 [ Symptoms ] when should a hysterectomy be performed [ Disease ] you know hysterectomies were done almost on every woman back twenty years ago it was like oh you need a hysterectomy today i look at a hysterectomy done when a patient has severe bleeding from fibroids that cannot be controlled in any other way she is tried medication she is tried birth control pills she is tried possibly even ablation or a d&c she is bleeding she is anemic the fibroids are the cause she may need a hysterectomy someone who has enlarging fibroids they are just getting bigger and bigger there is embolization which could decrease your fibroids by 60 however some women do not respond to it or they are not wanting to do an embolization and they may need a hysterectomy and of course women that have uterine cancer or have some other form of ovarian cancer possibly may even need a hysterectomy but i think that birth control pills sometimes can be used instead to control abnormal bleeding there are other options out there first i think it should be your last resort