Hysterectomy rates statistics: how often the uterus is removed in the U.S., and why the number keeps falling

She was 46, three kids, and three years of heavy periods that soaked through clothes at work. Fibroids the size of oranges. Two prior attempts at medical management, one failed ablation. On the consent form she paused at the line about removing the uterus permanently and asked the question I hear almost every time: "Is this still the usual thing people do?"

The short answer is yes. Hysterectomy remains one of the most common major operations U.S. women ever undergo. The longer answer is more useful: the operation is less common than a generation ago, more often done through tiny incisions or the vagina, and still distributed unevenly by region and rurality in ways that look more like practice pattern than biology. This article pulls the numbers a reporter can lift with the primary source named beside them.

Age group	Percent with hysterectomy
18-44	2.8%
45-64	22.1%
65-74	35.0%
75 and older	41.8%
Total (age-adjusted)	14.6%
Total (crude)	17.2%

Source: Gorina Y, et al. NCHS Data Brief No. 494, February 2024. National Health Interview Survey, 2021.

Year	Rate per 10,000 women
2010	39.9
2011	39.0
2012	36.5
2013	35.0

Source: Morgan DM, et al. American Journal of Obstetrics and Gynecology, 2018. Health Care Cost Institute claims; age-adjusted utilization per 10,000 woman-years.

How common hysterectomy is among U.S. women

Prevalence is the cleanest single number, and the federal source is current. According to NCHS Data Brief No. 494, which analyzed the 2021 National Health Interview Survey, the age-adjusted percentage of women age 18 and older who had received a hysterectomy was 14.6%. The crude estimate was 17.2%.

Age drives most of the cumulative total. Only 2.8% of women ages 18-44 reported a hysterectomy in that survey. The share jumped to 22.1% at ages 45-64, 35.0% at 65-74, and 41.8% at 75 and older. By the oldest age band, roughly two in five women have had the uterus removed at some point. The operation concentrates in the perimenopausal decades, and the cumulative tally rises as cohorts age.

Race and ethnicity still matter after age adjustment. Asian non-Hispanic women had the lowest prevalence at 6.1%. Hispanic women sat at 12.5%, White non-Hispanic women at 15.6%, and Black non-Hispanic women at 16.3%, per the same NCHS brief. Women with disabilities were more likely to report hysterectomy (20.9%) than women without (14.1%). Education and income moved inverse to the procedure: 10.6% among women with a bachelor's degree or higher, versus 16.0%-18.0% with less formal education.

Harvey and colleagues, analyzing Behavioral Risk Factor Surveillance System data for women ages 18-80, reported unadjusted prevalence near 21% across 2006-2016 (21.4% in 2006 and 21.1% in 2016). Different sampling frame than NHIS; same direction. Hysterectomy remains common enough to matter in any serious discussion of gynecologic surgery volume.

For conditions that often lead to the decision, see our statistics on endometriosis diagnosis and treatment, PCOS prevalence, and ovarian and endometrial cancer.

Annual volume and rates per 1,000 women

Prevalence counts women who already had surgery. Incidence counts how many operations happen each year. That second number is harder, because hysterectomy has migrated from the inpatient ward to outpatient centers, and many classic national samples only saw the inpatient half.

The most-cited inpatient series remains Wright and colleagues' Nationwide Inpatient Sample analysis in Obstetrics & Gynecology (2013). After weighting, annual volume rose from 543,812 in 1998 to a peak of 681,234 in 2002, then fell every year to 433,621 in 2010. That is 247,973 fewer procedures, a 36.4% decline from the peak. Textbook estimates of "about 600,000 a year" that still circulate in secondary sources are outdated for inpatient care alone.

Rates per population tell the same story with a different denominator. Whiteman and coauthors, using the National Hospital Discharge Survey for 2000-2004, reported an inpatient rate of 5.4 hysterectomies per 1,000 women in 2000, falling slightly to 5.1 per 1,000 in 2004. The five-year average sat at 5.4 per 1,000 women age 15 and older.

Morgan and colleagues closed the inpatient-outpatient gap for commercially insured women. In Health Care Cost Institute claims covering more than 25 million women, utilization fell from 39.9 to 35.0 hysterectomies per 10,000 women between 2010 and 2013, a 12.3% relative decline. Inpatient rates dropped from 26.6 to 15.4 per 10,000 while outpatient rates rose from 13.3 to 19.6. By 2013, outpatient care had overtaken inpatient care in that insured population.

