How to tell if you’ve started the menopause if you’ve had a hysterectomy or ablation

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Today's topic

Hello and welcome to my weekly video blog. And today on A.Vogel Talks Menopause, I'm going to be discussing how can you tell if you're starting the menopause if you've had a hysterectomy or an ablation.

Now, this is a question I get asked on a regular basis. It's very difficult to tell generally because the one thing you don't have is your periods as a guide. And normally one of the first indications that you're starting the approach to the menopause is that your periods start to change.

How can you tell?

Now, there's no real guide to this. There's a few situations that you can look at, and then it really is very often just a little bit of guesswork.

What happens if you've had a complete hysterectomy

Now, if you've had a complete hysterectomy, which means you've had the womb and the ovaries out, regardless of what age you are, as long as you're before the average age when you would have started the menopause, you will go straight into a full menopause. There's no preamble here. You've lost your ovaries, and your ovaries dictate how your hormones run, and when they are removed, you will very suddenly hit the menopause. 

The role of HRT

For most women in this situation, you will be offered HRT. And again, once you have HRT, your symptoms are going to disappear and you would literally just continue as normal.

Where you may start to get problems is if years down the line, you need to come off the HRT, and that's the point where you may find that you're starting to get menopause symptoms. In this situation, you would treat those menopause symptoms as you would normally treat them.

What happens if you've had a partial hysterectomy

Now, if you have had a partial hysterectomy where your ovaries have remained, then normally you would start the menopause at roughly the same time you would have done had you not had the operation. Now the average age group, if you like, is between 45 and 55.

How can you tell?

And I know, you know, it's a huge gap, when on Earth are you going to know when you're starting the menopause when you've got no periods to give a really clear indication of what's going on? In this situation, it really is a question of being aware of how you are feeling.

Are you starting to get menopause-like symptoms like hot flushes or night sweat? Or maybe joint aches or low mood or anxiety or maybe a bit of fatigue, or you're just feeling out of sorts? If you're in the average age group, then it's more than likely that this is you starting the approach to the menopause.

How long is this going to last?

Now, I then get asked, "Well, how long is this going to last?" On average, from the minute your hormones start to change until you would have been two years without a period when you are considered through the menopause, is roughly about five years. So if you're in this situation, you would have a normal menopause lasting the normal length of time as well.

So from the moment that you start to see any significant changes, you're going to be counting roughly five years, and that would be you postmenopausal. Again, it's one of these things. It's going to be different for absolutely every single one of you.

What happens if you've had an ablation

Now, if you've had an ablation, and this is where the lining of the womb has been removed, this is often done for women who may well be approaching the menopause.

You might have already started to get some menopause symptoms, and one of those has been really, really heavy periods or prolonged periods or flooding, or you may have had fibroids or other issues like that. So very often in this situation, they would do an ablation, and that then stops your periods.

How can you tell?

Now, in this situation, if you have already been getting some menopausal symptoms, then you would count from when you first noticed those symptoms. Now, for some women, this might be already one or two years into the menopause before you've actually had this procedure.

If you've had this procedure before you're in the average menopausal age, then it would be a question of waiting and seeing just in case you start to get some symptoms. And again, we're looking at five years as a sort of average. For some women, it's gonna be shorter. For other women, it could be that little bit longer.

What can you do?

Now, what can you do in this case? There's no hard and fast rule. And as I said before, it's going to be very frustrating because you're working from nothing. You don't have a set start point, therefore it's very difficult to...excuse me, talk about when you're getting to that last particular point.

Is there a test that can help?

One of the things that you can do is that you can go and ask your doctor for a hormone test. Now, the further through the menopause you go, the more accurate this test is going to be. But if your hormones have just started to change, then very often the test can come back negative purely because your hormones have been a little bit high on that particular day, and therefore you will think that you're not in the menopause.

So, if you think to yourself, "I'm sure I'm starting the menopause. I'm getting some of the usual symptoms," but the test comes back negative, then just go again in six months and ask to be retested. And you might find things have changed at that particular point.

How should you treat your symptoms?

Now, for all these issues, so that's a total hysterectomy, partial hysterectomy, and ablation, if you get any menopause symptoms, then you can still treat them the same as you would in any other circumstance. 

For those of you where you've either had HRT or HRT wouldn't be a problem, you can look at phytoestrogens such as our menopause support to help to gently balance and raise oestrogen levels.

If these remedies are not appropriate, then you can treat all your symptoms individually and you can go along in that particular way. So this is one of the situations in the menopause where there's no simple answer to everybody's questions. It is going to be very much an individual situation, and I know it can be a really frustrating one as well.

Any questions?

Now, if any of you have any questions on this, if you think you might be going through the menopause but you're not too sure, then please, by all means, send me a little email and we can have a look at it together and see if there's some way we can maybe pinpoint things a little bit better for you.

So until then, I look forward to seeing you next week on another edition of A.Vogel Talks Menopause.