Preparing For Radical Hysterectomy

co written by Hannah Charman and Jeanette Brown

What is a Radical Hysterectomy?

Some hysterectomies are called partial hysterectomies, because they only remove the uterus itself, leaving the ovaries and cervix behind. With a radical hysterectomy, the uterus, ovaries, fallopian tubes and surrounding tissues, including some lymph nodes are removed. This is a common procedure where there is cancer in the ovaries, uterus or cervix. I’ve written this to be relevant for any form of hysterectomy where your ovaries are being removed.

If you’ve already gone through menopause, losing your ovaries isn’t going to have such an impact, although you may notice some new symptoms if your ovaries were still producing testosterone. If you’re still having periods, taking out your ovaries is going to throw you into menopause immediately after surgery, so it helps to be prepared and minimise the impact as best you can.

What is Menopause?

The official definition of menopause is the permanent cessation of periods, but there’s far more to it than that! During menopause our reproductive hormones decline in a mirror image to adolescence. Both transitions normally happen over a number of years, with your body driving the process, and hopefully keeping the right checks and balances in place to ensure it goes as smoothly as possible.

Your ovaries are part of your endocrine system, which creates your reproductive hormones. Most of the type of oestrogen you need to drive your menstrual cycle is made in your ovaries, along with some of your progesterone and testosterone. During a natural menopause, the ovaries stop producing the most potent form of oestrogen, and production of less potent forms moves up the chain to the adrenal glands. This process can take anywhere from 2-14 years, but normally takes around 7 in the UK.

With a surgical menopause from a radical hysterectomy, the body is not driving the process and can’t prepare as it naturally would. Suddenly being without the main source of your key reproductive hormones will come as a shock, and inevitably lead to menopause symptoms starting straight away. Whether you’re going through a natural or surgical menopause, there are always means of supporting your body as it readjusts. Although your body will need most care after the procedure, there’s a lot you can do to reduce your menopause symptoms beforehand too, depending on how much time you have before your surgery. By ensuring you’re as fit and well as possible before your hysterectomy, you maximise the chances of a smooth and speedy recovery.

How To Prepare For A Hysterectomy At Home

Many of my patients say that they’d underestimated how long their recovery would take, and that they couldn’t return to normal life as soon as expected. With this in mind, clear as much recovery time and space for yourself as you possibly can. If you’re able to organise help with childcare, housework or running your business, do. Be aware that you might need more time off work than you think, and little things like batch cooking and freezing meals can make a big difference.

If you can, prepare some light nutritious foods for visitors to bring into hospital for you whilst you start to recover. Soups made with bone or vegetable broth or miso are ideal, as well as vegetable smoothies and juices. Papaya and pineapple contain constituents which help to prevent blood clotting after surgery, and are best eaten between meals.

Think about ways that you can prepare your mind and body for a radical hysterectomy. Starting with your mind, it’s normal to feel apprehensive and your healthcare team will be able to help reassure you about any specific concerns you may have. Some women have a lot of fear around the surgery, especially if they’re already highly stressed following a cancer diagnosis. If you have any anxiety about your surgery, or treatment in general, advanced hypnotherapy can really help you feel more in control. It’s also great for helping to manage pain levels, and I use a technique called ‘hypnohealing’ which helps to stimulate your body’s own healing processes.

Daily meditation before surgery has been shown to:

reduce pain and recovery times
maintain healthy heart function
reduce risk of bleeding during and after
keep stress and chronic inflammation at low levels

It takes time and patience to get the hang of meditation, so if you’ve never tried it before, join a class if you can. Otherwise there are online classes, and apps like ‘Calm’ which talk you through. There are different forms of meditation too, so try a few out and see which work best for you.

Detoxing Before Hysterectomy

The idea behind doing a detox before a hysterectomy is to ensure your liver and other eliminatory organs are in the best possible condition to deal with the medication you’ll be taking. It’s usually safe to do some form of detox regime in the run up to a hysterectomy but if you’re on cancer medication in particular, it may be best to stick to a gentle food detox rather than a herbal one. Drinking fresh organic green vegetable juices daily and having a couple of servings of fresh or frozen berries, apples or pears is a good place to start. Don’t detox without professional supervision if you have abnormal blood pressure, blood sugar or you’re very fatigued.

Diet For Hysterectomy

It’s important to be as well nourished as possible before your surgery, although I’m a firm believer in ‘a little of what you fancy does you good’ too! Aim to eat well at least 80% of the time, and when you have a treat, make sure you really enjoy it. As a rough guide it helps to:

Batch cook from fresh and freeze some for after your surgery.
Ensure you have some form of good quality dense protein with each meal.
Drink plenty of water, organic vegetable/fresh herb smoothies and herb teas.
Limit caffeine drinks to 2 daily, and keep alcohol intake as low as possible.
Include one probiotic food or drink a day.
Make and drink bone broths from a variety of raw bones, preferably from traditionally raised animals. Alternatively drink Aloe vera juice to heal and seal the gut.

