Experiences of menorrhagia and hysterectomy : an exploratory study

Hysterectomy is the second most commonly performed women’s operation today, and yet still ‘the psychological implications remain obscure’ (Meikle, 1977; p i28). Previous research focused on whether hysterectomy ‘caused’ psychological distress, but was methodologically flawed. Despite lack of evidence, researchers assumed that post-operative distress, not explicable by pre-operative distress, must be due to changes in self-concept.This study advocates a first-principles approach, returning to those who are most important - the patients. Two main aims were fulfilled during the study - to capture the experience of hysterectomy and menorrhagia, and to carry out trustworthy research in accordance with preset criteria.Qualitative interviews were used to draw themes & discourses from women’s accounts. Comparison was made between those awaiting endometrial ablation/ hysterectomy, and those post-hysterectomy (N=16 in total).Main themes included effects of menorrhagia on women’s lives, fighting but failing, searching for meaning, reducing cognitive dissonance, unfulfilled hopes, stepping into the void, operative fears, removing the womb - endings, switching roles, assumptions and misunderstandings, needing to trust the surgeon, lack of information, and resolution. Issues of choice and control permeated women’s accounts and gave rise to the core theme of disempowerment.Attribution theory and a formulation are used to account for the processes described by participants. Implications for gynaecology practice and future research are discussed; the researcher concludes that self-view may be altered prior to hysterectomy as a result of menorrhagia. Fears of hysterectomy relate to the symbolism of endings, and the relative importance of functions of the womb to the individual