Women undergo hysterectomy procedures more often than you might think. American women alone have about 600,000 hysterectomies per year.
Given the prevalence of this surgery, it’s important to know how it affects menopause.
Not all procedures are the same, and the impact on menopause can vary. So if you’re considering the procedure, or know a woman who is, find out everything you need to know about the potential menopausal impacts.
There are degrees of hysterectomy that are chosen based on the conditions that prompt the procedure.
Partial – The upper part of the uterus is removed, but the cervix is left intact.
Total – The entire uterus is removed, including the cervix.
Radical – A total hysterectomy with the removal of additional surrounding structures as needed. This variation is often recommended when cancer is present or suspected.
A significant percentage of hysterectomies coincide with the removal of the ovaries. This procedure is called an oophorectomy.
Reasons For Surgery
Uterine fibroids prompt hysterectomies more than any other single cause. This condition alone is responsible for about 30% of all hysterectomies performed.
Other reasons for the procedure include: Endometriosis (The potentially painful growth of uterine lining tissue outside of the uterus), uterine prolapse, abnormal bleeding, chronic pain, and gynecological cancer.
The obvious result of a hysterectomy is the elimination of the underlying issue that prompts the surgery. The removal of the uterus also means the end of the monthly menstrual cycle as well the potential for pregnancy.
Impact On Menopause (When Ovaries Remain)
Removal of the uterus alone does not induce menopause. When a hysterectomy leaves the ovaries intact, the impact to menopause is relatively minimal.
The main effect on menopause in this circumstance would be the subsequent lack of information about where you are in the process. Menopause technically occurs when there’s been no period for one year.
If the menstrual cycle is ended by the surgery, there will be no such designation. But the hormonal decline should proceed the same as before the operation.
Impact On Menopause (When Ovaries Are Taken)
Natural menopause is a process. Estrogen, progesterone, and testosterone levels shift and decline gradually, as the ovaries produce less and less. For many women, this process can take over a decade.
When the ovaries are removed, however, the loss of ovarian hormone production is immediate. The result is referred to as medically-induced menopause. Normal symptoms of menopause such as hot flashes, night sweats, and loss of sexual function and desire are common following the procedure.
When menopause is artificially induced, symptoms are usually more intense than with the natural process. This is because the hormone decline is immediate, rather than gradual. Hormone replacement is often utilized to mitigate these effects.
Long-Term Effect Of Ovary Removal
The main reason that ovaries are removed during a hysterectomy is to avoid the potential for ovarian cancer. For those with a family history of the disease, doctors often remove the ovaries as a preventative measure.
According to the American Cancer Society, ovarian cancer is the fifth leading cause of cancer deaths among women, so the removal of the ovaries brings the benefit of avoiding this potentially deadly cancer.
On the downside, removal of the ovaries (especially in younger women) can be a considerable risk factor for bone density loss and osteoporosis. This is because estrogen plays a key role in maintaining bone density. The early removal of the ovaries deprives the body of all of the estrogen that they would have produced in the subsequent years.
Women who have their ovaries removed need to monitor their bone health, and prepare accordingly. Hormone replacement therapy is an important part of these considerations, but there other steps that can be taken to preserve skeletal integrity.
For more information on ways to keep your bones healthy, check out our article: Bone Health and Menopause.