Albright and colleagues, writing in BJOG in 2023, estimated the prior-hysterectomy-adjusted population rate of hysterectomy for benign disease at 49 per 10,000 eligible adult residents across four states (Florida, Kentucky, Maryland, North Carolina) from 2012 through 2016. The rate drifted from 51.0 in 2012 toward 47.9 later in the window. Age-standardized state rates ranged from 42.2 per 10,000 in Maryland to 69.0 in Kentucky.

HCUP Statistical Brief #214 adds an all-payer angle from five states with dual-setting data. The combined hysterectomy rate (alone or with oophorectomy) fell 12.3% from 2005 to 2013, from 526.7 to 461.8 visits per 100,000 adult women; 60.4% of those surgeries were outpatient by 2013. HCUP Statistical Brief #252 ranked hysterectomy among the highest-volume invasive ambulatory surgeries in 2016, with an estimated 368,300 hospital-owned ambulatory procedures. Historically, Simms and coauthors estimated U.S. incidence for women ages 18-64 rose from 2.4 per 1,000 in 1935 to a peak of 10.6 in 1975, then declined toward a projected 3.9 per 1,000 by 2035.

Route	2010 share	2013 share
Abdominal	38.6%	28.3%
Laparoscopic (incl. robotic in study coding)	26.1%	43.4%
Laparoscopically assisted vaginal	20.2%	16.7%
Vaginal	15.1%	11.5%

Source: Morgan DM, et al. American Journal of Obstetrics and Gynecology, 2018. Health Care Cost Institute, 2010-2013.

Leading indications for surgery

Most hysterectomies are not for cancer. Cohen and colleagues' 2009 Nationwide Inpatient Sample analysis found 479,814 hysterectomies that year, and 86.6% were for benign indications. Fibroids and bleeding drive many cases, as do endometriosis and prolapse plus other pelvic pathology.

Uterine leiomyoma sits at the top of nearly every national list. In Whiteman's 2000-2004 inpatient surveillance, the proportion performed for leiomyoma fell from 44.2% in 2000 to 38.7% in 2004. It was still the single largest indication category. Wright's inpatient series showed absolute volume for leiomyoma peaking at 373,629 procedures in 2002 and falling to 195,735 in 2010 (−47.6%). Endometriosis-related inpatient hysterectomy fell from 239,844 operations in 2002 to 83,158 in 2010 (−65.3%).

Morgan's commercial claims, which include outpatient cases, again place fibroids first by utilization rate: 17.6 per 10,000 woman-years in 2010, down to 15.6 in 2013. Abnormal uterine bleeding rates fell from 15.8 to 13.0 per 10,000, and endometriosis from 14.9 to 13.5. Those three categories still dwarf gynecologic cancer codes among commercially insured women of working age.

Concurrent ovary removal has its own trend. Whiteman reported that concomitant bilateral oophorectomy accompanied 54% of inpatient hysterectomies overall in 2000-2004, declining from 55.1% in 2000 to 49.5% in 2004. HCUP Statistical Brief #214 later found combined hysterectomy-oophorectomy rates fell 29.4% from 2005 to 2013 in five states, while hysterectomy alone rose 14.8%. The clinical conversation about ovarian conservation at benign hysterectomy has shifted practice. Our review of menopause and hormone therapy statistics covers the hormone decisions that follow surgical menopause.

How often the procedure is minimally invasive

Route of surgery is where the last fifteen years of gynecology show up most clearly. Abdominal hysterectomy used to be the default. It is no longer, in series that capture outpatient care.

Wright found abdominal hysterectomy still accounted for 54.2% of inpatient procedures by 2010, down from a peak of 68.9% in 2002. Vaginal hysterectomy fell from 24.8% of inpatient cases in 1998 to 16.7% in 2010. Those inpatient-only percentages understate minimally invasive care, because same-day laparoscopic cases leave the sample.

Cohen's 2009 NIS update put benign-case routes at 56% abdominal, 20.4% laparoscopic, 18.8% vaginal, and 4.5% robotic (about 43.7% non-open if those three routes are grouped). Morgan's commercial sample is the cleaner modern snapshot: laparoscopic share (including robotic-assisted cases under their coding rules) rose from 26.1% in 2010 to 43.4% in 2013, while abdominal fell from 38.6% to 28.3%. By 2012, laparoscopy was the single most common approach in that insured population. Inpatient share of all hysterectomies fell from 66.6% to 43.9% over those four years.

