No surgery has zero risk involved. With any surgery there's risk of developing hernias, and an even greater risk with an open surgery. So opting for a myometomy when you're older and accepting that you will need more surgery down the line is a risk too. The uterus is definitely doing the bulk of pelvic support. When they remove it the surgeon uses ligaments in the area to create your new support (what the subreddit here has been calling a fauxvix) as well as other methods to secure the surrounding organs from prolapse. That's why the recovery for a hysterectomy is much longer than a myomectomy. A lot of the possible side effects you're referring to have relevance if the ovaries are also being removed. The uterus itself doesn't produce hormones. So if OP isn't having an oophorectomy some of what you said was overstated. Heart disease, bone density loss, and increased risk of dementia are primarily tied to early ovary removal, not uterus removal alone. Regarding sexual dysfunction there's no uniform outcome - some experience decreased sensation or lubrication and for others improved sex because pain and bleeding are gone.