Any woman on the Pill should come off it a month before surgery, substituting a non-hormonal method of contraception, such as a condom or diaphragm in the meantime. Women who smoke should stop at least a week before a hysterectomy. They should also consider a permanent break from smoking as their risk of heart disease and osteoporosis is likely to increase as a result of the surgery, and smoking will increase this risk still further.
A GnRH agonist may be prescribed prior to surgery in a bid to reduce the size of any fibroids a woman may have. When this approach was systematically studied in 142 women, only half of whom received a GnRH agonist, the results were encouraging. The surgery was less likely to be difficult in the treated women who also experienced significantly less blood loss on average. It has been suggested that the beneficial effect of GnRH agonists is due partly to their ability to shrink fibroids and partly to their reduction of uterine blood flow.
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