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Do You Go Into Menopause After Hysterectomy

What Are The Symptoms Of Menopause After Hysterectomy

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For most women, menopause occurs when they are between the ages of late 40s to early 50s. However, women who undergo hysterectomy surgery may start experiencing the symptoms of menopause much earlier than this.

The procedure involves removal of the uterus and is used to treat a variety of conditions such as chronic pain, infection and even certain kinds of cancer. Typically, the extent of surgery required will vary depending on the reason why you are having hysterectomy. Sometimes the doctor may also recommend taking out the cervix and ovaries, which can ultimately affect the symptoms you are experiencing.

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Why Do Women Have Hysterectomies

Hysterectomies are most often done for the following reasons:

  • Uterine fibroids common, benign tumors that grow in the muscle of the uterus. More hysterectomies are done because of fibroids than any other problem of the uterus. Sometimes fibroids cause heavy bleeding or pain.
  • Endometriosis another benign condition that affects the uterus. It is the second leading reason for hysterectomies. It occurs when endometrial tissue begins to grow on the outside of the uterus and on nearby organs. This condition may cause painful menstrual periods, abnormal vaginal bleeding and loss of fertility.
  • Uterine prolapse a benign condition in which the uterus moves from its usual place down into the vagina. Uterine prolapse is due to weak and stretched pelvic ligaments and tissues, and can lead to urinary problems, pelvic pressure or difficulty with bowl movements. Childbirth, obesity and loss of estrogen after menopause may contribute to this problem.
  • Cancer the reason for about 10 percent of all hysterectomies. Endometrial cancer, uterine sarcoma, cervical cancer, and cancer of the ovaries or fallopian tubes often require hysterectomy. Depending on the type and extent of cancer, other kinds of treatment such as radiation or hormonal therapy may be used as well.
  • Hyperplasia thought to come from too much estrogen and occurs when the lining of the uterus becomes too thick and causes abnormal bleeding.

Are There Any Risks

The risks associated with hysterectomy are among the lowest for any major surgery. However, as with any major surgery, problems can occur, including:

  • Blood clot in the veins or lungs
  • Infection
  • Bleeding during or after surgery
  • Bowel blockage
  • Injury to the urinary tract or nearby organs
  • Problems related to anesthesia
  • Early menopause

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Reactions To Surgical Menopause

A surgical menopause can be a difficult time for many women. Menopausal symptoms are often severe, and depression and anxiety are more likely.

How you react can be influenced by the reason for the surgery. If your surgery is necessary because of a diagnosis of cancer, this creates challenges to cope with at the same time as coping with menopausal symptoms. On the other hand, if your surgery is the solution to ongoing chronic pain, then a surgical menopause may offer relief.

What’s happening in your life will affect your reactions to surgical menopause. This includes your age, whether you are in a relationship, whether you have children, whether you wanted to have children or more children, and whether you have support and help.

Some women say the impact of surgical menopause is that they no longer feel like a woman other women feel a sense of freedom from pain and fear. Some women feel they might not be as sexually attractive to their partner, and others feel they can be more sexual because they are not worried about pain or heavy bleeding.

No feeling should be dismissed as silly or small. It is important to talk to someone if you are upset and distressed about a surgical menopause. You can ask your doctor for help with symptom relief and with referral to a psychologist to discuss your feelings.

Hrt And Surgical Menopause

Hysterectomy and Menopause Part 1

So what is surgical menopause? It’s menopause that develops suddenly after the ovaries — the main producers of the hormone estrogen — are surgically removed.

The removal of the ovaries is called an oophorectomy. The procedure is often combined with a hysterectomy — removal of the uterus — but not always. And in fact, women who only have their uterus removed will not go into surgical menopause. Their ovaries are still making estrogen. They’ll go into menopause naturally when they get older, although sometimes a bit earlier than usual.

Estrogen plays a key role throughout the body. It affects the brain, the bones, the skin, the heart, the blood vessels, and more. While estrogen levels lower gradually during natural menopause, they plummet with surgical menopause. That sudden drop in estrogen can lead to menopausal symptoms that can be quite severe.

Hormone therapy after surgery — either with estrogen and progestin or with estrogen alone — is a way to counteract the supply of estrogen you’ve lost. Women who have both the uterus and ovaries removed usually just get estrogen replacement therapy alone. But women who have only the ovaries removed need both estrogen and progestin. That’s because estrogen alone can increase the risk of cancer in the uterus. Adding progestin removes this risk.

Rarely, if ever, will both ovaries be removed without the uterus. Often, only one ovary may be removed, which will negate the need for HRT at the time of surgery,

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How Long Do Ovaries Last After Hysterectomy

This is known as a surgical menopause. If a hysterectomy leaves 1 or both of your ovaries intact, theres a chance that youll experience the menopause within 5 years of having the operation. Although your hormone levels decrease after the menopause, your ovaries continue producing testosterone for up to 20 years.

