They told me to remove my uterus. I refused.

They informed me to remove my uterus. I refused.

Key points

• Haleema Younus Published August 28, 2026 Updated August 28, 2026 10: 37am.
• The American College of Obstetricians and Gynaecologists gives Uterine Artery Embolisation a Level-A recommendation as a legitimate alternative for women who want to keep their uterus.
• Note: This piece is based on personal experience and should not be taken as medical advice.
• During the first few days, particularly, the pain is so severe that it is impossible to move.
• But why they have always been this way is something I discovered out on the first scan of my highly first pregnancy.

They informed me to remove my uterus. I refused. An alternative to hysterectomy that few women in Pakistan know exists.

Haleema Younus Published August 28, 2026 Updated August 28, 2026 10: 37am. Remove your uterus; it's the simplest solution.

My gynaecologist pronounced the verdict just months after I had my first miscarriage, hardly a year into my marriage. I remember sitting throughout from her with my arms wrapped around my abdomen, where the pain was the worst-it felt like someone had kicked me hard in the stomach.

I was diagnosed with submucosal fibroids at the age of 26. It is a non-cancerous tumour that grows in the muscle just beneath the inner lining of the uterus and is common in regarding 25 per cent of women between the ages of 18 and 45 throughout the world. Think of it this way: the uterus is like an onion, created up of a number of layers. Submucosal fibroids grow on the layer nearest to the centre of the uterus, where a baby would develop.

Irrespective of their position, fibroids cause heavy periods. During the first few days, particularly, the pain is so severe that it is impossible to move. At night, I lay paralysed in bed for hours, praying for an end to the misery. In the morning, painkillers-as plenty of as four-helped me function, barely.

My periods have always been this painful. But why they have always been this way is something I discovered out on the first scan of my highly first pregnancy. It was terminated a month before my second trimester concluded.

Four months afterwards, I was in the boxy clinic of my gynaecologist, where she informed me the 'only solution' that exists for my condition. As if the organ my body was built around was disposable, removing the uterus will cure it, she remarked, almost as a matter of fact.

Thus began a 10-year journey that took me from one doctor to another and ultimately to an alternative most women never knew regarding: a procedure that could treat what was wrong with me without taking my uterus. But reaching there meant going through two rough pregnancies.

During my second pregnancy, a majority of the doctors I met were particularly direct: secure your uterus removed without trying to conceive ever again. I held my ground, and thankfully discovered a doctor who was eager to backing me in those nine anaemic months. I had to undergo four follow-up scans every month to track the baby's expansion and position, not to mention the a number of times I stayed the night at the hospital for pre-term labour pain, triggered by the expansion of the baby, and the fibroids.

Notably, the cycle repeated six years afterwards. At the time of my third delivery, I had around five to six fibroids covering almost the entire outline of my uterus-it was truly a miracle that my baby survived. That was the point where my husband and I created the reluctant decision not to have more children.

By this time, my doctors too had cautioned that I would need a myomectomy sooner or afterwards. It is a generally recommended procedure to remove fibroids. It often converts into a hysterectomy-in which both the uterus and fibroids are removed-due to medical complications such as excessive blood loss.

I wasn't a stranger to the procedure. I had watched my mother go through multiple surgeries for fibroid removal, all of which ultimately led to a hysterectomy. After that, I saw a real decline in her health, and that of a number of other women her age who went through the same. It was for this reason that I had decided against it and that I had realised the uterus was not just a reproductive organ.

So my quest for better treatment continued. I had grown more desperate than ever. After my last pregnancy, things took a serious turn: my period obtained so heavy I couldn't step out of the house. I applied that time for obsessive research, and that's when I came throughout Uterine Artery Embolisation-a procedure that shrinks fibroids by blocking the blood vessels that feed them.

In practice, the procedure itself follows a set sequence: a sedative and IV line to keep the patient comfortable, local anaesthesia at the groin, a small incision to reach the femoral artery, and a catheter guided by X-ray up to the uterine arteries. Dye is injected so the doctor can see the vessels feeding the fibroids, then tiny particles are published through the catheter to block that blood supply. Once the fibroids are cut off from circulation, the catheter is withdrawn and pressure is applied to the incision to stop the bleeding.

In comparison with a hysterectomy or a myomectomy, the recovery tends to be faster. There's no major incision, hospital stays are shorter, and the uterus stays where it is. A 2025 study by Dr Ziauddin Hospital in Karachi-which followed 67 women treated for symptomatic fibroids-found that patients were typically discharged within hours, if not days, and that those who responded to treatment saw symptoms improve within one to two days. In my case, the stay was two and a half days, followed by counselling for post-op pelvic pain. It took a week to subside.

Just like every other procedure, this treatment too comes with risks: abnormal bleeding, uterine infection, internal injuries, blood clots, and a small chance of premature menopause in women over 45. Some additionally go through post-embolisation syndrome in the days after the surgery. It involves pelvic cramps, low-grade fever, nausea and fatigue that typically lasts between two and seven days and can easily be managed with medication. Since I had done my research, I knew what to expect and managed it with medication.

Since the procedure does not involve removing the uterus, pregnancy remains feasible, and yes. Nevertheless, there isn't enough research on that front yet.

As successful as it is, the procedure is not cheap, that remarked. It generally runs between Rs400, 000 to Rs1, 000, 000-at least twice the cost of a myomectomy or hysterectomy. Yet, for a majority of the women I met during my journey, funds was never the deciding factor, autonomy over their bodies was.

Hence the question arises: why don't women know regarding the treatment? Part of the answer is structural. The procedure is performed by interventional radiologists and technologists, not gynaecologists. Research on the question backs this too: even as favourable outcome data for the treatment grew, plenty of gynaecologists still did not routinely offer it as an alternative to hysterectomy or myomectomy, and patients seeking less invasive options sometimes had to bypass their gynaecologist altogether, going directly to an interventional radiologist themselves or getting referred by a primary care doctor.

Notably, the American College of Obstetricians and Gynaecologists gives Uterine Artery Embolisation a Level-A recommendation as a legitimate alternative for women who want to keep their uterus. Yet, hysterectomy remains what one industry publication called the "gold standard from payers' perspectives", largely since it is a one-time, definitive procedure that's simpler for insurers to process than an evolving, sometimes-repeated embolisation course.

None of this involves a doctor telling a patient her uterus is good for nothing. It points to a referral gap built into the way medicine is structured and paid for. The fix then is awareness, not blame.

When my gynaecologist informed me to secure my uterus removed, I had noted no as I was educated and stubborn enough to keep asking the same question: is there any other way to treat this condition?, years back. But not every woman walking into a clinic today has the means, the confidence, or the information to do the same. That's the gap I am trying to close. Header art by Mohsin Alam.

Note: This piece is based on personal experience and should not be taken as medical advice. Please consult a qualified doctor to confirm your diagnosis before considering any treatment, including Uterine Artery Embolisation. The author is a teacher. She never obtained her period, and no one informed her why. THE MIDWIFERY CRISIS IN PAKISTAN. When women need permission to heal, everyone pays.

Taken together, the developments around they told me to remove my uterus. I refused point to a situation that is still moving, and the coming days should bring more clarity.