Why Leave the Cervix? Why I Left My Cervix in During My Hysterectomy

Disclaimer: This article discusses surgery, sex, and controversial personal opinions. Please use your discretion when reading. I am not a medical professional and I am not giving medical advice. I am merely explaining why I chose to leave my cervix during my hysterectomy.

Four months ago, I got a laparoscopic supracervical hysterectomy after spending 15 months convincing medical professionals that I needed this procedure (and hell yeah I threw myself a party after all that work, as evidenced by the picture above).

In case you don’t know, a laparoscopic hysterectomy is when they use robotic instruments to remove the uterus through tiny cuts in your abdomen and belly button instead of doing a longer incision down your middle. It’s less recovery time, results in significantly smaller scars, and is generally less painful for the patient.

A supracervical hysterectomy is when the cervix is left intact while the uterus is taken out. This is not commonly done in a hysterectomy, although it was a more popular procedure in the 90s when it was first being performed.

Many women and people with vaginas aren’t super familiar with their cervix. I became intimately familiar with mine after doing the fertility awareness method (FAM) for five years before my procedure.

The cervix is technically connected to the uterus—it’s all one organ—and it connects the uterus to the vagina. You can usually feel your cervix by sticking your finger up your vag and feeling for something that feels firm and squishy, like the tip of your nose.

Removing the cervix is generally done because of fear of cervical cancer. The majority of medical professionals will argue that there is no good reason to leave the cervix in during a hysterectomy. I spoke with three surgeons during my 15-month process and two of them tried to talk me out of leaving my cervix in.

So why would I choose to leave the cervix in during my hysterectomy?

Research shows that leaving the cervix in is less traumatic (it cut my recovery time in half): you recover faster, can return to sex sooner, and have minimal blood loss during the surgery. But all of this is not why I chose to keep my cervix.

Here’s why I left my cervix in during my hysterectomy.

The Cervix Impacts Sexual Pleasure

So this is a controversial statement, but I believe the cervix does impact sexual pleasure.

Doctors will tell you it doesn’t.

Other people will tell you it doesn’t.

Research will tell you it doesn’t.

The thing is, you have to decide for yourself if it does.

For me, and we’re just gonna be really blunt here, it feels good when my cervix is stimulated by my partner’s penis. I can’t imagine what it would feel like if my cervix wasn’t there, but I have a feeling it wouldn’t be great. The cervix doesn’t have a ton of nerve endings in it, but it does feel like more of a pressure when stimulated, which can be pleasurable for some people.

The cervix is essentially the “end” of your vagina. When the cervix is removed during surgery, the surgeon has to reconstruct the top of your vagina. There won’t be anything there but scar tissue—and nothing for a penis (or sex toy) to bump up against.

For lack of a better way to describe it, the cervix drops down into your vagina, so removing the cervix essentially “lengthens” your vagina. And, depending on the size of your partner, it may or may not feel the same when you have sex. (The cervix can also be stimulated during masturbation too!)

Not to mention there is such a thing as cervical orgasms.

Two Words: Cervical Mucus

So this goes along with the sex thing, and it’s really important to discuss.

The cervix is responsible for producing cervical mucus. If you are familiar with your cycle, you may notice that you are much more wet during ovulation (which can happen between days 12-22 of your cycle) than you are right before or right after you get your period. This wetness is your body preparing to receive sperm for pregnancy. Your body is making it as easy as possible for sperm to get where they need to go.

In other words, this is a really bad time to have intercourse if you don’t want to have a baby.

If the cervix isn’t there, guess what? There’s no cervical mucus.

Yes, the vagina has natural moisture in it. But it’s nowhere near the wetness produced throughout the fertility cycle.

My thought process was this: what was the point of not being able to get pregnant if I couldn’t have sex with my body producing that amazing fluid? Why would I want to get rid of that?

For the past five years, my husband and I have been meticulously avoiding intercourse when I am fertile, as we’ve chosen not to have children. So I was about ready to start enjoying my natural fluid during intercourse again.

