Will You Go Through Menopause If You Have a Hysterectomy?

Pre-menopausal people often enter menopause right after having a hysterectomy to remove their ovaries. The ovaries produce estrogen, a hormone that depletes during menopause, so removing them pre-maturely may trigger menopause.

The ovaries are not always removed during a hysterectomy, though. If they are not removed, they will produce estrogen until menopause naturally begins. The decision to remove the ovaries hinges on the purpose of the surgery and your overall health.

This article covers what to expect if you are having your ovaries removed via hysterectomy, how to prepare for menopause whenever it comes, and the symptoms you may experience after your procedure.

Understanding Hysterectomy

A hysterectomy refers to the surgical removal of the uterus. It may be performed for a number of reasons, both benign (for example, uterine fibroids) and cancerous (such as uterine cancer).

Depending on the reason behind why a hysterectomy is being done, a healthcare provider may also remove the ovaries and fallopian tubes (the tubes that connect the ovaries to the uterus).

In addition to these symptoms, there are also health conditions associated with the low-estrogen state of menopause, like osteoporosis (when your bones weaken and become prone to breaking).

If you are premenopausal and your ovaries are not removed during a hysterectomy, your body will continue to produce estrogen. However, you will not have periods anymore, as there is no uterine lining to shed.

Surgical Menopause

There are a number of symptoms linked to both natural and surgical menopause. Two of the most common ones include vaginal dryness and hot flashes.

Vaginal Dryness

With the loss of estrogen, the lining of the vagina becomes dry and itchy—a phenomenon called vaginal atrophy. This vaginal dryness, itching, and burning often make sex painful and, in turn, can lower the desire to have intercourse.

Hot Flashes and Night Sweats

Estrogen deficiency throws off how the brain regulates body temperature, and this may lead to hot flashes. A hot flash is a sudden, intense feeling of heat or burning in the face, neck, and chest, often accompanied by redness.

A night sweat refers to a hot flash that occurs during sleep. Night sweats can negatively impact your sleep cycle, which may lead to tiredness during the day.

Other Symptoms of Surgical Menopause

There are a number of other symptoms of surgical menopause, although some of them are believed to also be caused by increasing age. 

These symptoms include:

• Mood changes, like depression and anxiety
• Weight gain, especially around the waist
• Dry skin and hair loss
• Increased urinary problems, especially urinary tract infections and urinary incontinence (loss of urine without any control)

This greater intensity of menopausal symptoms is attributed to the abrupt removal of the ovaries, which are a primary source of estrogen. In natural menopause, the ovaries gradually lose their ability to produce estrogen, so the body can (usually) adjust more easily.

Hysterectomy With Ovaries Left Intact

People who have their ovaries intact, but without their uterus, won't get their period anymore. They may, however, still experience premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) because the hormones made by the ovaries cause the body to continue to "cycle" monthly.

Occasionally, people whose ovaries were not removed during a hysterectomy experience hot flashes and other menopausal symptoms. This is mostly due to the disturbance of the blood supply to the ovaries during surgery.

In addition, some people may undergo menopause a few years sooner than they normally would if they never underwent a hysterectomy (the average onset age for menopause is 52).

Summary

A hysterectomy that removes the ovaries triggers what's known as surgical menopause. This happens because the ovaries produce estrogen, the reproductive hormone that depletes in menopause. A person who has a hysterectomy with ovaries left intact will not begin surgical menopause immediately, but will no longer have a period.

A Word From Verywell

After a hysterectomy, it's common to feel a sense of loss. This is true whether the ovaries were removed or not. Emotional distress can be especially strong when an unexpected hysterectomy prevents a couple from having the biological children they planned on.

The good news is there are resources like support groups that can help you through this time. Please seek out guidance from your healthcare provider so you can heal and thrive after surgery.