Blog article
Is hysterectomy needed for heavy periods?
Heavy menstrual bleeding (HMB) affects around 1 in 4 Australian women of reproductive age.1
It’s more than just an inconvenience – it can disrupt day-to-day life, affect mental health, and cause sufferers to feel physically and emotionally drained, making effective management crucial.2
Hysterectomy (surgery to remove the uterus) has traditionally been frequently used to treat HMB. Thanks to advances in medicine, however, newer, less invasive treatments are now available, allowing women to manage their symptoms effectively without needing this major surgery.3
What causes heavy menstrual bleeding?
There are many reasons someone might experience heavy periods, including:2
- Hormonal imbalances
- Fibroids or polyps in the uterus
- Blood clotting disorders
To find the cause, your doctor will usually:2
- Ask about your symptoms and medical history
- Do a physical exam
- Order blood tests or an ultrasound
- Sometimes recommend a hysteroscopy (a small camera inserted into the uterus), which can include taking a biopsy
How is heavy menstrual bleeding treated?
Treatment depends on your symptoms, preferences, and whether you want to have children in the future. Options fall into two main groups, medical and surgical interventions:2
1. Medical treatments (no surgery required):
- Non hormonal treatments like tranexamic acid or non-steroidal anti-inflammatory drugs like ibuprofen (NSAIDs) to reduce bleeding and pain.
- Hormonal treatments such as the levonorgestrel-releasing intrauterine system (LNG-IUS) – a small device placed in the uterus that’s highly effective and recommended as a first-line option. The pill or progesterone-based medications are also widely used.
2. Surgical options:
- Minimally invasive procedures like endometrial ablation (removing the lining of the uterus) and uterine artery embolisation (reducing blood flow to fibroids) are highly effective for those who aren’t wishing to preserve their fertility.
- While effective, a hysterectomy is associated with higher risks, longer recovery times, and significant costs. For these reasons, it’s generally reserved for cases where other treatments have failed or cannot be performed.3
Is hysterectomy the right choice for treating heavy menstrual bleeding?
Not usually, but every woman’s experience is different. Between 2021-22, over 24,000 hysterectomies were performed in Australia for non-cancer reasons – and heavy periods were the most common cause. This figure means Australia performs more hysterectomies than many similar countries, including the UK and New Zealand.4
Since hysterectomy is a major operation with a long recovery and a 4.9% risk of serious complications (when performed through the abdomen),⁶ and research which shows that non-surgical treatments help 77–80% of women avoid surgery after five years,⁵ organisations like the Australian Commission on Safety and Quality in Health Care recommend trying uterus-preserving treatments first.⁴
In other words, hysterectomy should typically only be considered when other treatments haven’t helped or aren’t possible.4
Making the right choice for you
Every woman’s experience is different. The best treatment is the one that fits your symptoms, your needs, and your lifestyle. Choosing Wisely, an initiative supported by the Australian Government, encourages people to ask their doctors: Is this test or procedure really necessary?
Understanding your options means you can make confident, informed decisions – and focus on treatments that genuinely improve your health.
If you do need a hysterectomy, HBF is here to help. Log in to myHBF or give us a call to check your level of cover and find a specialist using our Find a Provider tool.