A National Surgical Quality Improvement Program analysis of 206,119 benign hysterectomies by gynecologic surgeons between 2014 and 2022 found 64.5% laparoscopic, 21.2% abdominal, and 14.3% vaginal overall. Laparoscopic share climbed from 54.4% to 71.8% by 2022, while abdominal fell from 29.5% to 16.0%. Albright's four-state study found state-level minimally invasive proportions clustered between 71.0% and 74.8%, but Hospital Service Area proportions ranged from 27% to 96%.

Outpatient volume rewrites older national totals. Cohen and colleagues identified 64,612 outpatient hysterectomies in 16 states in 2011 (81.5% laparoscopic, 16% vaginal) and estimated roughly 100,000-200,000 outpatient cases nationally, invisible to pure inpatient surveillance.

Census region	Percent of women ≥18 with hysterectomy
Northeast	10.2%
West	13.3%
Midwest	15.5%
South	16.9%

Source: Gorina Y, et al. NCHS Data Brief No. 494, February 2024. National Health Interview Survey, 2021; age-adjusted estimates.

Age at procedure

Hysterectomy for benign disease is a midlife operation. Morgan's commercial rates per 10,000 woman-years in 2013 were 2.6 under age 35, 12.0 at ages 35-44, 12.2 at 45-54, 4.6 at 55-64, and 2.7 at 65-74. The steepest declines from 2010 to 2013 sat in those high-volume bands: −21.2% under 35, −16.7% at 35-44, and −15.3% at 45-54.

Albright's population rates peak even more sharply in the forties, exceeding 100 per 10,000 eligible residents at ages 40-49 (Kentucky ages 40-44: 159.5 per 10,000). Rates fall after 50, with a small secondary bump at ages 65-69 after Medicare eligibility. HCUP Statistical Brief #214 likewise found the highest dual-setting rates at ages 35-54 in 2013; mean age for hysterectomy alone was about 44 years. Lifetime prevalence then accumulates those midlife surgeries. Surgical menopause has bone and cardiovascular implications, plus symptom effects; ovary removal is a separate decision from uterus removal and should not be conflated on a consent form.

Patients tracking heavy bleeding often need simple tools before any surgical discussion. Our period calculator, cycle length calculator, and ovulation calculator help organize a bleeding diary. They do not replace evaluation for fibroids or hyperplasia.

Regional and small-area variation

If rates only varied by age, this would be a straightforward clinical story. They also vary by state line and hospital market. That is the classic practice-variation pattern.

NCHS Data Brief No. 494 is the cleanest national prevalence map by census region for 2021. Age-adjusted hysterectomy prevalence was 16.9% in the South, 15.5% in the Midwest, 13.3% in the West, and 10.2% in the Northeast. That is a 6.7-point gap between South and Northeast after age adjustment. Urbanization runs the same direction: 11.8% in large central metropolitan areas, 12.8% in large fringe metros, 16.8% in medium and small metros, and 19.0% in nonmetropolitan areas. Rural women are more likely to have had the operation.

Harvey's BRFSS analysis for 2006-2016 shows the same geography. Unadjusted prevalence ran highest in the South (25.4% in 2006, 24.6% in 2016) and lowest in the Northeast (16.2% to 15.6%). Compared with the Midwest, living in the South raised the odds of reporting hysterectomy (OR 1.36); living in the Northeast lowered them (OR 0.67), even after adjustment for age, race, BMI, smoking status, and insurance coverage.

Albright's Hospital Service Area work is the sharpest small-area picture. Across 322 HSAs in four states, average annual benign rates ranged from 12.9 to 106.3 per 10,000 eligible residents (interquartile range 44.0-64.9). State age-standardized rates spanned 42.2 to 69.0. Local population characteristics explained only 31.8% of observed variation in multilevel models. The residual is what health-services researchers usually attribute to provider practice style and patient preferences interacting with local supply.

Race differences appear in both prevalence and operative rate. NCHS put Black non-Hispanic women at 16.3% lifetime prevalence versus 15.6% for White non-Hispanic women in 2021. Albright found higher midlife rates among Black eligible residents (about 169 per 10,000 in peak ages versus 106 for White residents). Cohen's 2009 analysis linked minority race, Medicaid or self-pay status, and fibroids to lower odds of a minimally invasive route. The data are stronger on gaps existing than on a single causal story.

