Hysterectomies and menopause

Menopause is the time in a woman’s life when the ovaries stop working—her estrogen and progesterone levels drop, her ovaries stop releasing eggs and her periods stop.

The average age for these events is 51, but the normal range for menopause is anywhere between 45 and 55.

A hysterectomy, the surgical procedure of removing the womb (or uterus), can cause a premature menopause, but it depends on the type of operation performed. There are two main types of hysterectomy: total (complete) and sub-total (incomplete).

If you’ve already gone through menopause and then undergo a hysterectomy, it’s unlikely that you’ll experience any new or additional menopause symptoms as a result of the surgery, no matter what type of hysterectomy is performed.

This surgical procedure removes the womb as well as both ovaries. Normal production of estrogen and progesterone is interrupted and you’ll no longer release eggs (ovulate) each month.

If your periods haven’t already stopped, a total hysterectomy means that you’ll automatically go through menopause, no matter how old you are. This is called an induced or surgical menopause, and it’s one possible cause of a premature menopause.

Menopause symptoms will begin right after the operation. The abrupt transition and sudden change in hormonal patterns may mean that your symptoms are more pronounced than they would be during a natural menopause.

As symptoms are often more severe, a higher proportion of women look for treatments for their menopause symptoms after a complete hysterectomy than those who are going through a natural menopause. The most effective treatments will vary by individual, but they range from hormone replacement therapy (HRT) to herbal remedies and supplements. Remember, however, that not all treatments may be suitable for you and you should seek medical advice before embarking on any self-medication.

If your ovaries remain intact, estrogen levels in the body will not be affected. Without the womb, you will no longer menstruate each month, but this doesn’t mean that you’re going through menopause.

In theory, natural menopause will normally come as you approach the magic age of 51, as you would have without any surgery. However, women who’ve had a partial hysterectomy often enter menopause prematurely by roughly two years.

Without monthly bleeding, it can be difficult for women who’ve had a partial hysterectomy to determine whether they’re going through menopause—the first significant indication might be menopause symptoms such as hot flashes and night sweats.

If you’ve had a partial hysterectomy and are uncertain as to whether you’re entering menopause, your doctor can perform a blood test that may indicate whether or not you’re at this stage of life.