Secretion of cervical mucus, in my opinion, can enhance sex.

Research shows that the cervix is also responsible for the secretion of mucus during arousal, not just during ovulation, and at various points throughout intercourse, including when the penis (or toy) bumps against the cervix. However, despite our knowledge of this, researchers still can’t definitively conclude that the cervix plays a role in sexual satisfaction.

But I made that decision for myself, and it was the main reason I chose to leave my cervix in during my hysterectomy.

It’s Less Trauma Internally

We’ve already touched on this briefly, but leaving the cervix in during hysterectomy results in a much faster recovery time. And you can return to sex sooner, so, bonus.

Leaving my cervix in cut my hysterectomy recovery time by half, from eight weeks to four weeks. I was able to resume intercourse at six weeks (my primary surgeon suggested we wait an additional two weeks just to be safe, although my other surgeon said four weeks).

The surgery time is also shorter when leaving the cervix in during hysterectomy, and it generally lowers your risk of complications.

Your cervix also has a bunch of connective tissue attached to it, which keeps it anchored at the top of your vagina. When the cervix is removed, this tissue has to come with it. It’s not proven, but suggested that leaving the cervix—and, as a result, the attached ligaments—may result in better pelvic organ function and patient sexuality post-surgery.

However, again, contemporary research says there is no evidence to support leaving the cervix during hysterectomy over taking it out.

Eliminates Risk for Vaginal Cuff Dehiscence

Have you heard about vaginal cuff dehiscence?

Don’t worry, I hadn’t either—until the third surgeon I spoke to mentioned it.

(In case anyone is wondering why I spoke to different surgeons, there are a couple reasons. First, I didn’t trust the first surgeon I spoke to. She told me that she would not consider leaving my cervix in during my hysterectomy. Second, the next surgeon I spoke to—the one I ultimately chose to do my procedure—wanted an additional surgeon there to assist with severing my uterus from my cervix to ensure the procedure went well, so I had to meet with this person too.)

This last surgeon was the only one who told me that if I wanted to leave my cervix in, it was fine. Even my primary surgeon suggested removing the cervix, but I was adamant about keeping it. This third surgeon mentioned that leaving my cervix in during the hysterectomy would eliminate the risk of vaginal cuff dehiscence.

Huh?

I looked it up. Vaginal cuff dehiscence is similar to vaginal prolapse, but worse. Instead of all your female organs sagging or falling out of your vagina, in vaginal cuff dehiscence, all of the organs in your abdomen are at risk of falling out. Vaginal cuff dehiscence is life-threatening.

It’s true. It’s a thing. And if you have your cervix removed, you are at risk for this, even though the risk is low.

So, yeah.

Also, I talked to my primary surgeon about having a higher risk of prolapse after my hysterectomy. He said I’m not at higher risk and, turns out, research shows he’s right—there’s not a much higher risk of prolapse between getting a supracervical hysterectomy and a total hysterectomy (where the cervix is removed).

If you don’t know what prolapse is, please Google it and learn how you can prevent it, because I personally know three women who have had this happen to them and your risk increases if you’ve had kids.

A Word on the Dreaded “Cyclic Bleeding”

One of the reasons my surgeon wanted me to get my cervix removed was because of what medical professionals call cyclic bleeding.

Cyclic bleeding is bleeding that still occurs during your period even when you don’t have a uterus but still have your ovaries (your ovaries control your fertility cycle via hormone production, so if you keep your ovaries during a hysterectomy, you will still ovulate and go through the cycle, even though you won’t have a period).

So how on earth can you still bleed if you don’t have a uterus?

When you have the cervix removed during hysterectomy (also called a total hysterectomy), the surgeon will essentially detach your uterus and cervix from your body and pull them out through your vagina. With a total hysterectomy, there is no risk for cyclic bleeding.

However, when you leave your cervix in during hysterectomy, things get a bit more complicated.

