Hysterectomy is one of the most common surgical procedures performed on women in gynecology. With advances in modern medicine, hysterectomy has become a relatively straightforward and rapid operation. Whether performing a subtotal hysterectomy (removing the uterine body) or a total hysterectomy, specialists can complete the procedure efficiently.
Although national statistics on the number of hysterectomies performed in China are not available, the high volume of procedures suggests that many women lose their uterus unnecessarily. One surgeon alone commonly performs seven to eight such procedures each week, illustrating the scale of this practice.
Alarming Number of Hysterectomies
Two main scenarios lead to hysterectomy in clinical settings. The first is for genuine uterine disease requiring surgical intervention. The second involves women who have already had children requesting hysterectomy due to perceived inconvenience of menstruation, severe dysmenorrhea, or similar reasons. This trend is partly driven by some physicians’ guidance — such as the claim that the uterus is no longer necessary after childbirth — and can also serve as a source of increased medical revenue. Similar patterns and high hysterectomy rates have been reported in Taiwan.
Uterine fibroids, the most common benign tumor of the female reproductive tract, affect 20% to 40% of women aged 30 to 50. Nearly one in four women over 35 has uterine fibroids, and their prevalence has been rising in recent years. Despite this, the emergence of modern, minimally invasive and non-invasive treatments — including high-intensity focused ultrasound (HIFU) — means hysterectomy is often avoidable. Yet for various reasons, physicians still frequently recommend prophylactic hysterectomy.
Four Reasons Against Unnecessary Hysterectomy
In reality, hysterectomy is unwarranted for many women. Even experienced surgeons who have performed thousands of hysterectomies caution against removing the uterus without careful consideration, for the following four reasons:
- Three main surgical approaches are currently used: open abdominal hysterectomy, vaginal hysterectomy, and laparoscopic hysterectomy. Any surgery, regardless of size, is invasive and carries some degree of physical impact.
- No surgery is entirely free of complication risks. Even simple procedures can lead to issues such as intestinal adhesions, and pelvic surgery carries a risk of injury to the bladder, intestines, and other adjacent organs.
- Surgical accidents can occur, including risks associated with anesthesia.
- Even if surgery is completely successful with no complications or adverse events, hysterectomy can impair ovarian function. The uterus and ovaries share a connected blood supply; when the uterus is removed, approximately 30% of ovarian blood flow — supplied by branches of the uterine artery — is lost. Reduced perfusion compromises ovarian function, potentially leading to premature menopause, menopausal symptoms, and even accelerated aging.