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Why Menopause Sometimes Occurs After a Hysterectomy

Naturally occurring menopause is defined as when a woman has not had a period in 12 months. However, a hysterectomy can sometimes cause what is known as surgical menopause for women under age 45. Here’s what you need to know.
What is a Hysterectomy?
A hysterectomy is a surgery wherein we remove the uterus. This procedure is typically done as a way to treat problems in the uterus, such as uterine fibroids, endometriosis, or heavy periods. The hysterectomy causes women to no longer menstruate, however, their ovaries should continue to produce estrogen as they normally would. In this scenario, women do not enter menopause until their body naturally does so.
It’s important to understand that hysterectomies only include the removal of the uterus. Some women may opt to remove their ovaries as well, which is called an oophorectomy. In these situations, one or both ovaries may be removed. This is usually done to treat breast cancer or severe endometriosis, or to lower a woman’s risk of ovarian cancer.
About 50% of women who have a hysterectomy in America also opt to remove their ovaries during the same procedure. Women typically make this decision based on a few factors: medical history, doctor’s recommendations, and personal feelings.
Why Does Hysterectomy Cause Menopause?
In cases of natural menopause, women in their 40s and 50s experience a shift in their hormones, as their ovaries stop making as much estrogen. This causes irregular periods and menopausal symptoms, like hot flashes, vaginal dryness, mood swings, and insomnia. Once a woman has not had her period for 12 consecutive months, she has officially entered menopause.
Women who have had their uterus and ovaries removed (also known as a total or radical hysterectomy) experience a steep decline in estrogen, as their body’s main source of the hormone is no longer there. In surgical menopause, the symptoms are often much more severe and exaggerated. In these cases, women don’t get to experience the gradual shift in hormones that comes with natural menopause. Instead, menopause occurs virtually overnight, and women must cope with it on a much faster scale.
Additionally, there is a chance that regular hysterectomy can cause menopause. Even with hysterectomies that leave one or both ovaries in place, there is still a chance that a woman will experience menopause within five years of the surgery. Without the uterus, ovaries still have the possibility to produce hormones, but it is not guaranteed. Some women experience ovarian failure, which can cause early menopause.
Menopause Relief & What You Can Do
Some women are offered hormone replacement therapy, or Bio-identical HRT (BHRT), after having their ovaries removed. BHRT is a medication that replaces the hormones your ovaries would otherwise be making, and it’s used for menopause relief. With BHRT, women can avoid the symptoms of menopause and feel more like their normal selves. However, it’s important that BHRT is administered under the care of a doctor.