Hysterectomy

A hysterectomy is the surgical removal of the uterus. At times it is combined with an oopherectomy, in which the ovaries are removed.

There are two types of hysterectomy. In a total hysterectomy, the entire uterus, including the cervix, is removed. Since the niddah status results from uterine bleeding only, a woman can no longer become niddah following a total hysterectomy, regardless of whether her ovaries remain.

In a subtotal hysterectomy only part of the uterus is removed. It may be possible for a woman to become niddah again following this procedure. She should discuss her operative report with a rabbi to determine whether future bleeding might make her niddah.

Does a hysterectomy make a woman niddah?

There is dispute among halachic authorities as to whether a hysterectomy renders a woman niddah. An individual question should be asked.

Spotting immediately following a hysterectomy is generally from trauma to the vaginal wall, not from the uterus. Therefore, it does not render a woman niddah.

Becoming tehorah after a hysterectomy

A woman who becomes niddah as a result of a hysterectomy, or who was already niddah before the surgery, will need to count seven clean days and immerse in the mikveh. This may take several weeks. Although the vaginal bleeding that follows a hysterectomy does not render her niddah, it will impede the bedikot of the seven clean days.

In light of the difficulty in completing the seven clean days, and the fact that almost all her bleeding is likely to not be from the uterus, she may modify the taharah process as follows to prepare for the first post-operative mikveh immersion: She performs the hefsek taharah examination, omitting the moch dachuk. She then counts seven clean days, but she does not wear white underwear, and she does only two bedikot: one on day 1 and one on day 7. (It is essential to remember the bedikah on day 7. If it is omitted, she will need to restart the clean days.) She then immerses in the mikveh.

In the case of a total hysterectomy, she can never become niddah again. In the case of a subtotal hysterectomy, if she bleeds after her first post-operative immersion, an individual question should be asked.

Permissibility of hysterectomy

There is a halachic concern about hysterectomy because it is a form a sterilization, which is generally considered a rabbinic prohibition for women. There is also halachic caution regarding any elective surgery. Nevertheless, when medically indicated, particularly if a woman is no longer fertile, hysterectomy is halachically permitted.