and Care Excellence. Heavy menstrual bleeding: assessment and management. NG88. London: NICE; 2018. Available from: https://www.nice.org.uk/guidance/ng88
  3. Royal College of Obstetricians and Gynaecologists. Patient information leaflets [Internet]. London: RCOG; [cited 2026 Jul 22]. Available from: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/