Since your cervix is attached to your uterus, your surgeon has to find a point to separate the two to leave the cervix intact. Although they do their best to separate the two, some endometrial cells (the cells that line your uterus and are responsible for monthly bleeding) can be left over after the surgery. This is what can cause cyclic bleeding after hysterectomy.

This didn’t sound good to me. After all, I wanted to stop my bleeding, not have it continue.

But then I looked at the research.

The risk for cyclic bleeding after a supracervical hysterectomy is pretty low. My surgeon told me the risk was about 15%, but some others I have talked to said 10% or less. And, cyclic bleeding only occurs for up to two years after the procedure.

In addition to the risk being low, the third surgeon I spoke to told me what cyclic bleeding actually was—it’s not a period or even close. It’s when you go to pee, wipe yourself, and see a teeny bit of blood on the toilet paper. That’s cyclic bleeding.

So has it happened to me?

Yes. And it was exactly what the surgeon said—just a tiny bit of blood, so small and so light that I wouldn’t see it if I wasn’t looking for it. It’s not even enough to get on my undies, so it’s not even really “spotting”, as people who mensurate know the term.

I have had cyclic bleeding twice out of my four cycles since my surgery, not counting the on-off spotting I had immediately after the surgery for about three weeks (which is expected and very normal).

I have not had ANY cramps at all since my hysterectomy, even with the cyclic bleeding. In my personal experience, this teeny bit of blood is a very small price to pay for being able to keep my cervix and have no change to my sex life.

Why I Got My Fallopian Tubes Removed

So while I left my cervix during my hysterectomy, I got my fallopian tubes removed. I originally didn’t plan on this, but my primary surgeon suggested it.

He said there is research that suggests that uterine cancer can start in the fallopian tubes, so by removing them, I could potentially help lower my risk of uterine cancer (even though I would no longer have a uterus).

This sounded good to me. Plus, I didn’t need my fallopian tubes. I researched it and got a little worried that severing the fallopian tubes from my ovaries would result in reduced blood flow to the ovaries, which I thought could impact hormone production. However, my surgeon said there was no evidence of this and I haven’t found research to suggest this either.

I also learned, after my hysterectomy, that getting the fallopian tubes removed eliminates the risk of ectopic pregnancy (where the fetus begins to develop in the fallopian tube—ectopic pregnancies are not viable and are life-threatening).

Although ectopic pregnancy after a hysterectomy is rare, it can and does happen. People who have their uterus removed but keep their fallopian tubes still have a small risk for ectopic pregnancy.

There’s really no reason to keep your fallopian tubes if you are having a hysterectomy. If you are pursuing a hysterectomy for any reason, I would highly recommend talking to your surgeon about removing your fallopian tubes to potentially reduce your risk of uterine cancer and eliminate risk of a future ectopic pregnancy.

When Leaving the Cervix Is Not an Option

Unfortunately, leaving the cervix during hysterectomy will not be an option for everyone.

There are two main reasons why someone would need to get their cervix removed:

  • You’ve had a recent abnormal Pap smear or are at high risk for cervical cancer
  • You have endometriosis on your cervix

Your surgeon will require your most recent Pap results before even considering leaving your cervix during a hysterectomy. If you have endometrial implants on your cervix or are at high risk for cervical cancer, it’s unlikely you will find a surgeon who will consider leaving the cervix during a hysterectomy.

And, in these cases, it will likely be much more beneficial for you to have it removed anyway (because you don’t still want cramping and bleeding after a hysterectomy, and you definitely don’t want to have a second surgery to remove your cervix if you have cervical cancer).

Are There Cons to Leaving the Cervix During Hysterectomy?

Yes, of course! Just like there are pros and cons to everything.

The first is that you will still need to have regular Pap smears to screen for cervical cancer. If you have your cervix removed, you will not need to have Pap smears.

The second is that there is a risk that you will develop cervical cancer and need to have your cervix removed during a second surgery. This is not ideal and surgeons like to avoid this, which is part of the reason why they want to get rid of your cervix in the first place.

