How to Prepare for a Hysterectomy

A hysterectomy is a surgery to remove a woman’s uterus. If you've been advised that you need a hysterectomy, the following discussion will help you to  be aware of the different issues that may arise before and after the operation.

What are the different types of hysterectomies?

There are two main types of hysterectomies -  a complete or total hysterectomy and a partial hysterectomy. A complete hysterectomy is one in which the uterus as well as the cervix and ovaries are  removed. In a  partial hysterectomy, also called subtotal or supracervical hysterectomy,  only the uterus is removed, the cervix and the  ovaries are left intact. The ovaries and the surrounding lymph nodes may or may not be removed, depending on the reason for the hysterectomy.

Are the ovaries always removed if they are healthy ?

In young women below the age of 45 years, healthy ovaries are not removed since they continue to secrete hormones like estrogen and progesterone for at least another 10 years. In older women, the ovaries  are usually removed.

Whether the ovaries  are removed will also depend on the reason for the hysterectomy. The commonest reason is endometrial hyperplasia (thickening of the uterine lining) and a  partial hysterectomy is adequate in this case. But in conditions like endometriosis, a complete hysterectomy with removal of the ovaries  will be necessary.

When will I be able to join work again?

Most people are able to return to work and their normal routines after about 4-6 weeks. Till then, you  can take light exercises like walking.  But you will still need to take plenty of rest and avoid lifting heavy weights during this time.

When can I have sex again? Will it be painful the first time? Will I bleed? Will I be able to orgasm?

If you have had a partial hysterectomy and the cervix is intact, then you can have  vaginal intercourse after 4 weeks. But in case of a complete hysterectomy, it will  be better to wait for 6 weeks since it takes that long for the incision in the upper vagina to heal. Oral sex  is possible earlier, after  the vaginal discharge stops.

There should be no pain the first time you have sex after hysterectomy. Nevertheless, it will be better to try only gentle and partial  penetration. If the ovaries are removed, there may be some amount of vaginal dryness and you may need to use a lubricant during sex. And no, bleeding will not occur.

There is a misconception that removal of the cervix causes difficulty in orgasm. But since orgasm is not dependent on the presence of the uterus or cervix, it is not affected in any way.

Will I get menopausal symptoms immediately after the surgery?

The periods will stop with the removal of the uterus. In premenopausal women, removal of the ovaries will cause surgical menopause. In this case, you may get menopausal symptoms  like hot flashes and  night sweats immediately after the surgery. But if surgery is limited to just the uterus, then the level of estrogen in the body will continue to be normal and you will not have any menopausal symptoms.

If cervix is not removed, will I have periods?

If the cervix is not removed, you may get an occasional spotting or mild bleeding at the time of the menstrual periods. But this does not occur in all women and many women stop getting their periods  even when the cervix is present.

Will I need to get pap smears again?

Since the pap smear tests for cervical changes (dysplasia), you will need  to continue to get pap smears  after a partial hysterectomy.

Pap smears are not necessary after a complete hysterectomy, unless it was done for a cervical cancer or a precancerous lesion.

Will I need hormone replacement therapy (HRT)?

If you are below the age of 50 years and the ovaries are removed, then yes, it will be better to start HRT immediately after the hysterectomy. But if you had already attained menopause before the hysterectomy, or if you are over the age of 50 years, then you may not need HRT.

Being informed that you need a hysterectomy can be overwhelming for anybody but information about the procedure will help you to face the challenge with confidence.

Exercise can help Decrease Arthritis Pain

A study carried out by Dr Sara Wilcox, of the Department of Exercise Science at the University of South Carolina, has revealed that three hours of exercise a week can help reduce the acute pain caused by arthritis. 

After the trial period,  it was found that the  level of pain decreased from 4.7 to 4.3 out of 10.  The participants also reported significant improvements in the level of pain relief, joint stiffness and tiredness after three months. 

The  exercise regimen consists of three exercises:

1. Sitting on a chair, back straight, arms crossed to touch the opposite shoulder. Stand up from the seated position without using the arms or any other support. Sit again. 

2. In a sitting position, the arms are outstretched to reach the toes keeping the knees straight.

3. Walking as quickly as possible around the house for six minutes.

To motivate oneself for exercise, the state of mind or emotional conditioning is as important as physical conditioning. for many people, the fear of pain rather than pain itself which prevents one from exercising.