Other Ways To Prepare For A Hysterectomy

Fitness makes a huge difference to your risk of complications after surgery. Fit people have just a 4% risk whereas unfit people have a 22% risk, so it’s important to exercise as best you can every day. That said, over exertion can be harmful too, so find forms of exercise that you enjoy and don’t overdo it. Jeanette will talk more about why it’s vital to work on your core strength in particular before a hysterectomy, and where to start later.

Herbal Remedies For Hysterectomy

Herbal treatment can be a little more tricky to manage around surgery even when you’re working with a Medical Herbalist. Doctors don’t have training in herbal medicine, so tend to err on the side of caution and warn patients off taking herbs before and after surgery. I recommend avoiding taking herbs for 4 days either side of your surgery, as a precaution rather than because I think there’s any genuine risk of them causing a problem.

Herbs can be used in various ways to help you prepare and recover from surgery, and some of my patients have even cancelled their hysterectomy because it was no longer needed once they’d been taking herbs for a while! Here are a few ways herbs could help you.

Coping With Stress and Anxiety

The prospect of surgery can be stressful, as well as dealing with the reasons for needing it in the first place. Chronic stress puts quite a strain on body and mind, contributing to inflammation, and overproduction of stress hormones. The adrenal glands which will be making your oestrogen after your hysterectomy will need to be as rested as possible, and using herbs alongside good sleep and stress management can be really helpful.

Adaptogens are herbs which nourish the adrenal glands and help you out of your stress response. Particularly good choices for before and after hysterectomy include Eleutherococcus, Shizandra, Ashwagandha and Liquorice.

Nervines work well alongside Adaptogens, but have a more direct action on the nervous system, helping to stimulate or relax as needed. Good choices in the lead up to surgery would include Lemon Balm and Lavender. Gotu kola can be used after surgery to encourage wound healing and repair.

Improving Immunity

There are 2 aspects to this: We want a normal inflammatory response AND to minimise the risk of infection.

Inflammation is a normal part of the healing process after surgery, but it needs to move properly through the different stages. Unfortunately, our modern lifestyle primes us for chronic inflammation which is not at all healthy, and will hinder your recovery, so we need to try and manage the inflammatory processes that will inevitably happen. Much of this is already covered in the lead up to your surgery, with the detoxing, healthy eating, deep relaxation and gentle exercise. Herbs like Astragalus, along with certain medicinal mushrooms can be hugely helpful in regulating immune function in the preparation for your hysterectomy. Don’t start taking Astragalus when you already have an infection – it’s best used as a preventative.

Exercises To Prepare For Hysterectomy

When we are waiting for surgery, it can feel like our life is on hold, and we’re too scared to move.

Whatever the reason for having a hysterectomy, we still need to move our bodies for our physical and mental health.

But what can you do?

We start with your breathing. How you breathe has an impact on your pelvic floor and core muscles. We will first address the diaphragm, your biggest breathing muscle. Whether you are a seasoned athlete or have a sedentary lifestyle, you can make some small changes to how you breathe which will benefit you pre-surgery and aid in your recovery post-surgery.

We need to ensure the remaining pelvic organs, the bladder and rectum, are held in place with muscle, tendons and ligaments of the deep core muscles.

Here is your free guide where we explain how your breath is connected to your pelvic floor, including suitable instructional videos.

Breathing and Your Pelvic Floor/Core

There are gentle movement exercises and breathing techniques to practice before and post-surgery.

Follow the ten-minute warm-up video on page six in this guide BUT if you feel pain or sensitivity, please listen to your body and take a break.

What to Expect During And After Hysterectomy

There are a number of different ways that hysterectomies can be performed, and your surgeon will talk you through the plan for your procedure nearer the time. The team caring for you in hospital will give you pain relief and encourage you to move around as much as you comfortably can. Movement helps you to recover faster as you’re less likely to get clotting problems or chest infections. It also helps to move the lymph which delivers healing nutrients and oxygen to your abdomen, and even a small change of scene will help to lift your mood.

You might well feel quite emotional after your surgery, especially if your hysterectomy was needed because of ovarian, uterine, cervical or breast cancer. It’s natural that anyone on a cancer journey will find it hard to cope with at times, but now we have the sudden hormone changes to factor in as well. Whatever happens, try to be gentle and patient with yourself as you recover, and take each day as it comes.

Alternative Hormone Replacement Therapy After Hysterectomy

It’s very difficult to give specific pointers for this section, as we all experience surgical menopause differently, and we each have our own backstory. All I can say is that herbal remedies can be really effective in helping your body to readjust after hysterectomy. Patients I’ve seen in this situation have seen great results from having a personalised herbal prescription made up for them, and their symptoms have started to calm down within a few days.

My herbal prescriptions typically contain a blend of nervines, adaptogens, hormone balancing herbs, and herbs for specific symptoms such as hot flushes. In the unlikely event that you experience any complications after surgery, your herbal prescription can be adjusted accordingly and aid your recovery. The Herbal Hormone Reset programme would be a great place to start, or you can book a free call with me here.