A hysterectomy is a significant surgery. People normally get a hysterectomy if other medical treatment hasn’t worked for treating conditions like:
Heavy or painful bleeding
Large fibroids causing pressure symptoms
Pre-cancer in the lining of the uterus
Gynaecological cancers
Some people have hysterectomies to make their bodies match their gender.
And some people who are at high risk for certain types of cancer have a hysterectomy to reduce the chances of developing cancer.
Because there are now more effective options for treating symptoms like heavy or painful bleeding, hysterectomies are much less common than they used to be.
A hysterectomy is surgery where your uterus is removed. Depending on why you’re having the surgery, you might also have some surrounding organs and tissues removed too. Your doctor will discuss the best option with you. Usually your cervix will be removed with the body of the uterus, but removal of the fallopian tubes and ovaries will depend on your situation.
If you’ve had your ovaries removed (oophorectomy) during your hysterectomy before natural menopause has occurred, this triggers what’s known as “surgical menopause.” This means you start perimenopause right away – and your symptoms can be more severe.
But if you haven’t had your ovaries removed, a hysterectomy doesn’t make your menopause experience all that different. Perimenopause symptoms may start a little earlier – on average five years earlier – but there’s no evidence it’s any more severe.
Hormone therapy (also known as MHT) is the most effective menopause treatment – including for people who’ve had a hysterectomy.
People who still have their uterus are normally prescribed combined hormone therapy – made up of oestrogen and progesterone. The progesterone protects the uterine lining against cancer.
But if you don’t have a uterus, you’ll normally be prescribed oestrogen-only hormone therapy.
Your menopause clinician will talk to you about your hysterectomy as well as other conditions, medical history, and medications. They’ll talk about why you had a hysterectomy and how this might influence your decision about which treatment is right for you.
Technically, a hysterectomy doesn’t cause menopause. But menopause might happen earlier after a hysterectomy – on average five years earlier.
But if you’ve had your ovaries removed before natural menopause has occurred, you will go into a type of menopause called surgical menopause. In surgical menopause, you experience the same symptoms as during natural menopause, but they’ll start suddenly and may be more severe.
Your periods stop when you get a hysterectomy. So you won’t have the period changes that often signal the start of perimenopause. But you might experience other perimenopause symptoms like hot flushes, sleep problems, and brain fog.
If you think perimenopause is causing your symptoms, book an appointment with us to discuss. We can help come up with a treatment plan that’s tailored to your needs.
Around 20% of women don’t experience any symptoms. If this is you, then there’s nothing you need to do.
