If you have been told you need a hysterectomy or are wondering if you need one, you might be concerned that it will affect your future health. This procedure involves removing the uterus and, sometimes, the ovaries. This may or may not cause immediate symptoms of menopause.
By age 60, 1 in 3 people will have had a hysterectomy.
55% of people have had their ovaries removed in a hysterectomy.
If you have had a hysterectomy with your ovaries removed, you can experience symptoms of menopause right away.
A hysterectomy is the second most common surgical procedure in the world. One in 3 women will have a hysterectomy by the time they reach age 60, according to the Centers for Disease Control and Prevention (CDC).
After a hysterectomy, you no longer will have your period and you are no longer able to get pregnant. Some people will have their ovaries removed along with their uterus.
If you only had your uterus removed in a hysterectomy, you might not have symptoms of menopause immediately. But, if your doctor removes your ovaries along with your uterus, you may go into menopause right away. About 55% of people who have had a hysterectomy in the United States also have their ovaries removed.
What is a hysterectomy?
When you have a hysterectomy, it means your uterus is surgically removed. In addition to your uterus, you may also have other reproductive organs removed such as the:
- Fallopian tubes.
- Parts of the vagina.
The reason for your hysterectomy can indicate which of these other reproductive organs need to be removed. There are different types of hysterectomies, depending on what organs are causing concern:
- A partial hysterectomy removes only the uterus.
- A total hysterectomy removes the uterus and cervix. The ovaries are left in place. This is the most common type of hysterectomy.
- A total hysterectomy with bilateral salpingo-oophorectomy removes the uterus, cervix, fallopian tubes, and ovaries.
- A radical hysterectomy removes the uterus, fallopian tubes, ovaries, cervix, and upper vagina. Nearby lymph nodes and surrounding tissues may also be removed. This is rare and usually done when cancer is present.
Why would you need a hysterectomy?
Hysterectomies are often performed to help decrease pain and certain symptoms of health conditions such as:
- Chronic pelvic pain.
- Heavy menstrual bleeding.
- Fibroids (noncancerous tumors).
- Uterine prolapse (a dropped uterus).
You might also have a hysterectomy if you have an increased chance of getting cancer of the breast, uterus, cervix, or ovary. For instance, removing the fallopian tube and keeping the ovaries may help prevent a certain type of ovarian cancer.
What happens after a hysterectomy?
Your ovaries make estrogen and progesterone, which are hormones that are important for your reproductive and bone health. If you have both ovaries removed in a hysterectomy, it means your body will experience a sudden drop in these hormones. This is known as surgical menopause. It can cause uncomfortable side effects such as:
- Hot flashes.
- Decreased sex drive.
- Vaginal dryness.
- Trouble sleeping.
Having a hysterectomy with the removal of your ovaries is a major change for your body. If you haven’t yet gone through menopause, you might have sudden changes in your hormones that can cause some symptoms similar to age-related changes including:
- Discomfort during sex.
- Dry skin, eyes, or mouth.
- Joint aches and pains.
- Difficulty concentrating or forgetting things.
- Changes in weight.
- Hair loss or thinning.
- Aging of your skin due to decreased elasticity of skin fibers.
- Increased facial hair.
- Urinary incontinence.
These are all signs of menopause and, when they come on suddenly after a hysterectomy, your symptoms may be more significant than if you went into menopause on your own. If you don’t have your ovaries removed in a hysterectomy, you may not notice symptoms of menopause right away. However, you may start experiencing menopause symptoms earlier than the average age of 52. This is because a portion of the ovarian blood supply was taken when the uterus and tubes were removed.
Certain health conditions can occur when you are no longer producing adequate amounts of estrogen after a hysterectomy with the removal of the ovaries. This is especially true if you are several years away from normal menopause. According to the Cleveland Clinic, these can include:
- Heart disease.
- Osteoporosis, due to low bone mineral density.
- Parkinson’s disease.
Rapid postmenopausal aging after hysterectomy
More than half of people who have a hysterectomy are younger than age 44. The highest rates for hysterectomy are between the ages of 40 and 44.
If you have a hysterectomy after you are already postmenopausal, it might be recommended you have your ovaries removed as well. This can help prevent ovarian cancer. Some doctors will only remove the ovaries if you have an increased chance of developing cancer due to family history, for instance.
Hormone levels naturally decrease after menopause, but typically, your ovaries will continue to make testosterone for up to 20 years, according to the National Health Service.
A lack of estrogen is what usually causes rapid skin aging after a hysterectomy. But, if you have your ovaries removed after menopause, you could still experience symptoms of low testosterone, such as decreased sex drive and pleasure.
How to manage these changes
Having a hysterectomy doesn’t necessarily mean you’ll experience signs of rapid aging. But you may enter menopause a few years earlier than the average person. If you have your ovaries removed along with your uterus, you can experience signs of menopause right away, since your levels of estrogen and progesterone will decline sharply.
Talk with your healthcare provider about taking hormone replacement therapy (HRT) to help ease some of the symptoms of menopause. They can help you decide if HRT is right for you.
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