Some women prefer an abdominal/pelvic surgical intervention (a myomectomy) that removes the fibroids and muscle tissue, but spares the uterus. However, 15-30% of women who have a myomectomy eventually require further surgery because fibroids can recur. A myomectomy requires a search for a very competent surgeon because greater skill is required in the procedure. Even if a woman is not concerned about protecting her fertility, a myomectomy should still be considered as an alternative to a hysterectomy. A hysterectomy appears to be too great a sacrifice for a condition that is considered to be benign 99.9% of the time. However, 30% of hysterectomies performed are to remove fibroids.
It is thought that much of an individual's sexual response is psychic in origin. Therefore, if a woman considers that her internal feminization is a part of her sexual mystique, then the absence of her uterus could prove to be her undoing: 25% of women who have a hysterectomy report increased difficulty becoming sexually aroused and then having a disappointing orgasm, if it occurs. The uterus contracts on the impulses of the orgasm, making the sensation deeper and more satisfying. The uterus also responds pleasurably to breast stimulation. Without a uterus, no such response occurs. When the uterus is removed because of fibroids, the ovaries are usually left intact. This lessens the degradation.
Research indicates that a retained sexual nature retards aging. Some women recount the removal of their uterus as entering the operating room young and emerging old. Chronic dysthymia (despondency) is frequently observed. Many women are also disappointed in their lack of bladder control after surgery. Others are plagued by intestinal adhesions which are not considered to be rare following abdominal surgery and can actually be life-threatening. Alternatives to radical surgery should first be carefully explored before any decision to operate is made.