What to Know About Menopause After a Hysterectomy

A [hysterectomy is a surgery to remove your uterus.

If you’re considering this procedure, you may be wondering about its wider impact on your body and reproductive health.

And at the front of your mind may be this question: Do you go through menopause after a hysterectomy?

The answer is that it depends on the type of hysterectomy.

Here, we’ll talk you through the different kinds and their effect on menopause.

In this article: 📝

What is menopause?

Menopause is defined as the point 12 months after you have your last period.

In the US, the average age for this is 52 years.

In the build-up to that time (aka perimenopause), your body produces fewer and fewer fertility hormones (in particular, estrogen).

And as a result of this, many women experience menopause symptoms, including hot flashes, vaginal dryness, and mood changes.

What is a hysterectomy?

A hysterectomy is a surgical procedure in which your uterus—and sometimes some of your other reproductive organs—are removed.

It’s carried out to treat various health issues that affect your reproductive system when other, less invasive treatments haven’t helped.

A hysterectomy might be used to treat:

• Heavy periods or severe period pain
  
• Long-term pelvic pain
  
• Uterine fibroids
  
• Uterine prolapse
  
• Cancers affecting the reproductive system, such as uterine, ovarian, or cervical cancer, or cancer of the fallopian tubes

So what impact can a hysterectomy have on menopause?

Do you go through menopause after a hysterectomy?

It all depends on the type of surgery you have.

If the hysterectomy leaves one or both of your ovaries in place, you’re likely to go on to experience menopause at the “normal” time (usually in your late 40s or early 50s).

But if the hysterectomy removes both of your ovaries, you’ll go through menopause straight after the procedure.

This is also called surgical menopause.

The type of hysterectomy you have will depend on why you need the surgery.

For example, to treat fibroids, it might be enough to remove only the uterus, while if there’s a risk of cancer, you may be advised to have your ovaries removed, too.

Let’s explore all this in more detail.

Types of hysterectomy

Total hysterectomy

This is where your uterus and cervix (the neck of the uterus) are both removed.

(A “subtotal” or “partial” hysterectomy leaves the cervix in place.)

It’s the most common type of hysterectomy.

Because your ovaries aren’t removed with this type of surgery, they can continue making estrogen—so you won’t experience menopause right away.

The likelihood is that you’ll go through “natural” menopause when you would have anyway, although you might start to experience symptoms a few years earlier than usual.

Rarely, you may get some menopausal symptoms after the surgery if blood flow to the ovaries has been disrupted so they can’t release their usual amount of estrogen.

You won’t get your period any longer after you’ve had a hysterectomy because the uterus isn’t there to shed its lining each month.

So you might not be aware when you actually hit menopause—particularly if you don’t have many noticeable symptoms.

Total hysterectomy with bilateral salpingo-oophorectomy

With this type of hysterectomy, your uterus, cervix, fallopian tubes, and ovaries are all removed.

Because your ovaries are taken out (also called oophorectomy) and are no longer there to produce estrogen for your body, you’ll go through menopause straight after the surgery, even if you’re younger than the usual age for menopause.

So how is this surgical menopause different from “natural” menopause?

The main thing is that you’ll experience a sudden drop in estrogen rather than a gradual decline over several years.

This means the body doesn’t have as much time to adjust, often leading to more intense menopause symptoms.

If you’re below age 45, going through surgical menopause can also lead to an increased risk of other health issues in the long term, including an increased risk of heart disease, osteoporosis, and reduced enjoyment of sex.

(Hormone replacement therapy can help reduce these risks—which we will get into in a moment.)

If you have a hysterectomy after menopause, when your body has already adjusted to the loss of estrogen, you may not notice extra symptoms.

Treating symptoms of menopause after a hysterectomy

After a hysterectomy where your ovaries are removed, you might be offered hormone replacement therapy (HRT).

This helps to replace the estrogen that your ovaries used to make, relieving your menopausal symptoms.

It can also help reduce the risk of health issues associated with losing your ovaries if you’re younger than the usual age for menopause:

• Surgically induced menopause comes with an increased risk of cardiovascular disease, partially because of the drop in estrogen. HRT can help reduce this risk.
  
• Surgically induced menopause also comes with an increased risk of cognitive issues such as Parkinson’s and dementia. Some studies mention how HRT use for at least 10 years, initiated in the first 5 years post-menopause can slow down this decline or show improvement. But more studies are still being carried out to find out more about the effect of HRT in this case.
  
• Bone loss is common in menopause, those who have had surgically induced menopause are at a risk for osteoporosis (decrease in bone strength). This study found that HRT can have a protective effect, but only while you’re on HRT.

But HRT isn’t suitable for everyone.

Ultimately, it depends on the symptoms you may face, your circumstances, and what your healthcare provider recommends, but it’s still your decision.

If you’ve had certain types of cancer or liver disease, for example, then your doctor might advise against it.

Other treatments and lifestyle changes can still make a big difference if you struggle with menopause symptoms.

For example, cutting back on caffeine, alcohol, and nicotine can help reduce hot flashes.

What happens if you keep your ovaries after a hysterectomy?

You won’t go through menopause straight away, because your ovaries are still there to make estrogen for your body.

Instead, you’re likely to go through menopause when you would otherwise have done naturally, or possibly a couple of years earlier.

Is menopause easier after a hysterectomy?

If you have a hysterectomy where your ovaries are removed, you go through surgical menopause after the procedure.

This can lead to menopausal symptoms that are more intense than those of “natural” menopause because your body hasn’t had time to adjust to the drop in estrogen.

But everyone is different, and you might experience surgical menopause without noticeable symptoms.

If you’ve had a hysterectomy but kept your ovaries, this might not have much impact on your menopause experience.

The main difference is that, as you stop having periods after a hysterectomy, you won’t be able to depend on this as a sign that you’ve gone through menopause.

A last word on menopause after a hysterectomy

A hysterectomy of any type is a major event in your life, and it’s important to give yourself time to recover physically and emotionally.

And this is even more crucial if you experience surgical menopause, too.

If you’re struggling with menopause symptoms or concerned about the long-term health impact of the surgery, talk to your doctor about treatment options.

And if you need friendship, support, or a listening ear, remember that the Peanut menopause community is here for you.

You’re not alone. ❤️