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Holly Thacker, M.D.

How does a hysterectomy affect menopause?

Women who have had hysterectomies do not have menstrual periods, but they can still produce hormones (estrogen) if one or both ovaries are intact. When the estrogen levels fall in a woman who has had a hysterectomy but still has her ovaries, she may experience symptoms of menopause just like any other woman.

Sometimes women who have had hysterectomies begin menopause a few years earlier because of disturbance to this sensitive reproductive area. Women who have both the uterus and ovaries removed during a hysterectomy are likely to experience the immediate onset of menopausal symptoms because their bodies no longer produce estrogen. (No ovaries, no estrogen.) This type of menopause is known as surgical or induced menopause, and it tends to be more severe.

Many women who have had hysterectomies ease into menopause without a problem. Without a uterus, most of these women no longer experience monthly bleeding or pain, and they generally enjoy fulfilling sex lives. But there are no absolutes.

One of every six to ten women whose ovaries were removed during a hysterectomy is thrown into a tailspin during menopause. Not only are her hormones out of balance, her body may be depleted of estrogen and testosterone. Hysterectomy surgery can cause a woman to lose most or all of her estrogen and as much as 25 to 50 percent of her testosterone sources.

For most women in this situation, hormone therapy is an effective treatment choice for the alleviation of severe menopausal symptoms. And there are many different ways to take HT, including pills, creams, gels, vaginal rings, and patches.

Is menopause easier with or without ovaries?

A hysterectomy is a major surgery to remove a woman's uterus, often performed to treat a health issue. The procedure may also include removal of other reproductive organs, including one or both ovaries, the fallopian tubes, and the cervix.

I advise my patients to keep their ovaries until at least age 65 unless there is good reason to remove them, such as cancer or the presence of one of the mutations of the breast cancer gene (BRCA genes), which indicate high risk for breast and ovarian cancer.

When physicians deny women in this condition the opportunity to take hormone therapy, it's like telling a woman who needs shoes that she should be able to get along with slippers or boots, or just go barefoot. If you've had your ovaries removed during hysterectomy, be sure that your doctor is familiar with all the therapy options. There's no reason for you to suffer.

Dr. Holly Thacker is a menopause health specialist and the author of the Vibrant Nation Health Guide, Recognizing and Treating Menopause Symptoms: A 50+ woman's guide to managing hot flashes, weight gain, mood swings, depression, vaginal dryness, night sweats and other menopause symptoms.


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