If I Have a Hysterectomy, Will I Go Through Menopause?

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Undergoing a hysterectomy, like any surgery, can be a stressful process. But with a hysterectomy, it's understandable if you are also concerned about the aftermath, including the possibility of menopause.

The truth is that whether or not you enter menopause after a hysterectomy depends on one key factor—if your ovaries were also removed during the surgery.

Let's take a closer look at why (or why not) your ovaries may be removed during a hysterectomy, and what you can expect if they are.

Understanding a Hysterectomy

A hysterectomy refers to the surgical removal of a woman’s uterus. A hysterectomy may be performed for a number of reasons, both benign (for example, uterine fibroids) and cancerous (such as uterine cancer).

Depending on the reason behind why a hysterectomy is being done, a doctor may also remove a woman’s ovaries and fallopian tubes (the tubes that connect a woman's ovaries to her uterus).

With the removal of the ovaries, a premenopausal woman will immediately go into menopause, called surgical or induced menopause. Since a woman no longer has ovaries to produce estrogen, she may experience classic symptoms of estrogen depletion like hot flashes and/or vaginal dryness.

In addition to symptoms, there are also health conditions associated with the low estrogen state of menopause, like osteoporosis (when your bones weaken and become prone to breaking). 

If you are premenopausal and your ovaries are not removed during a hysterectomy, your body will continue to produce estrogen.

However, you will not have periods anymore, as there is no uterine lining to shed.

Common Symptoms of Surgical Menopause

There are a number of symptoms linked to both natural and surgical menopause; two of the most common ones include hot flashes and vaginal dryness.

Vaginal Dryness

With the loss of estrogen, the lining of a woman’s vagina becomes dry and itchy—this phenomenon is called vaginal atrophy.

This vaginal dryness, itching, and burning often makes sex painful and, in turn, can lower a woman’s desire to have sex.

Hot Flashes

Estrogen deficiency throws off how a woman's brain regulates body temperature, and this may lead to hot flashes. A  hot flash is a sudden, intense feeling of heat or burning in your face, neck, and chest, often accompanied by redness. 

A night sweat refers to a hot flash that occurs during sleep. Night sweats can negatively impact a woman's sleep cycle which may lead to tiredness during the day. 

Other Symptoms of Surgical Menopause

There are a number of other symptoms of menopause, although some of them are believed to also be caused by increasing age. 

These symptoms include:

  • Mood changes, like depression and anxiety
  • Weight gain, especially around the waist
  • Dry skin and hair loss
  • Increased urinary problems, especially urinary tract infections and urinary incontinence (loss of urine without any control)

It’s important to note that in women who have undergone surgical removal of their ovaries, menopausal symptoms tend to be more intense than a woman who experiences menopause naturally.

Of course, this is not a hard and fast rule—menopausal symptoms vary widely and in degree from woman to woman.

Even so, this greater intensity of menopausal symptoms is attributed to the abrupt removal of a woman’s ovaries, which are her primary source of estrogen. 

On the flip side, in natural menopause, the ovaries gradually lose their ability to produce estrogen, so the body can (usually) adjust more easily.

Hysterectomy With Ovaries Left Intact

Women with their ovaries intact but without their uterus won't get their period anymore. You may, however, still experience premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) because the hormones made by the ovaries will cause your body to still "cycle" monthly.

Occasionally, women whose ovaries were not removed during a hysterectomy experience hot flashes and other menopausal symptoms. This is mostly due to the disturbance of the blood supply to the ovaries during surgery.

In addition, some women may undergo menopause a few years sooner (the average age is 51) than they normally would if they never underwent a hysterectomy. 

A Word From Verywell

After a hysterectomy, it's common for women to feel a sense of loss. This is true whether a woman has had her ovaries removed or not. Emotional distress can be especially strong when an unexpected hysterectomy prevents a woman and her partner from having the biological children they planned on. 

The good news is there are resources out there to aid you through this difficult time, like support groups. Please seek out guidance from your doctor so you can heal and thrive after surgery. 

Sources:

Lonnée-Hoffmann R, Pinas I. Effects of hysterectomy on sexual function. Curr Sex Health Rep. 2014;6(4):244-51.

The North American Menopause Society. (2017). Instant Health for Induced Menopause.

The North American Menopause Society. (2014).The Menopause Practice: A Clinician’s Guide, 5th ed.Mayfield Heights, OH: The North American Menopause Society.

WomensHealth.gov. (2017). Hysterectomy

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