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Experiencing menopause post hysterectomy: A clarification

Undergoing a surgical procedure that involves the removal of both ovaries, known as a double oophorectomy, can lead to symptoms characteristic of menopause, such as hot flashes and weight gain. Hormone therapy might serve as a potential relief for these symptoms.

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Surgical removal of uterus and ovaries triggers menopausal symptoms including hot flashes and...
Surgical removal of uterus and ovaries triggers menopausal symptoms including hot flashes and weight gain. Hormone therapy could provide relief.

Experiencing menopause post hysterectomy: A clarification

In the realm of gynecological surgeries, a hysterectomy - the removal of the uterus – is a common procedure, with approximately half a million women undergoing it annually[2]. One of the primary concerns post-hysterectomy for many women is whether it would precipitate menopause symptoms.

To shed light on this topic, let's dive into the insights of menopause specialist, Pelin Batur, MD[3].

Is menopause a given after a hysterectomy?

Typically, a hysterectomy mainly involves the extraction of the uterus and cervix. With this, menopause symptoms might not surface earlier than expected due to the presence of ovaries, which generate estrogen and progesterone[3]. However, in certain instances, the surgery might impact blood flow to an ovary, hampering its function[3].

In the event that an oophorectomy (removal of both ovaries) is carried out, menopause is imminent[3]. This process, often referred to as "surgical menopause," brings about an abrupt cessation of hormone production, which can be shocking to the body and result in more severe menopause symptoms[3].

How does surgical menopause differ from natural menopause?

Natural menopause usually occurs during a woman's 40s and 50s[3]. When ovaries stop producing hormones, menopause is initiated. On the other hand, surgical menopause following an oophorectomy can cause menopause symptoms very soon after the surgery[3].

Does everyone undergo menopause after a hysterectomy?

Not necessarily. If the ovaries are still in place, menopause is highly unlikely[3]. Women who have undergone a hysterectomy may be uncertain regarding the specific parts of their reproductive system that were removed[3]. To establish this, asking your surgeon is crucial, as it impacts Pap tests requirements and hormone therapy options[3].

Symptoms of Surgical Menopause

The symptoms of menopause following an oophorectomy are similar to those experienced without surgery but may be more severe[3]. These include hot flashes, night sweats, vaginal dryness, sexual health issues, anxiety, depression, breast pain, skin and hair changes, sleep problems, weight gain, and more[3].

Duration of Menopause Symptoms after Surgery

The length of time that menopause symptoms persist varies widely. While many women feel better within one to two years, a small number experience symptoms throughout their lives[3]. However, reports suggest that most symptoms dissipate within seven to 10 years, with improvements being observed over this period[3].

Managing Menopause Symptoms Post-Hysterectomy

The type of hysterectomy and age at the time of hormone loss influence the approach to managing menopause symptoms[3]. For those still retaining their ovaries, lifestyle changes and communication with healthcare providers might suffice[3]. If ovaries have been removed, especially at a younger age, hormone replacement therapy (HRT) might be recommended to alleviate symptoms and reduce the risk of bone loss[3].

Regardless of the type of surgery or age, initiatives such as proper nutrition, stress management, and adjusted sleep habits can help mitigate menopause symptoms[3]. Most importantly, it's crucial to discuss any symptoms with your healthcare provider to find suitable management strategies.

[1] National Institute on Aging. (2021). Menopause: How Hormone Therapy Can Help. https://www.nia.nih.gov/health/menopause-how-hormone-therapy-can-help[2] American College of Obstetricians and Gynecologists. (2020). Hysterectomy. https://www.acog.org/patients/faqs/hysterectomy[3] Cleveland Clinic. (n.d.). Menopause after a hysterectomy. https://my.clevelandclinic.org/health/diseases/21047-menopause-after-a-hysterectomy[4] Mayo Clinic. (2021). Perimenopause: Navigating menopause's early stages. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/perimenopause/art-20048173[5] Office on Women's Health. (2020). Menopause symptoms. https://www.womenshealth.gov/a-z-topics/menopause-symptoms

  1. In cases where an oophorectomy is performed during a hysterectomy, menopause is immediate due to the sudden halt in hormone production from the ovaries, a phenomenon known as "surgical menopause."
  2. Unlike natural menopause, which typically occurs in a woman's 40s and 50s, surgical menopause following an oophorectomy can cause menopause symptoms soon after the surgery.
  3. If the ovaries are not removed during a hysterectomy, menopause is unlikely post-surgery. However, women who have undergone a hysterectomy may be uncertain about the parts of their reproductive system that were removed; asking the surgeon is important to understand this, as it impacts hormone therapy options and Pap tests requirements.
  4. Symptoms of menopause following an oophorectomy are similar to those experienced without surgery but may be more severe, including hot flashes, night sweats, vaginal dryness, and sleep problems, among others.

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