Hysterectomies and the menopause

The menopause is the time in a woman’s life when the ovaries stop working. Levels of oestrogen and progesterone drop, her ovaries stop releasing eggs and she does not experience any more periods.

The average age for these events to take place is 51 years but menopause can occur ‘normally’ anywhere between the ages of 45 and 55.

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

If you have already gone through the menopause and need a hysterectomy, it is unlikely that you will experience any new or additional menopause symptoms as a result of surgery, no matter what type of hysterectomy is performed.

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

If your periods have not already stopped, a total hysterectomy means that you will automatically go through the menopause, no matter how old you are when you have the operation. This is called an induced menopause or surgical menopause, and is one cause of a premature menopause.

Symptoms of the menopause will begin straight after the operation. The abrupt transition and sudden change in hormonal patterns may mean that your symptoms are more pronounced than during a normal 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 depend on the individual, but range from HRT to herbal remedies and supplements. Remember however that not all of these treatments may be suitable for you and you should seek advice before embarking on any self-medication.

If your ovaries remain intact, oestrogen levels in the body will not be affected. Without the womb, you will no longer menstruate each month, but this does not mean that you are going through the menopause.

In theory, ‘proper’ natural menopause will come as you approach the magic number of 51, as you would have without any surgery. However, women who have had a partial hysterectomy are often seen to enter the menopause prematurely by roughly two years.

Without monthly bleeding, it can be difficult for such a woman to determine if she is going through the menopause. The first significant indication might be menopause symptoms such as hot flushes and night sweats.

If you have had a partial hysterectomy and are uncertain as to whether you are entering the menopause, a blood test from your doctor may give you an indication as to whether or not you are at this stage of life.