My hysterectomy: 'This op is tough on women So why would anyone still agree to a hysterectomy? In my own case, the motivating factor was despair. I had suffered chronic pelvic pain throughout my fertile years - which, in the last few years, had become almost constant, requiring strong painkillers. I'd also developed several ovarian cysts, suffered irritable bowel syndrome tied to my monthly cycle, and had had numerous exploratory operations of my womb and ovaries to find out why. Monthly injected implants of goserelin acetate (Zoladex), which switches off hormone production, offered relief for a while - but the drug's side effects left me deeply depressed, and suffering menopausal symptoms including blazing hot flushes. Finally, an MRI scan last spring showed up a condition called adenomyosis, which is when endometrial tissue, which normally lines the womb, moves into its outer muscular walls, and is known to cause great pain. I gratefully agreed to the TAH, the recommended treatment for this condition. At 47, with a daughter of seven, I had already called time on hopes for a bigger family. I spent that summer getting as healthy as I could. I lost 10lb on the Cambridge Diet, convinced that if my surgeon had less belly fat to slice through, it could only be a good thing. It's easy to criticise waiting periods, but the standard 18 weeks" wait I had before my operation gave me the chance to come to terms with having my "female"" organs removed; I had been warned that this can result in a sense of loss. But by September, the month of my op, I was at peace with such a big change, and even looking forward to it, organising child care and arranging time off work. On the actual day, the 19th, however, my cool collapsed. On arrival at the hospital at 7am, I was shown into a lovely single room with an enormous, spotless ensuite. But I became very emotional and wept on the nurses, the anaesthetist and the consultant, through pure fear. I went into surgery at 8.30am prompt. About two hours later I was awake in the recovery room, feeling shockingly ill and weak, but chatting away. Later that day, the surgeon explained what he had found in my pelvis, in addition to the adenomyosis: a jumble of endometriosis (when the endometrial tissue grows outside the womb), a 3cm fibroid and numerous adhesions (scar tissue which forms after operations, such as the C-section I had some years earlier). He clearly felt that my hysterectomy had been a good idea. The next two days were spent on a self-administered morphine drip. The nurses made me feel cared for and protected, and I was allowed home after three nights. However, my recovery was difficult. There were moments in the first six weeks when pain, tiredness, post-op constipation, hormonal mood-swings and a brain that felt like porridge combined to make me wonder why I had ever agreed to the operation. Six weeks along, my six-inch scar (which replaced my C-section scar along my bikini line) had healed nicely, although my stomach was still swollen and would remain so for some time (as the inside layers knitted together). I also started taking HRT to combat the risk of osteoporosis and menopausal side effects that accompany the removal of the ovaries and the ensuing loss of oestrogen. Six months later, the awful pelvic pain I suffered for years has gone. But no one warned me that even now I would not yet be back to normal. I still have tenderness in my abdomen and my stomach seems to swell and drag down towards the end of the day. I can now ride - my passion - without needing to spend a day in bed afterwards. Most afternoons my brain feels woolly - a sign that I am still suffering from post-op fatigue. In desperation, I asked my brother-in-law (a retired surgeon) when I would feel normal again, and he suggested that I might have to accept that "normal"" wouldn't arrive until this spring. Judging by the online forums on the subject, up to a year spent recovering is not unusual. A common complaint from women is that they are not adequately prepared for this and that leaflets on recovery are basic at best. Like me, many end up feeling embarrassed at not being able to "bounce back"." I know that some women are left seriously depressed or in pain after a hysterectomy, but I cannot say it holds true for me. I don't regret my operation and I appreciate being free of the pelvic pain that has dogged me for years. On the other hand, it has been a long winter and I have felt at times that this dark tunnel of fatigue had precious little light at the end of it. Even now, as I write, I'd rather be napping. And I am certainly treating our family rabbit with a lot more respect - and carrots - these days. There are four different types of hysterectomy: The most common operation removes the womb and cervix (neck of the womb). The womb may be removed leaving the cervix in place. The womb, cervix, ovaries and fallopian tubes (which connect the womb to the ovaries) may all be removed. The womb and all surrounding tissues may be removed, including the fallopian tubes, part of the vagina, ovaries, lymph glands and fatty tissue. Hysterectomies can be carried out through a cut in the vagina or in the lower abdomen. Some are done through keyhole surgery, which entails small cuts in the abdomen. My hard road to recovery A hysterectomy is a major operation, yet today women are likely to stay no more than three days in hospital. While our mothers would have spent weeks on the ward, enduring bed baths, syrup of figs and gentle perambulations around the gardens, we are sent home with two weeks" worth of painkillers, an instruction not to lift anything heavier than a mug for four weeks and the ward's telephone number for emergencies. But as I've found, recovery is not a piece of cake. At times, the pain has been unbearable, the exhaustion crippling and the mind befuddled by fatigue. In my experience, women should allow themselves far longer than the six to eight weeks normally advised. In that time, they should rest as much as possible to allow time for the abdominal muscles and surrounding tissue to heal. Driving is probably out for several weeks, as is sex (many women experience loss of libido, although research shows that the quality of sex improves in the longer term). Walking is recommended and swimming, too, once the wounds have healed. I don't think women are warned properly about the effect of the operation on bladder and bowels. A complication of surgery is damage to these vital organs, so I was delighted when my consultant told me there were no problems there. But I didn't know that pressure, swelling and sheer shock would disrupt natural functions so much. Post-operative constipation, I was told, is due to the pre-operative fasting, handling of the bowel during the operation, opioid painkillers given afterwards, and the time spent relatively immobilised.My bladder, temperamental after surgery, was cajoled into working normally by gallons of water and Redbush tea. But it took two weeks of pain and every imaginable laxative to relieve the constipation. It's not a nice subject to talk about, but most women experience this. Indeed, were I to single out one piece of advice to those on the waiting list, it would be to discuss it in advance with your doctor or, better still, a continence nurse (see bladderand bowelfoundation.org). Daily walks were a struggle, but after six weeks I managed a half-hour walk without getting out of breath - which doctors say is about right. I was warned not to ride for at least 12 weeks as the core abdominal muscles are put under so much pressure by sitting on a horse. Some steps can be taken in advance, such as being as healthy as possible pre-surgery. I lost weight, which wasn't only good for my general health; it's harder to keep your incision line clean post-surgery if it's sitting below a mound of flesh. I tried to cover all bases, including my appearance - vital for maintaining self-esteem. Knowing I wouldn't be able to stretch back over a sink at the hairdresser's for weeks, I took advice from my hairdresser, Adam, who warned me that a reduction in oestrogen levels can leave hair looking thinner. He cut new layers and dyed it a darker shade to make it look shiny and thick. More frivolously, I also had my eyelashes dyed, and a bikini-line wax to avoid having it shaved pre-surgery. Convalescence is when you most need your friends. I was lucky that Alex, an old university friend, offered to help nurse me for my first week after hospital. She fed the family, mopped my brow, made endless cups of tea and reminisced with me long into the night when I couldn't sleep. Other friends brought food, did the school run, cleaned the kitchen and took me out for a coffee when I became stir crazy. It's important for those who don't have an adult support network to talk to their GP, and arrange for help from social services. It's also crucial to stock the freezer with ready-made meals and to become dust-blind. To my surprise, I have not been summoned back to the hospital for follow-up. My NHS Trust expects me to call if there is a problem - and get on with life if there isn't.