Do You Go Through Menopause After a Hysterectomy?

Every year, more than half a million women undergo a hysterectomy, a surgical procedure to remove the uterus. If you’re one of them, you may wonder whether the surgery will trigger menopause symptoms.

Menopause specialist Pelin Batur, MD, explains what you need to know about menopause after a hysterectomy.

Do you experience menopause after a hysterectomy?

Typically, a hysterectomy involves removing your uterus and cervix. If this is the type of surgery you have, you probably won’t experience menopause symptoms earlier than expected because you’ll have your ovaries.

According to Dr. Batur, a small number may experience symptoms even with their ovaries remaining, as occasionally, the surgery may impact the blood flow to an ovary, impacting its function.

Your ovaries are small glands that make the reproductive hormones estrogen and progesterone. When your ovaries stop making those hormones, menopause occurs. So, if your hysterectomy involves ovary removal, menopause is on the horizon.

“An oophorectomy, which is the surgical removal of both ovaries, brings on menopause symptoms,” affirms Dr. Batur.

What is surgical menopause?

Surgical menopause is menopause that occurs after an oophorectomy (or after a hysterectomy with an oophorectomy). You may also hear the terms “surgically induced menopause” or just “induced menopause.”

Most females naturally enter perimenopause, the early stage of menopause, during their 40s, and then start menopause in their early 50s. (Though many factors can influence your menopause age.)

But if you’ve had a hysterectomy with oophorectomy, you may experience menopause symptoms very soon after surgery. In this case, it’s not your age that’s to blame. It’s your sudden loss of hormones.

Does everyone go through menopause after hysterectomy?

No. If you still have ovaries, you typically won’t go through menopause after your hysterectomy. But many who have a hysterectomy aren’t sure which parts of their reproductive system have been removed.

This may sound surprising, but there are different types of hysterectomies and specific nuances to each. Unless you’re a healthcare professional, the names of the procedures can be confusing and difficult to remember.

Here’s a look at common hysterectomy procedures:

• Total hysterectomy removes only your uterus and cervix. You still have ovaries.
• Supracervical (partial) hysterectomy removes the upper part of your uterus but not your cervix. It may or may not include removing your ovaries and fallopian tubes (salpingectomy).
• Total hysterectomy with bilateral salpingo-oophorectomy removes your uterus, cervix, fallopian tubes and ovaries.
• Radical hysterectomy with bilateral salpingo-oophorectomy removes the upper part of your vagina, nearby tissue and lymph nodes, as well as your uterus, cervix, fallopian tubes and ovaries.

With such complex terms, it’s understandable if you can’t remember what type of surgery you had done. And a provider can’t always tell from a pelvic exam either.

“You don’t need to remember the name of the surgery. The important thing is to know what was removed,” says Dr. Batur, “So, ask your surgeon. This information affects whether you still need Pap tests or what sort of hormone therapy you can have.”

The surgery type should be in your health records. If it’s not, contact your surgeon to get the information and ask them to update your records. If you’re seeing a new-to-you provider, especially one who isn’t part of the health system where your surgery took place, Dr. Batur recommends bringing a copy of your health records with you.

What are the signs or symptoms of menopause after a hysterectomy?

Menopause symptoms after an oophorectomy are the same as those that occur without surgery, but they may be more severe.

“Hormone production abruptly stops after surgery,” explains Dr. Batur. “That’s a shock to the body, compared with the gradual drop in hormones that occurs during the years you naturally go through menopause.”

Common menopause symptoms include:

• Hot flashes and night sweats
• Vaginal dryness
• Sexual health issues
• Anxiety, depression and/or panic attacks
• Breast pain
• Skin and hair changes
• Sleep problems
• Weight gain

How long do menopause symptoms last after a hysterectomy?

Your doctor won’t be able to tell you how long you might have hot flashes or other symptoms will last because it varies.

“Blood testing won’t tell you when your symptoms will go away,” reiterates Dr. Batur.

Many feel better within one to two years, she says, while a small number have symptoms for life. But studies show that on average, most symptoms go away within seven to 10 years.

“The good news is that symptoms often get better and better throughout these years,” she reassures.

How to manage menopause symptoms after a hysterectomy

Your age and the type of hysterectomy you had inform what’s likely to happen next.

If you still have your ovaries, you may not have menopause symptoms after your hysterectomy. And if you do, you may be able to manage them with lifestyle changes.

“Stay in communication with your healthcare provider about any symptoms you’re experiencing so they can help you figure out how to best manage them,” advises Dr. Batur.

If you’ve had your ovaries removed at a young age, your healthcare provider is likely to recommend starting menopausal hormone therapy (MHT) (sometimes referred to as hormone therapy or hormone replacement therapy).

“Lab-made hormones replace the ones your body no longer makes, which eases menopause symptoms,” Dr. Batur explains. “If you’ve lost estrogen before age 45, and especially before age 40, it typically needs to be replaced.” That’s because when you’re younger than typical menopausal age, a lack of estrogen raises your risk of bone loss (osteoporosis and osteopenia).

But again, the type of surgery you had will dictate the type of MHT you need:

• If you still have part or all of your uterus, you’ll need a combination of estrogen and progestin to lower your risk of uterine (endometrial) cancer.
• If you don’t have a uterus, you’ll only need estrogen. “If you have a history of endometriosis, though, it’s not uncommon to still use progestin to prevent recurrence,” she adds.

You shouldn’t start MHT if you had surgery to treat or prevent cancer that thrives on hormones, like estrogen-dependent cancers. These include certain breast cancers and uterine (endometrial) cancer. But even if you’re not eligible for MHT, your healthcare provider can help you find other ways to manage menopause symptoms.

“In survivors of cancers fueled by estrogen or progesterone, we can’t easily use high-dose hormonal options,” Dr. Batur confirms, “but there are many medications we can turn to for safely managing menopause symptoms like hot flashes and vaginal dryness.”

Final thoughts on menopause after a hysterectomy

No matter your age or the type of hysterectomy you had, your healthcare provider can help you find ways to manage symptoms of menopause. Some lifestyle changes can act as natural “remedies” for menopause, too.

“Eating the right foods, managing stress and changing sleep habits may improve how you feel,” Dr. Batur encourages, “but I always say: Menopause should not be making your life miserable. If it is, it’s important to talk to your provider so we can help.”