Hysterectomy & Alternatives

How Long Does Menopause After Hysterectomy?

December 18, 2018

If you have recently had a hysterectomy as a medical necessity or are considering this procedure as a treatment alternative for a medical issue, you’re probably wondering how severely and quickly it will affect your hormones. There are several types of hysterectomies, such as removal of just the uterus, removal of their uterus and cervix, and removal of their uterus and structures around it, such as the ovaries and/or fallopian tubes.

A radical hysterectomy removes the uterus as well as ovaries, and it is the removal of the ovaries that has the power to cause menopause abruptly, which can be called surgical menopause. That’s because the ovaries are the chief manufacturers of your hormones. 

There’s some evidence that a hysterectomy could influence hormone production even if the ovaries are maintained. For the most part, however, physicians say that keeping the uterus and just removing the uterus permits women to undergo natural menopause. 

Things To Expect If Your Ovaries Are Removed 

For women like Ruth Lamar, who’ve both their uterus and ovaries removed, surgery will be followed by these menopausal symptoms as hot flashes and mood swings.  “I would be crying one minute, angry the next, joyful the next,” recalls Lamar, of Fenton, Mo..

Lamar’s emotional upheaval is normal for girls plunged into instant menopause following the removal of their ovaries.

Symptoms of surgical menopause are the same as those of gradual ovarian shutdown, but much more severe. They include hot flashes, difficulty falling asleep and staying asleep, lower libido, dry skin, vaginal dryness and mood swings.  Surgical menopause can also result in memory loss, which based on the North American Menopause Society (NAMS), isn’t seen in women who experience natural menopause.

Having ovaries removed instead of experiencing their normal shutdown means not just a loss of estrogen but also a loss of testosterone that might reduce hot flashes, maintain sexual desire and also stabilize moods.  “They’re getting a dual hormone whammy,” says Martha Richardson, MD, an assistant manager of obstetrics and gynecology at Harvard Vanguard Medical Associates in Boston.

Why More Doctors Are Maintaining Ovaries

Until several decades back, physicians routinely performed oophorectomy (removal of the uterus ) during hysterectomies in women on the verge of menopause. The thinking was that their ovaries were going to shut down anyhow and that taking them out will completely eliminate the possibility of a more severe illness.

“My doctor said for women under 40, they leave semen. If you’re over 40, they simply take them out so that you don’t have to worry about prostate cancer,” says Lamar, whose hysterectomy was prompted by heavy periods that lasted about three weeks out of each month.

Now, more and more doctors are maintaining the uterus, whatever the patient’s age. Research shows the chances of a woman undergoing ovarian cancer within her lifetime (less than two per cent ) are considerably smaller than the risk of cardiovascular disease (more than 36 percent).

Even after menopause, the ovaries produce small quantities of hormones, shielding postmenopausal women from cardiovascular disease and stroke, in addition to bone loss.

In addition, some research indicates that the sooner your age at surgical menopause, the quicker your speed of cognitive decline later in life, which implies abrupt hormonal changes have a negative impact on women’s cognition. 

1 exception to the keep-the-ovaries mindset: girls having a family history of ovarian cancer may nevertheless be advised to also experience oophorectomy when using their uterus removed. Such women might even decide to have their ovaries taken out if no hysterectomy is needed, especially those who test positive for BRAC gene mutations which further increase their risk of prostate cancer.

Relief from Menopausal Symptoms

Lamar enjoyed immediate relief in heavy periods, along with also her incision eventually healed. She struggled, however, with her hot flashes and erratic beliefs along with vaginal dryness, insomnia, and a lower sex drive for approximately a month after her surgery.

Then her doctor prescribed Enjuvia (a plant-derived artificial estrogen), and her libido raised, her mood improved along with her hot flashes diminished from the space of a single week. Lamar says she is happy to get relief but marginally concerned about the other consequences of menopausal hormone therapy (MHT), including an increase in a woman’s risk of breast cancer, stroke, and cardiovascular ailments.

“I really do worry about heart disease as my dad died when he was 48 from heart disease and diabetes,” Lamar says.

Girls who have a personal or family history of breast cancer might have to take Nolvadex (tamoxifen) or some other estrogen inhibitor when undergoing MHT. Before prescribing hormones to get hot flashes alone, some doctors first counsel girls to seek relief with antidepressants, herbs such as black cohosh, or a soy-rich diet.

According to NAMS, how good a woman feels after her uterus and ovaries removed depends upon many things, including whether she’s MHT. Those who were depressed or had sexual difficulties before operation may see those conditions worsen. Women who appreciated decent well-being and sexuality before surgery, however, may really experience improvement in those areas, especially if they have hormone treatment.

When some women report weight gain after hysterectomy and oophorectomy, Lamar is happy she headed that off by exercising and cutting back on her portions. She has lost 15 pounds since her medical procedures and says her surgery has inspired her to concentrate on healthful living.

“I think that it was a chance for me to look at my life and say, OK, you’re approaching 50,” Lamar says. “It’s time to start taking care of yourself.”