The third con is one we’ve already discussed—the cyclic bleeding.

That’s All, Folks

I will be posting articles soon about my healing process for my supracervical hysterectomy and about what my life is like without a uterus. So far, it’s been totally blissful and I am loving life. If you have any questions about my procedure or more questions about cervix stuff, please feel free to reach out to me or leave a comment below and I will get back to you ASAP!

What Is My Life Like Without Boobs?

Two words: freaking awesome.

It’s been over nine months since I had my double mastectomy and my life has changed in some subtle but also significant ways. My life without boobs is everything I’d dreamed it would be, but there were also some surprises along the way, as I imagined there would be when getting this major surgery.

So what is my life like without boobs? How have things changed? Is anything the same?

I’m More Confident

I actually feel like my body represents me now, at least much more than it did. I’m so much more confident in my appearance. Before, I would wear big flowy tops and dresses to hide my chest because I hated it so much. This summer, I actually bought my first form-fitting clothes in years.

I love wearing tight tops to show off my chest, and it feels so good to just be out there in the world without my boobs. My breasts always felt like a hindrance. There was never a time when they didn’t feel like a hindrance. Without them, I feel sexy, confident, and bold.

I’m still learning to be confident without a shirt on. This summer, I went for a run when it was hot outside, and after three miles into the run, I really just wanted to take my shirt off.

But something stopped me. I was worried about people seeing me and what they would think. Then I thought, “The whole point of you getting this surgery was so that you’d feel more like yourself and more confident—who cares what they see or say or think?”

So the shirt came off. About five minutes later, I ran into one of my aunts, who lives on the road I was running on. She didn’t know about my surgery and I self-consciously threw my tank top over one of my shoulders, which almost covered one of my scars. But the other one was still visible.

We chatted for a couple minutes and she didn’t say anything about the fact that I was topless and no longer had boobs. So it went ok. But, being one of my nicest and kindest aunts, even if she did say something, I doubt it would have been anything that made me feel bad.

Mostly I think it just feels weird to be walking (and running, ha) around completely topless after having breasts for nearly 20 years. I hope by next summer I won’t think twice about taking my shirt off!

I Can Actually Breathe When I Run

Speaking of running.

I’ve been a runner for the last 13 years and wore really tight sports bras to keep my chest from moving when I ran. Like, my breasts were DD’s and I would buy A-cup sports bras and wear them.

Yeah. Don’t ask me how I got those bras on.

It also affected my ability to take a deep breath when running. Over the last decade, I’ve probably run thousands of miles in tight-ass sports bras. I didn’t realize how much I couldn’t breathe until I ran without a bra on. WOW!

It’s incredible to be out there feel unhindered by my body and just moving comfortably and confidently in the world. I feel so much less weighed down by my boobs when exercising, not to mention I love the way my chest looks after doing upper-body workouts 🙂

I’m Insanely More Comfortable

Fuck bras. I can’t believe I lived wearing a bra for so long. I LOVE not having to worry about bras or how my breasts look in clothing. It’s like not having hair and not having to decide what to do with it. Freaking awesome.

It’s so comfortable to just put on whatever I want and leave the house feeling confident because there aren’t any boobs, there’s no bra, and it just my chest meets the world. I knew I’d be more comfortable without my breasts (mentally and physically), I just didn’t know how much more comfortable. The answer is INSANELY. I’m insanely more comfortable!

Sex Is Different

So I expected my sex life to be a little different after getting my breasts removed, and I’m still navigating this department of my post-boob life. Not having anything there to touch is just a little weird after having boobs for the last two decades.

That being said, I 100% feel like my sex life has improved since the boobs are gone. How could it not? I feel more comfortable, more confident, and unhindered. How’s that for sexy?

I occasionally ask my husband if he misses my boobs and he says “a little”, which is weird because sometimes I miss them a little too. For the most part, our sex life has been frickin hot since I got rid of those obscene lumps on my chest.