The Female Reproductive System

The female reproductive system is made up of the:

  • womb a pear-shaped organ in the middle of your pelvis where a baby develops the lining of the womb is shed during a period
  • cervix the neck of the womb, where the womb meets the vagina the cervix is the lower part of the womb and not separate
  • vagina a muscular tube below the cervix
  • fallopian tubes tubes that connect the womb to the ovaries
  • ovaries small organs by the fallopian tubes that release an egg each month

Page last reviewed: 01 February 2019 Next review due: 01 February 2022

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How Does Premature Menopause Affect Your Body

Youll go through the same changes during premature menopause as you would if you entered menopause naturally. The sudden loss of hormones triggers all the classic symptoms, including:

  • Hot flashes and night sweats
  • Vaginal dryness

Since estrogen affects tissues throughout your body, system-wide changes take place such as:

  • Loss of bone density and increased risk for osteoporosis
  • Accelerated skin aging due to dehydration and loss of collagen
  • Changes in blood vessels that increase the risk for cardiovascular disease

Although hormone-related changes following an oophorectomy can be difficult and affect your quality of life, its important to know that medical therapies and rejuvenation with the advanced MonaLisa Touch® are available to alleviate premature menopause symptoms.

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What Is Surgical Menopause

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Surgical menopause is when surgery, rather than the natural aging process, causes a woman to go through menopause. Surgical menopause occurs after an oophorectomy, a surgery that removes the ovaries.

The ovaries are the main source of estrogen production in the female body. Their removal triggers immediate menopause, despite the age of the person having surgery.

While surgery to remove the ovaries can operate as a stand-alone procedure, its sometimes performed in addition to hysterectomy to reduce the risk of developing chronic diseases. A hysterectomy is surgical removal of the uterus.

Periods stop after a hysterectomy. But having a hysterectomy doesnt lead to menopause unless the ovaries are removed too.

Surgical menopause also causes hormonal imbalances. The ovaries and adrenal glands produce progesterone and estrogen, the female sex hormones. When both ovaries are removed, the adrenal glands cant produce enough hormones to maintain balance.

Hormonal imbalance can increase your risk of developing a variety of conditions including heart disease and osteoporosis.

For that reason, and depending on your medical history, some doctors may or may not recommend hormone replacement therapy after an oophorectomy to reduce the risk of disease. Doctors will avoid giving estrogen to women who have a history of breast or ovarian cancer.

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Menopause After Complete Hysterectomy Or Oophorectomy

The symptoms of menopause develop because the ovaries are no longer working, and no longer produce the female hormones estrogen and progesterone. Many women find themselves wondering, do you still go through menopause after a hysterectomy?

A hysterectomy is a surgical procedure during which all or part of the uterus is removed, which may be performed for a variety of different reasons. Sometimes the ovaries are removed as well, and this is medically known as oophorectomy.

Removing the ovaries and uterus will induce menopause. In this case the levels of female hormones drop abruptly and symptoms like hot flashes, changes in sex drive and mood will be more severe and acute compared with those experienced when the menopause occurs naturally.

If the uterus only is removed, and the ovaries are left in place, the production of hormones will continue. After hysterectomy a woman will no longer have a period, without experiencing other menopausal symptoms . When the time comes, and the woman goes through menopause, hot flashes, mood swings, vaginal dryness, lack of sex drive, and sleeping issues may occur.

In other words, removing the uterus alone will only stop menses, without causing other menopausal symptoms, which sometimes leads to women being confused over if they will go through menopause after a hysterectomy. Removing the uterus and ovaries will induce all symptoms of menopause, and these symptoms are usually more severe.

Hot Flashes After Hysterectomy: Your Guide

Contents

Research shows that hot flashes and night sweats are almost twice as common in women who have had a hysterectomy, than those who are going through ânaturalâ menopause. How long you have them for and how you manage them will largely depend on the type of hysterectomy you have had, as well as your stage of life and other lifestyle factors.

In this article, weâll take a look at hot flashes after a hysterectomy, and what management tools are available to you.

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Your Sex Life Isnt Over

While the surgery can have lasting effects on your body, and youll need time to heal, this does not mean that youll never have sex again. How soon you can have sex after a hysterectomy really depends on the type of hysterectomy: partial, total, or radical. Waiting two to four weeks to get back to sex is generally okay, with your doctors go-ahead, if your cervix was not removed along with your uterus, says Lauren Streicher, MD, an Everyday Health columnist, an associate clinical professor of obstetrics and gynecology at Northwestern University in Chicago, and the author of Sex Rx: Hormones, Health, and Your Best Sex Ever. But if your cervix was removed, it takes about six weeks for the back of the vagina to heal.

Ask your doctor to define what they mean by sex, advises Dr. Streicher. What doctors usually mean is vaginal intercourse. Orgasm may be fine, oral sex too, and vibrator use as well your questions need to be specific.

