Will having a hysterectomy cause menopause? Understanding the impact on hormones and what to expect

For women considering or preparing for a hysterectomy, questions around how this surgery might impact menopause are common. A hysterectomy is a major decision, and understanding the effects on your hormones can help you prepare for any changes that may come afterward.

This post will explore how a hysterectomy can lead to menopause or menopause-like symptoms, what types of hysterectomies affect hormone levels, and how to manage your body’s transition if menopause follows surgery.

Types of hysterectomy and their impact on menopause

A hysterectomy is the surgical removal of the uterus, but there are different types that vary in how much tissue is removed. Whether or not the surgery causes menopause depends on which reproductive organs are removed.

1. Partial (or Supracervical) hysterectomy

A partial hysterectomy removes only the uterus while leaving the ovaries and cervix intact. Since the ovaries are still producing oestrogen and progesterone, this type of hysterectomy typically does not cause immediate menopause. However, some women may experience a natural decline in ovarian function slightly earlier than they would have without the surgery.

2. Total hysterectomy

A total hysterectomy involves the removal of both the uterus and cervix, but the ovaries are left in place. In this case, oestrogen production continues as normal, so this surgery alone does not cause immediate menopause. However, as with a partial hysterectomy, some women may enter menopause a bit earlier than they would have otherwise.

3. Hysterectomy with Bilateral Oophorectomy

A hysterectomy with bilateral oophorectomy is the removal of the uterus along with both ovaries. Since the ovaries are the body’s primary source of oestrogen, removing them induces immediate menopause, regardless of age. This type of menopause is often called surgical menopause, and it brings a sudden drop in hormone levels that can lead to intense symptoms.

Symptoms of surgical menopause

For women who undergo a hysterectomy with removal of the ovaries, the onset of menopause symptoms can be abrupt and intense, as the body no longer has a gradual decline in oestrogen. Symptoms often include:

• Hot flashes and night sweats
• Mood swings and irritability
• Fatigue and low energy
• Vaginal dryness and reduced libido
• Joint pain and muscle aches
• Brain fog and memory issues
• Loss of bone density

These symptoms can be similar to those experienced in natural menopause but may be more pronounced due to the sudden drop in hormones.

Managing menopause symptoms after hysterectomy

If your surgery leads to menopause, there are ways to manage symptoms and support your body through this transition:

1. Consider Menopause Hormone Therapy (MHT)

For those experiencing surgical menopause, Menopause Hormone Therapy (MHT) can help replace the lost oestrogen and alleviate symptoms. MHT may involve oestrogen alone or a combination of oestrogen and progesterone, depending on your health history and needs.

Note: Always discuss with a healthcare provider to determine if MHT is right for you, especially after surgery.

2. Explore natural supplements and lifestyle adjustments

Many women opt for natural ways to manage menopause symptoms, especially if they’re unable or prefer not to use hormone therapy. Supplements like phytoestrogens (e.g., soy isoflavones and red clover), calcium and Vitamin D for bone health, and Omega-3 fatty acids for heart health can support hormone balance.

Regular exercise, especially strength training, can also protect bone density and improve mood, while practices like mindfulness or yoga help reduce stress and improve sleep quality.

3. Prioritise diet for bone and heart health

Since low oestrogen impacts bone density and heart health, aim for a balanced diet rich in:

• Calcium and Vitamin D for bone strength
• Healthy fats, especially Omega-3s, to support heart health
• Fibre-rich foods like fruits, vegetables, and whole grains to stabilize blood sugar and reduce inflammation

4. Stay hydrated and moisturise

The drop in oestrogen can affect skin elasticity and moisture levels, so staying hydrated is essential. Drinking plenty of water and using gentle, hydrating skin products can help ease dryness.

What to expect if you don’t enter immediate menopause

If you retain your ovaries after a hysterectomy, you may not experience immediate menopause. However, it’s not uncommon for ovarian function to decline somewhat earlier than it would have naturally. This could lead to menopause symptoms a few years sooner than expected. In this case, you may have a more gradual transition, with symptoms appearing over time.

Deciding what’s right for you

Choosing a hysterectomy is a deeply personal decision, often guided by medical necessity and personal preferences. Understanding the potential effects on your hormone levels and knowing your options for managing symptoms can make this transition smoother and more manageable.