People Stare at My Chest

So this doesn’t happen all the time, but I have definitely been out several times and have full-on caught people staring at my chest when I’m wearing a tight shirt.

Instead of feeling self-conscious, I think it’s hilarious. In my head, I think, “You can look all you want, there’s nothing there!” and then I prance away giggling to myself. It doesn’t make me self-conscious at all. In fact, I feel like it makes me more confident since it’s a feature about myself that I love now.

I didn’t get nipple grafts with my mastectomy, so my chest is just two lines of scar tissue where my boobs used to be (and some gross spots where I got two moles removed that are still healing!). So I can imagine people staring at my chest in a skin-tight shirt and not seeing any nipples or anything and wondering what is going on. Tee hee.

I Can’t Wear Tube Tops Anymore

This might sound dumb, but I didn’t realize that I wouldn’t be able to wear tube tops after my mastectomy. I truly didn’t realize that my breasts were what was holding up tube tops that whole time. Wow.

So when I got my mastectomy and healed up and summer came and I tried to wear some of my favorite dresses and tube tops, I couldn’t. I had to get rid of one of my favorite dresses that I got for free at Charlotte Russe like 15 years ago because it literally fell off of me.

I did buy a tube top that actually stays up on my chest and looks nice, but it’s an extra small and I have trouble (like, lots of trouble) getting it on and off. If anyone has any tips for wearing tube tops and dresses post-mastectomy, I’m all ears!

I’m Happier

I knew getting my breasts removed would make me happier, but I didn’t realize how free and confident I would feel.

Making the decision to get this procedure wasn’t easy, and going through with it wasn’t easy, and healing wasn’t easy.

It wasn’t easy to know I’d never have boobs again, and to not know what that would be like.

It wasn’t easy to know I was unconscious for two and half hours while a stranger sliced off parts of my body in a room full of people I didn’t know.

It wasn’t easy to know that my life would be different, and I didn’t know exactly how.

It wasn’t easy to pay so much money to not know exactly what the outcome would be, or exactly how I would look.

But I will say this: It was ABSOLUTELY WORTH IT. And I’d take that leap again in a heartbeat.

I’m currently pursuing a hysterectomy, which I hope to have by the end of this year, to complete my journey of removing body parts that I have always hated and wanted gone. I will definitely give an update about my process for pursuing this procedure as a gender-neutral person as well as my healing process when the time comes!

Thank you so much to everyone who has supported me on my journey of making my body a more comfortable place for me to live!

The Five Stages of Grief and Plastic Surgery

I got plastic surgery five weeks ago. I was so excited about the surgery (I got an elective double mastectomy without nipple grafts—you can read the story here) that it didn’t seem to me that I could feel anything other than wildly excited about having my dream of not having breasts come true.

However, I had enough sense to know that I would likely experience many different emotions after the surgery—and not all of them would be positive.

As the surgery got closer, I became less excited and more anxious, despite knowing that I had made the right decision. Of course, I couldn’t anticipate the exact emotions that I would feel after the surgery. I was surprised by some of them. In the months before my surgery, I wondered: would I miss my breasts? Would I think I had made a huge mistake? What I went through was a little like the five stages of grief after my plastic surgery procedure.

Denial

It didn’t feel like my breasts were gone for a while after the procedure. It’s hard to explain this to people. I had two wounds on my chest after my surgery, two long incisions starting in the middle of my chest and extending to the end of each armpit. I had stitches. I didn’t feel “free” or unburdened by not having breasts anymore. Instead, I couldn’t lift my arms over my head and I had a bandage on that was wrapped so tight that I couldn’t take a deep breath.

For the first week, before the bandage came off and I got to see my new chest for the first time, I literally felt like I was wearing a corset and that my breasts were simply smushed underneath that white binder (it didn’t help that my chest was numb, so I couldn’t really feel anything).

In a way, it felt like I was in denial that I had just had major surgery and that both my breasts were gone. When the surgeon removed my bandages at my post-op appointment and I saw my new chest for the very first time, I finally realized that they weren’t there. They were gone forever.