Being flexible in the timing of the exercise to adjust with the time of minimal arthritic pain helps people to continue with the exercise regime. If pain and stiffness is maximum in the morning, as is common in most forms of arthritis, it is better to exercise in the late afternoon or evening. If the pain is particularly severe  in any particular day, it will be better to cut the duration of the exercise in half or to walk very slowly. 

Keeping one's mind focussed on the benefits of exercising  cna help with motivation adn keeping up with the exercise regime.

The study was published in the American Journal of Preventice Medicine

Searching for a New Earth

Is there anybody else out there? Or are we the only living things in the universe? Humans have  asked themselves this question for as long as anyone can remember. But so far, knowledge about the possibility of life in other planets have been minimal.

In 2009, NASA launched the ambitious discovery mission known as the Keppler Mission to look for possible life-supporting planets. On wednesday, NASA announced the discovery of 715 new Exoplanets (planets outside our own solar system) - this takes the total number of exoplanets discovered so far to 1700.

These  715 planets  revolve around only 305 stars, meaning that they are a part of multiplanetory solar systems like our own. Even more interesting, four of these planets revolve around their sun in the 'habitable zone' - a zone which is neither too hot nor too cold for liquid water to exist. This further increases the chances for life to be present on similar planets. These new planets were discovered from data sent back by  the Keppler mission between 2009 and 2011. Study of the data sent back from 2011 till now will probably pinpoint more such exoplanets.

Given the vastness of space, it was not possible for Keppler to study all of space and it is concentrating on  the study of the Cygnus and Lyra constellations, since these constellations have an abundance of stars, just like our own star.

The picture above is of the Keppler 22B, the first exoplanet discovered by the Keppler mission.

Keppler 22B, which is 2.4 times the size of our earth is our closest sister planet. It is 600 light years away, meaning that, travelling at the speed of light,  it will take about 600 years to reach the planet. It is in the constellation Cygnus.

Why is it important to  search for new habitable planets? The answer is that scientists believe that  these are the key to survival of the human race. There are definite  risks of  the earth becoming inhabitable - either due to an impact by an asteroid  or due to atmospheric changes due to solar flares or due to human actions like nuclear explosions. And unless some of the human race relocate to another habitable planet, this may well see the end of the human race.


The James Webb Space Telescope (JWST) will be launched in 2018. The JWST is the successor to the Hubble telescope  and has a massive  mirror which will help it to collect more light. This will help to accurately analyze the atmospheric conditions of distant exoplanets and identify which planets have environmental conditions suitable for extraterrestrial life.

Isro’s Mars Orbiter Mission

The  Indian Space Research Organisation has successfully sent the Mars Orbiter, Mangalyaan into interplanetary space, heading for Mars. This is a  major milestone in India's space history.

The manoeuvre to place the Mars orbiter spacecraft in the Mars transfer trajectory began at 00:49 hours.  The spacecraft is now on a course to encounter Mars after a journey of about 10 months around the Sun. (The Mars Orbiter ). Mangalyaan , also known as the MOM (Mars Orbiter Mission) will reach Mars on 24th September. 

What is interesting is that  the cost for the MOM  at $73 million is about 9 times cheaper than Maven - the Mars explorer launched by the USA on the 18th of November ($671 million). There are a couple of reasons for this variation.

- USA used a much more powerful  launch vehicle called the Centaur  capable of pushing  Maven on the Mars trajectory directly after cruising around the earth for about 27 minutes. This required a larger amount of fuel, pushing up costs.

 India, on the other hand, is using the smaller and less powerful  PSLV (Polar Satellite Launch Vehicle) requiring less fuel. The PSLV  set  MOM on the Mars trajectory in stages. The MOM cruised around the earth in gradually  larger and more elliptical orbits until it was finally set on the trajectory yesterday.

- Another factor is labor costs.  Labor costs are much higher in the USA  than in India.

- A third factor is that Maven is much larger at 2500Kg that the MOM at 1340 Kg.  It is  carrying more equipment than MOM. However, MOM is carrying a methane sensor (maven is not) that would look for signatures for the possibility of life on Mars.

The Mars trajectory both the space crafts are on, is the same. Maven will reach Mars on 22nd September and MOM on the 24th. 

This is a great day for India - a great achievement.