Other Symptoms Of Surgical Menopause

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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

Menopausal symptoms tend to be more intense for people who have undergone surgical removal of their ovaries than for those who experience menopause naturally. However, menopausal symptoms vary widely and in degree from person to person.

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 adjust more easily.

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The Cons: Reasons To Lean Against Hrt After Surgical Menopause

  • Your menopausal symptoms aren’t bothering you, or other treatments work fine. Some women don’t have very severe symptoms after surgical menopause and don’t want or need treatment. Even if you do have acute symptoms, HRT is not the only way to control them. Other drugs or lifestyle changes can help. Talk to your doctor.Ã
  • You’re 50 or older. Many women who go into surgical menopause at 50 or older — the natural time of menopause – decide not to get HRT. That’s because their supply of estrogen would naturally drop during menopause anyway. There is some evidence that the older you are when you start HRT, the higher the cardiovascular risks – at least initially.Ã
  • You have liver disease. Estrogen pills can put a lot of stress on the liver. So if you have liver disease, your doctor may not want you to take oral HRT. Other ways of getting estrogen – like patches and gels – bypass the liver and are safer options.Ã
  • You’re concerned about the side effects. HRT can also cause symptoms of its own. Many resemble the symptoms of premenstrual syndrome — swollen and painful breasts, headaches, and nausea
  • You’re at a higher risk of health problems like:

o Strokes. Hormone therapy can increase the risk of stroke, although your odds are still very low.

o Blood clots. Oral estrogen, at least, may also raise the risk of blood clots. Estrogen patches and creams may pose a lower risk, but that’s still unclear.

Why Does It Occur

In a female body, the ovaries are responsible for maintaining normal levels of female hormones progesterone and estrogen. If both of your ovaries are left intact during the hysterectomy, there are two possible outcomes:

Your ovaries may function normally and continue to produce estrogen and progesterone until the usual age of menopause. So, you may experience pre-menopausal symptoms even if you are not menstruating. This happens due to the fluctuating female hormones.

In some cases, ovaries stop producing hormones sooner than they normally would. This condition is known as apparent early ovarian failure, and usually, happens one or two years after the surgery. This is the most common outcome, where the patient undergoes early menopause. It is still unknown what triggers ovaries to shut down after hysterectomy.

When they remove the ovaries and fallopian tubes along with the uterus, you directly enter into surgical menopause stage. Apart from the sudden surgical menopause symptoms, women may experience long-term negative effects such as osteoporosis, lack of sex drive, and cardiovascular diseases.

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Will You Go Into Premature Menopause

You may have heard that your hormone levels drop after a hysterectomy, but that isnt accurate. Your uterus, cervix, and vagina arent part of your endocrine system, which means theres no effect on your hormones, if they must be removed.

You can have one ovary removed and, as long as it stays healthy, it produces the hormones you need. Its different when both ovaries are removed, however. A bilateral oophorectomy causes an abrupt loss of hormones. As a result, you enter premature menopause.

Indications For Surgical Menopause

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Surgical menopause is commonly performed at the time of hysterectomy for benign disease, most commonly for heavy menstrual bleeding or fibroids . Another common reason to remove normal ovaries at the time of hysterectomy is to reduce the risk of ovarian cancer. This has been shown to be beneficial in women with an inherited increased chance of developing ovarian cancer , and for some women with very strong family histories of ovarian cancer, but is not recommended for other women as the disadvantages of removing normal ovaries at the time of hysterectomy are likely to be greater than their very small risk of ovarian cancer . Very little is known about the impact of removing normal ovaries from postmenopausal women.

Some premenopausal women will elect to have their ovaries removed for other indications, such as endometriosis or chronic pelvic pain. Depending on the circumstances, removal of the ovaries may improve pain, but it is not always effective. Some doctors may suggest a trial of a drug to bring on a short term chemical menopause before surgery to try and mimic the effects of surgical menopause. However, it is not currently possible to predict how surgical menopause will affect individual women.

Although surgical menopause is common, there have been remarkably few studies which have followed women before and after oophorectomy to try and understand how surgery affects their menopausal symptoms and short and long term health.

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Common Side Effects Of Hysterectomy

Hysterectomy may affect the physical and mental health of a woman, especially when it is performed in the menopausal or perimenopausal stage. The woman suddenly and directly enters the post menopause stage without passing through the phases of perimenopause and menopause. The body cannot accept this drastic change and therefore a woman usually faces a lot of problems.

Hormonal changes do have a major impact on the womans health. Levels of hormones after hysterectomy decrease considerably. This increases the risk of cardiovascular and skeletal diseases. A reduction in the testosterone level may cause height loss and osteoporosis . Side effects of partial hysterectomy and side effects of total or radical hysterectomy are almost the same. They may vary slightly, depending upon the reason for which the surgery is performed and the procedure followed. Surgical complications are not discussed in this article.

Common side effects of hysterectomy include

  • Hot flashes
  • Development of excess facial hair on the upper lip and chin region
  • Vaginal dryness

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