Menopause Symptoms After Hysterectomy: What, When and Why

The transition to menopause, or the stopping of menstrual periods, usually takes place in your late ‘40s or early ‘50s, although symptoms such as hot flashes can occur up to a decade earlier as part of perimenopause. However, if you have your ovaries removed (oophorectomy) as part of a hysterectomy or as a standalone surgery, menopause will begin immediately. This is known as surgical menopause.

It’s important to understand the factors that could lead to menopause symptoms after a hysterectomy so you can make the best decision about the type of hysterectomy you need. Plus, you’ll want to know what to look for and what to discuss with your doctor if you have questions or concerns after surgery. Here are the basics.

Does a Hysterectomy Cause Menopause?

A hysterectomy alone doesn’t cause menopause to immediately begin – that happens only if you also have the ovaries removed, known as an oophorectomy. First off, there are 3 main types of hysterectomy:

• a partial hysterectomy removes just the uterus;
• a total hysterectomy removes the uterus and the cervix;
• a radical hysterectomy removes the uterus, cervix, top of the vagina, and adjacent tissue.

None of the above types of hysterectomy necessarily include removal of the ovaries. There are various reasons to keep or remove ovaries during a hysterectomy, depending on the underlying condition causing the need for a hysterectomy and what the surgeon discovers during the procedure. Discuss whether to remove or leave your ovaries as part of your hysterectomy with your doctor to decide what is best in your individual case.

Around half of all hysterectomies in the United States annually include a single or double oophorectomy for various reasons. This percentage has dropped from about 2/3 of all hysterectomies including ovarian removal a decade ago. However, since so many women also have their ovaries removed when they have a hysterectomy, many people mistakenly believe a hysterectomy causes menopause.

Surgical Menopause and a Hysterectomy with Oopherectomy

Here’s the basic thing to remember:

• If you remove your ovaries along with your uterus at your hysterectomy, surgical menopause begins immediately after the surgery, no matter how old you are. Surgical menopause can be more sudden and severe than age-related menopause, which tends to arrive gradually over many years as estrogen production wanes.
• If you keep your ovaries after a hysterectomy, menopause will not immediately begin. However, studies have shown that women who have had hysterectomies typically enter menopause sooner than women who still have their uterus, even if they keep their ovaries.

So while menopause won’t suddenly happen because of a hysterectomy, even if you keep your ovaries you will likely hit menopause at an earlier age without a uterus. Depending on your age at the time of the hysterectomy, you may experience perimenopausal symptoms earlier as well.

Surgical Menopause vs. Gradual Menopause Symptoms

Menopause commences when the ovaries stop working. In a woman whose ovaries deteriorate gradually, menopause symptoms typically come on slowly, over a period of years. However, when a patient has an oophorectomy (ovary removal) as part of a hysterectomy or as a standalone procedure, symptoms like hot flashes, vaginal dryness and mood swings often arrive suddenly.

Basically, the symptoms of menopause are the same whether your ovaries are failing due to age, injury, or whether you’ve had them surgically removed. The sudden vs. gradual drop in hormone levels from surgically induced menopause can make the symptoms feel stronger and more severe. If you are entering menopause at an earlier age due to ovary removal you may also worry about aging faster or feel nervous about what is happening to you when others around your age are more concerned with birth control or pregnancy.

If you’re having your ovaries removed as part of a hysterectomy or alone, talk with your physician about hormone replacement and other options that could help relieve sudden-onset menopause symptoms.

One Size Does Not Fit All in Menopause Symptoms and Treatment

Just as no two women are alike, no two journeys to menopause are the same. Even among women who have never had a hysterectomy or an oophorectomy, it's difficult to predict when perimenopause will strike, how it will affect you, and how severe or long-lasting any symptoms may be.

If you’re experiencing menopause symptoms due to surgery or getting older, you don’t have to give up your sex life or your energy levels. There’s a variety of treatment options available over the counter and in partnership with your doctor.

Explore the Best Remedies for Menopause Symptoms

For vaginal dryness associated with menopause, try Replens Long-Lasting Vaginal Moisturizer for an estrogen-free way to help soothe and replenish vaginal cells. Changes in diet and exercise can also help with perimenopausal symptoms such as hot flashes and night sweats.

Remember that whether your menopause is surgical or age-related, you’re not alone. Find a support group, reach out to friends and family members, and talk with your doctor as you navigate this transition, together.