The Connection Between Hysterectomy and Menopause

A hysterectomy is a surgery to remove your uterus. It is a major procedure that significantly affects your reproductive health. If you’re premenopausal and faced with this surgery, you may wonder about the side effects of a hysterectomy. You may also wonder whether it causes symptoms of menopause.

What Is a Hysterectomy?

Hysterectomy is the second most common women’s health surgery next to a cesarean section. Sometimes, it’s medically necessary, as with cancer in your uterus or other reproductive organs.

Your doctor might also recommend a hysterectomy to treat these and other conditions if nonsurgical treatments don’t work:

  • Adenomyosis. This condition causes tissue that lines the uterus to grow inside the walls of the uterus where it doesn’t belong. The uterine walls thicken, causing ongoing pain and heavy bleeding.
  • Endometriosis. This is when tissue that lines the uterus grows outside the uterus on the ovaries or other places in your body, like your bladder or intestines. Endometriosis can cause severe pain and bleeding between periods.
  • Fibroids. These are common noncancerous growths inside the uterus. They can cause pain and heavy bleeding.
  • Uterine prolapse. This happens when loss of support in your vagina causes your uterus to fall down. It can cause pelvic pressure as well as urinary or bowel leakage.
  • Gender-affirming care. Having menstrual periods can be very distressing for people who do not identify as being female even if that was their sex assigned at birth.

There are different types of hysterectomies. Depending on your medical condition, you might have:

  • A partial (also called a subtotal or supracervical) hysterectomy. This surgery removes only the body of the uterus but leaves your cervix in place.
  • A radical hysterectomy. A surgeon removes all of the uterus, cervix, the tissue on both sides of the cervix, and the upper part of the vagina.
  • A total hysterectomy. This is the most common type of hysterectomy. A surgeon removes all of your uterus, including the cervix.

Your surgeon may also remove your ovaries and fallopian tubes during a hysterectomy to treat or prevent certain types of cancer.

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Can You Get Pregnant After a Hysterectomy?

All types of hysterectomies remove your uterus, also known as your womb. This is where a sperm fertilizes your egg and where a baby grows.

You can still have sex after a hysterectomy. But without a uterus, you can no longer get pregnant. You will also no longer have monthly menstrual periods.

A hysterectomy causes permanent changes to your body that impact your life. If you’re thinking about pregnancy in the future, it’s essential to discuss your options with your doctor. You may have other treatments or routes to parenthood available.

Does a Hysterectomy Cause Menopause?

Menopause happens when your ovaries stop producing estrogen. It marks the point when your menstrual periods stop permanently and you can no longer get pregnant.

If you’re premenopausal and your hysterectomy leaves one or both ovaries intact, you should still produce estrogen. You won’t go into menopause immediately, but it may happen a few years earlier than the average age of 52.

Even with your ovaries, there is a chance that the surgery temporarily causes a hormone imbalance or lower estrogen levels. This can cause hot flashes or other menopause symptoms that are likely to improve with time.

A hysterectomy that includes the removal of your ovaries (called an oophorectomy) means you’ll no longer make estrogen. The sudden drop in estrogen causes you to go into menopause immediately. Doctors call this surgical or induced menopause.

Hysterectomy Side Effects

The side effects you might experience after a hysterectomy depend on whether you still have your ovaries. If your doctor did not remove your ovaries, you might experience mild, temporary menopause symptoms. However, if you are premenopausal and your doctor removes both ovaries, you’ll likely experience symptoms of menopause. These include:

  • Hot flashes and night sweats.
  • Low sex drive.
  • Mood changes, like depression or anxiety.
  • Sleep disturbances or trouble falling asleep.
  • Urinary problems, like bladder leakage or more urinary tract infections.
  • Vaginal dryness, which can make intercourse painful.
  • Weight gain.

These symptoms are often more intense after surgical menopause because, without ovaries, you have a sharp decline in estrogen levels. With natural menopause, the estrogen decline is gradual, so menopause symptoms appear gradually.

Talk to your doctor about these symptoms, especially if they affect your quality of life or relationship with your partner. Depending on your age, health, and risk factors, they may recommend various types of hormone replacement therapy. These are pills, patches, or creams that replace estrogen and other hormones and reduce menopause symptoms.

Besides these symptoms, it’s normal to feel sadness over the change in your body or your loss of fertility.

You’ll also need time to rest and recover after surgery. That can take between three and six weeks. You shouldn’t lift anything heavy or have sexual intercourse until your doctor gives you the OK.

Long-Term Health After a Hysterectomy

Whether you experience surgical or natural menopause, it’s essential to know that the loss of estrogen has effects throughout your body. After menopause, women have a greater risk of:

  • Abdominal weight gain, which increases your risk of diabetes.
  • Certain types of cancer.
  • Cognitive decline and dementia.
  • Heart disease and stroke.
  • Osteoporosis.

Those who experience surgical or natural menopause before age 45 have a higher risk of these health problems over time.

Hormone replacement therapy can help, but lifestyle changes also significantly reduce your risks. Healthy lifestyle goals after a hysterectomy include:

  • Eat a healthy diet rich in high-fiber plant foods and low in added sugar, fast foods, and packaged snacks. This diet makes maintaining a healthy weight, blood sugar, blood pressure, and cholesterol levels easier.
  • Don’t smoke, and limit alcohol to one drink or less each day to reduce your risk of cancer.
  • Get a weekly mix of cardio and strength training exercises to keep your bones and muscles strong.
  • Learn ways to manage stress, like meditation, yoga, talk therapy, or spending time in nature.
  • Prioritize sleep; It can help maintain healthy hormone levels and weight.
  • Take vitamin D and calcium supplements if your doctor recommends them to keep your bones strong.

A hysterectomy is a life-altering procedure, whether it causes menopause or not. It’s crucial to work with your health care team to prepare. They can provide education and support throughout the process to make things easier for you and your family.

U. S. Department of Health and Human Services. Office on Women's Health. Hysterectomy. LINK

Medicina. Surgically Induced Menopause—A Practical Review of Literature. LINK

About UPMC Magee-Womens

Built upon our flagship, UPMC Magee-Womens Hospital in Pittsburgh, and its century-plus history of providing high-quality medical care for people at all stages of life, UPMC Magee-Womens is nationally renowned for its outstanding care for women and their families.

Our Magee-Womens network – from women’s imaging centers and specialty care to outpatient and hospital-based services – provides care throughout Pennsylvania, so the help you need is always close to home. More than 25,000 babies are born at our network hospitals each year, with 10,000 of those babies born at UPMC Magee in Pittsburgh, home to one of the largest NICUs in the country. The Department of Health and Human Services recognizes Magee in Pittsburgh as a National Center of Excellence in Women’s Health; U.S. News & World Report ranks Magee nationally in gynecology. The Magee-Womens Research Institute was the first and is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology, with locations in Pittsburgh and Erie.