Why rates have fallen over time

The decline is not one mechanism. It is several, stacked.

First, alternatives matured. Wright and others document large drops in fibroid- and bleeding-related inpatient cases as embolization, endometrial ablation, levonorgestrel IUDs, and better medical regimens entered routine care. Morgan's 2010-2013 rates for fibroids, abnormal bleeding, and endometriosis fell in parallel with overall utilization.

Second, measurement changed. Inpatient databases recorded a collapse partly because cases moved same-day. Any "hysterectomy is disappearing" headline based only on hospital discharges overstates the true drop. The true drop is real (commercial rates fell 12.3% in four years, Albright's rates edged down, and HCUP dual-setting rates fell 12.3% from 2005 to 2013), but smaller than inpatient-only charts imply.

Third, oophorectomy practice shifted: combined hysterectomy-oophorectomy rates fell faster than hysterectomy alone in HCUP's five-state series. Fourth, history: Simms and colleagues place the modern era well below the 1975 peak of 10.6 per 1,000 women ages 18-64. Harvey's BRFSS work shows only modest lifetime-prevalence change from 2006 to 2016, with clearer declines among women 40 and older.

What the data do not support is a claim that hysterectomy is rare, or that geographic variation has been solved. A procedure that still leaves 14.6% of adult women without a uterus, peaks above 100 per 10,000 in midlife markets, and varies more than twofold across hospital service areas remains common, with unfinished equity work. Every woman offered hysterectomy for benign disease should also have been offered a serious alternative when one exists, and every woman who needs surgery should have a realistic path to a minimally invasive route if anatomy allows. National averages have moved toward that standard; local rates and routes show how far individual markets still sit from it.

For related statistics, see our pages on endometriosis, perimenopause symptoms, and iron deficiency anemia in women. Tools such as the late period calculator and implantation calculator can support symptom timing before surgical referral without substituting for imaging or exam.

Frequently asked questions about hysterectomy rates

What percentage of U.S. women have had a hysterectomy?

According to NCHS Data Brief No. 494 (2021 National Health Interview Survey), the age-adjusted percentage of women age 18 and older who had received a hysterectomy was 14.6%. The crude estimate was 17.2%. Prevalence rises with age, from 2.8% at ages 18-44 to 41.8% at age 75 and older.

How many hysterectomies are performed each year in the United States?

There is no single current all-setting federal count. Wright et al. found inpatient volume fell from 681,234 in 2002 to 433,621 in 2010. Cohen et al. estimated an additional 100,000-200,000 outpatient procedures around 2011. Among commercially insured women, Morgan et al. reported 35.0 procedures per 10,000 women in 2013. Older "600,000 a year" figures are outdated for modern practice.

What is the hysterectomy rate per 1,000 women?

Whiteman et al. reported inpatient rates of 5.4 per 1,000 women in 2000 and 5.1 per 1,000 in 2004. Albright et al. estimated about 49 benign hysterectomies per 10,000 eligible residents annually (roughly 4.9 per 1,000) in four states during 2012-2016. Morgan's commercial all-setting rate was 3.5 per 1,000 in 2013 (35.0 per 10,000).

What are the most common reasons for hysterectomy?

Benign disease dominates. Cohen et al. found 86.6% of 2009 inpatient hysterectomies were for benign indications. Uterine fibroids are the leading single category in Whiteman (38.7% of inpatient cases by 2004) and remain first by utilization rate in Morgan's commercial data, followed by abnormal uterine bleeding and endometriosis.

What share of hysterectomies are minimally invasive?

It depends on the year and whether outpatient cases are included. Morgan et al. found laparoscopic share rose from 26.1% to 43.4% among commercially insured women from 2010 to 2013. A Downey et al. NSQIP analysis of benign cases from 2014-2022 put laparoscopic routes at 64.5% overall and 71.8% by 2022. Albright et al. reported state-level minimally invasive proportions of 71.0%-74.8% for benign disease in 2012-2016.

Why do hysterectomy rates vary by region?

NCHS data show age-adjusted prevalence of 16.9% in the South versus 10.2% in the Northeast in 2021. Albright et al. found more than eightfold variation across Hospital Service Areas (12.9 to 106.3 per 10,000 eligible residents), with local demographics explaining only about 32% of that spread. The remaining variation is widely attributed to practice style, surgical training, and access to uterine-sparing alternatives.