I Thought I Just Needed To Endure My Awful Periods. What I Needed Was A Hysterectomy.

The night before my scheduled hysterectomy, I decided to get my bulbs in: parrot tulips, winter aconite, blue Scylla, drumstick alliums. I had bought them all back in June, envisioning a carpet of spring flowers to wow and delight my sons. But now it was early November and the days had gotten significantly shorter. This was my last chance; by the time I was healed enough to crawl around on the ground and move buckets of soil, the earth would be frozen, and, likely, covered with snow.

As the darkness dropped around me, I persisted, working with a headlamp. My husband, Dan, tried to intervene, telling me he could finish the work over the weekend. But I told him I needed to do it, I wanted to do it, I had a plan. He nodded but couldn’t hide the shadow of bafflement crossing his face.

I watched him walk back inside to gather my younger son's soccer kit to head to practice. A moment later, I saw Dan and both of my sons looking out the window, watching me, as I scrambled through the muddy dirt, working in a frenzy, packing down compost. They looked worried. When I think back to that moment, looking up at the window, their faces illuminated, it was as if I were seeing them through a mosaic; they were far away and pixelated in the orange kitchen light. I couldn’t quite connect what I was doing out there on the ground to the regular Wednesday night they all were living inside.

Looking back, I should have advocated for myself more vociferously. But I didn’t understand. I thought that maybe this is what all women endured.

Alone now, I stuck my hand into the paper bag of bulbs and realized I still had endless handfuls of pearly crocuses. Shaking off defeat, I made a hole and pulled three bulbs out of the bag. "Three by three," I said out loud. I placed them into the hole, their little nubbly buds pointing up. I noticed how feminine their shapes were, so hopeful and fecund; inside each papery layer was a tiny life, ready to start growing.

That same day, I had met a deadline for the first 100 pages of a new novel I am writing, one that will take place in France. After that, I had gone shopping for three pairs of sweatpants, then to see a friend's art show, and on to CVS; I still needed to shower and take my older son to a banquet for the cross-country team before I could sleep. I was tired, my time was running out, and it was cold and very dark. I started to cry. There were simply too many bulbs; my hands were freezing in the wet dirt. And I was about to have my uterus, the hidden organ in which I'd safely carried both of my children to term, removed from my body. I felt afraid. And I felt a little bananas, honestly.

Scheduling a hysterectomy had not been an easy decision. I had had heavy periods my entire life and had always been either borderline or diagnostically anemic. In the winter of 2020, just before Covid exploded, I was diagnosed with pica. A strong desire to chew substances with no nutritional value, such as ice, clay, soil, or paper, is often associated with anemia, though the reason is unclear. This helped explain why I wanted to (but didn’t) eat beach sand and why I did veer off into the woods while running to cram snow into my mouth. Anemia also explained the pounding pulse in my thigh that made my jeans thump up and down. A study published in 2023 showed that more than a third of women under 50 are iron deficient. Anemia can be very serious, and, if left untreated, can cause an irregular heartbeat, headaches, and chest pain; persistent anemia can cause organ failure.

Just before the world shut down for the pandemic, I started getting regular IV iron treatments, which my kids called "the soy sauce" for the brown color that traveled down the plastic tube into a vein in my wrist. When I went for IV iron treatments, the nurses were all so tenderly solicitous, I put my feet up and pretended I was at a spa.

The iron cost around $1,000 a pop (thankfully covered by insurance) and would get my hematocrit and hemoglobin numbers up a bit each time, but my periods were too heavy for my iron stores to catch up. One doctor said, "It's like you have money in your wallet, but no money in the bank."

My periods had been bad for years. Then, shortly after my second son was born in 2014, I was diagnosed with a fibroid. At first it was small. It was attached to my uterine wall, which made it hard to treat non-invasively. So we watched it slowly grow. Then, during that year-plus when the world shut down due to the pandemic, it more than doubled in size.

I felt afraid. And I felt a little bananas, honestly.

As it grew, it pressed on my bladder, so peeing became an emergency. My small intestine, with no room to zig-zag down my body, was shoved up under my breasts, making me look more and more barrel-shaped as time went on. I’m laying this all out because when I do so, the solution seems so obvious: solve all these problems by removing my uterus and the fibroid inside it. But it wasn’t so obvious at the time. Like anything, in the slow trickle of healthcare, these symptoms became more obvious to both me and my doctors as time passed.

Instead, I was given intense ibuprofen regimens, which graduated to drugs that promised to stop the bleeding, but could give me blood clots and made me extremely nauseous. I took nightly doses of psyllium for my non-moving bowels. I tried special physical therapy for my bladder, which did not work. I wore overnight pads inside of period underwear to run, trying to live with the incontinence I now thought I was stuck with forever. I peed through all of it, urine pooling in my running shoes by the time I got home. How many neighbors drove by me this morning and noticed? I'd wonder. When I got my period, I bled so profusely, I had a hard time leaving my house.