Anger

Why did I do this to myself?

It was hard not to wonder this in the first week, where for two days, I was so nauseous from the anesthesia that I couldn’t walk to the bathroom by myself. Where I couldn’t even lift a glass to my mouth and had to drink from a straw. Where I cried and thought that it was stupid of me to have maxed out two new credit cards to pay for this elective procedure.

I felt mad simply at the fact that I wanted so badly to have my breasts removed that I had actually gone through with this expensive and life-changing procedure. It was hard not to feel like the whole thing had been a giant mistake. My husband was very reassuring and told me my feelings were normal. After all, I couldn’t take a deep breath, bathe, or take care of my beautiful bunnies. It was natural that I’d be pissed, but at the time, it was hard to not be hard on myself.

Bargaining

What if I had gotten a different procedure done? The surgeon had asked me if I considered a breast reduction or another surgery such as a breast lift to “correct” my breasts. But my desire to get my breasts removed wasn’t about the way they looked; it was about the way I felt, and I just wanted them completely gone.

Should I have gotten a double mastectomy? Maybe removing my breasts wasn’t the right decision. Maybe I would miss them one day. Maybe I would find that, years from now, I would want to live my life as a woman with boobs.

I know this isn’t quite like the traditional bargaining stage of grief, but it’s difficult not to wrestle with yourself and consider if you might have taken another path. What I was facing in that moment—a lifetime with a new body that I was still getting used to—felt unbearable in a weird way, and thinking about alternatives to my decision was a result of that.

Depression

This is the part where I cried and told Ian (my husband) that I was afraid he wouldn’t love me anymore. Ian has always been amazing and so reassuring. We had so many conversations about my decision to remove my breasts, and have talked a lot about my feelings about my breasts over our 10 years of knowing each other and our two years of marriage.

I think what got to me was that almost every single person I told about the surgery asked about Ian first.

“What does Ian think?”

“Is Ian ok with this?”

“Did Ian know you were thinking about doing this before you got married?”

“I feel bad for Ian.”

After the surgery, I was feeling very emotional and experiencing a lot of feelings and I think I didn’t allow myself the space to acknowledge how much it had affected me that so many people had asked about Ian’s feelings about my body. News flash: Ian didn’t marry me for my breasts, and it’s my body, not his.

But lying in bed on the third day after surgery, Ian held my hand while I cried and I told him that I was afraid he wouldn’t love me anymore or find me attractive. I finally gave myself space to process these feelings. He was reassuring and we talked about our feelings, but I still felt depressed that not only was I recovering from major surgery, but that I had made a decision that I couldn’t take back (not that I wanted to take it back, but there’s something very sobering about making a decision that you can’t change).

Acceptance

I saw my new chest for the first time a week after the surgery. I was lying back on the chair in the exam room at my plastic surgeon’s office while the surgeon and an assistant unwrapped my bandages. There was a part of me that felt like my breasts were going to pop out after they unwrapped the bandages. I watched, looking down as the last bandage was removed and my new chest felt the cold air for the first time. “Welcome to your new chest,” the surgeon said.

It was strange looking down and seeing how small my chest looked. My breasts were a DD cup, and I had some fat around them, so I had also had liposuction during the procedure to prevent “dog ears”—pockets of fat left in the armpit area after a double mastectomy, as they’re known in the transgender community.

When I saw my new chest, I was amazed at how good it looked. Like I’d been dreaming for the past 15 years. Yes, I had stitches and purple marker and some blood around the wounds, but this was how I had wanted to look for so long. When I saw my new chest, I felt acceptance blooming in my heart, a love for something I could have only imagined in my other life.

It’s only been a little over a month, but I love my new chest. I’m still processing all the feelings that I’m experiencing as a result of choosing to get my breasts removed at age 30. But as I navigate my new body and my new life, I’m grateful to be able to say that my surgeon did an excellent job, the people in my life have been mostly encouraging and supportive, and I’m very happy with my new body.