Looking back, I should have advocated for myself more vociferously. But I didn’t understand. I thought that maybe this is what all women endured — it would end one day with menopause, and I should be a good girl and try all the options my doctors suggested.

The last straw came on a trip to Paris with Dan and our two sons. Instead of enjoying the our time in the city, a celebration of the impending publication of my first novel, I spent the whole time in search of a bathroom, no tampon or pad ever enough to stop the deluge.

At last, on the plane headed home across the Atlantic, wearing a thick French incontinence pad for the bleeding, as my husband and sons slept, I finally accepted that this was too much. I was done with this problem. Did I really need this organ anymore? I wasn't going to carry any more children in it. So why was I clinging to it?

I resolved then and there that I was going to push my doctors for its removal. I was done with trying anything else.

I am not alone in coming to the conclusion that a hysterectomy was the best answer to my untreatable fibroids and heavy periods. Recent data suggests that hysterectomy rates are rising. In the U.S. alone, around 600,000 of them are performed every year, and more than a third of women over 60 have had their uteruses removed. (In 2020, even with a pandemic, the rate went up slightly from 2019, which is remarkable.) One very simple explanation for this is that easy, fast, and safe laparoscopic surgery is now the first choice for outpatient hysterectomies.

Hysterectomies are an ancient surgery — the word first appeared over 2,000 years ago in a Greek text. By the 16th century, doctors were trying to perform them without anesthesia, with predictably poor results. The first successful abdominal hysterectomy — one in which the patient survived — wasn’t performed until the mid-1850s. By the 1930s, hysterectomies had become safer: antibiotics, anesthesia, and blood transfusions made the surgery more likely to succeed. But there was an ugly side, too: rather than a medical intervention, they were sometimes used to "cure" mental illness, or "hysteria" (a rather broad term that could mean a fondness for writing, postpartum depression, or infertility), or to sterilize Black and poor white women.

No wonder so many women are afraid of them. I was, too.

Nevertheless, when I got back home from France, I called my doctor as soon as her office opened on Monday morning. I went in and told her I was done. She agreed it was time. Then she told me that I would have to wait seven months until they could schedule the surgery. She said that they had so many women in need of hysterectomies that some patients were being sent to Boston.

We waited. Then, the morning after I had planted all my bulbs, Dan and I got up in the dark and drove to the hospital.

I remember succumbing to the slippery tide of anesthesia before I was even in the OR. I woke up scared, yelling for Dan. I had a distinct feeling that something had been taken from me, something was missing. Was it my leg? My arm? Oh right, it was my uterus.

My doctor told me while I was still bleary that the fibroid had, as ultrasounds had shown, been deeply lodged in the wall of my uterus and that it was as large as a mango. She held her hands apart as if she were cupping the sweet fruit. My ovaries were fine, she said, and still there. They had taken the uterus and cervix and some of the surrounding tissues. "Am I OK?" I asked shakily.

"More than OK. It was definitely the right thing to do," she assured me.

After I healed and could wear something other than sweatpants, I went back to France for a research trip for my next novel. Brazenly, I packed a pair of white jeans, even though it was February. I no longer needed an emergency bag of 20 nighttime pads and two boxes of tampons in my carry-on.

Reader, when I tell you that this is the freest I've felt in years, I'm being too understated. Thanks to my intact ovaries, I still have a hormonal cycle, albeit a quiet one that now involves tender breasts and some mild bloating, and culminates in, blessedly and exactly, nothing at all. I feel stronger than I have for years, maybe ever. My iron stores are replenishing, and I have more energy through the day. I no longer pee my pants, and I can wear anything, even a thin skirt, at anytime. Sex is now something I can do or not do based on how I feel at any given moment; my intense bleeding is not an impediment anymore. It's nuanced and hard to explain, but it's empowering to have my mind be the reason I can or will make love.

When I got back from that valedictory white-jeans trip to France, I was still curious about how much had changed for me. So I went for my first run, almost four months post-surgery. I did not wear a maxi pad. Instead, I drank a jar of water and a black tea before I left, pulled on a pair of normal underwear, and tempted the fates. I stayed dry. I couldn’t stop laughing with joy as I ran up to our house.

Still breathing hard, I walked through my garden to catch my breath. And suddenly, like it was all designed to go this way, I saw the first green point of a crocus pushing through the dark soil. Gratitude washed over me, for both myself and for the world which still delivers hope and beauty, over and over again. I thought, "OK, begin." I've restarted my life.

Caitlin Shetterly is the author of the novel Pete and Alice in Maine, just out in paperback, and has written for The New York Times, Orion, Elle, Self, and Oprah.com, as well as This American Life and other public radio shows. She previously wrote “The NICU Never Leaves You” for Romper. You can follow her on Instagram.