Will I Go Through Menopause After a Hysterectomy?

Every year, approximately 32,000 Australian women undergo a hysterectomy procedure. While this is a substantial number, there’s an unfortunate gap in knowledge and awareness that can leave too many women uncertain about how this surgery will impact on their menopause experience.

We’ve delved into what you need to know about hysterectomies, their potential influence on menopause, and what’s important to consider if you’re looking to undergo this procedure.

What exactly is a hysterectomy?

‘Do you know anyone who’s had a Cesarean section? Think of a hysterectomy as something like that, except that, instead of a baby, an organ – with its associated blood vessels and muscular attachments – is excised,’ writes Anna Homes for The New Yorker.

This surgery can take place in various forms. A total hysterectomy means removing the uterus and cervix, a partial hysterectomy looks to preserve the cervix, and a radical hysterectomy removes the uterus, cervix, and a segment of the upper vaginal area. Some surgeries will also involve the removal of one or both ovaries, leading to instant menopause if both are removed.

When is a hysterectomy necessary?

A hysterectomy isn’t a decision that is taken lightly, with other treatment plans often providing the first steps before this surgery is recommended. However, there are a wide range of reasons why a hysterectomy may be necessary, including:

• Uterine fibroids: these benign growths can lead to considerable bleeding, discomfort, and complications for some women. If other treatment plans aren’t successful, a hysterectomy may be the best way forward.
• Endometriosis: for many women, this is an incredibly painful and debilitating experience. In some severe cases, a hysterectomy may be the only form of successful treatment.
• Uterine prolapse: if weakened pelvic muscles cause the uterus to prolapse (such as after childbirth or as a part of natural aging), a hysterectomy may be necessary.
• Cancer: for cancers affecting the uterus, cervix, or ovaries, a hysterectomy can be a robust solution that stops any further cancerous growth.
• Irregular vaginal bleeding: for women with extremely intense or heavy periods, this can provide an ongoing form of relief.
• Persistent pelvic pain: when chronic pelvic pain can’t be treated through other pathways, a hysterectomy may be the solution.
• Adenomyosis: with symptoms like cramps, abdominal pressure, and swelling, a hysterectomy that can provide relief may be recommended to resolve this.

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What is the impact of a hysterectomy on menopause?

Neither menopause nor a hysterectomy is a straightforward experience, with all kinds of mental, physical, and emotional complexities inherent to each of them. For younger women, the need for a hysterectomy can not only mean the potential for menopause to begin through the removal of ovaries (in the case of some hysterectomies), but it can also mark the end of their fertile years through the removal of their womb.

For women who are yet to enter into menopause or who are in the midst of one of its stages, the choice to undergo a hysterectomy can add complexity to this experience. When a hysterectomy involves the removal of both ovaries, this leads to what’s known as surgical menopause. Unlike natural menopause, which unfolds over the course of multiple years, surgical menopause is sudden and immediate. 

Unfortunately, the abrupt nature of surgical menopause can actually intensify the classic symptoms of natural menopause. Hot flushes may become more intense, and mood fluctuations can become more common, as well as potential issues with vaginal dryness, decreased libido, and cognitive impacts.

For women who may be in need of a hysterectomy, hormone replacement therapy (HRT) can play a key role in providing some relief for the sudden whirlwind of surgical menopause symptoms that can be induced by the removal of both ovaries. HRT aims to support the body’s natural production of oestrogen through a supplementary effect and can help in bridging the sudden hormonal gap that’s left without the ovaries.

Of course, as with all kinds of menopausal treatments, there’s no one-size-fits-all approach with HRT. Working closely with an expert healthcare practitioner is necessary to make sure you’re receiving the best quality of personalised care for your individual health experience. 

The emotional impacts of a hysterectomy

Beyond the physical impacts of a hysterectomy, there are a number of emotional impacts that need to be considered when it comes to preparing for life beyond the surgery.

‘To reduce anxiety, it’s best to have a clear understanding of what the procedure entails and how it affects your body, fertility, and emotions,’ writes Jennifer Warner for Everyday Health. ‘Talk to your doctor, share your concerns and ask relevant questions, including what will happen during the procedure, what it will feel like, and what you can do to reduce any symptoms after surgery. The more you know, the more relaxed you’ll be on the day of surgery.’ 

For some women, the experience of having their uterus removed can be emotionally challenging. Drawing on support from friends, family, and loved ones can be a significant help in navigating this transition, as well as remembering why the hysterectomy is necessary in the first place. Mindfulness techniques, plenty of rest, and continuing to focus on the positive outcomes of the surgery can be helpful in reducing the emotional impact of this procedure.

If you’re a younger woman experiencing the loss of fertility as a result of a hysterectomy or surgical menopause, you may need to draw on the support of mental health practitioners in order to navigate this life experience. Psychologists and counsellors can all play a key role in supporting your mental health, creating space for you to process, grieve, and heal. 

Conclusion

At the Australian Menopause Centre, we provide integral support to thousands of Australian women throughout every stage of their menopause experience. Whether you’re in the midst of considering a hysterectomy or are looking for post-surgery support with your menopausal symptoms, we pride ourselves on providing the highest quality of attentive, customised care to women across the country. Contact our team today to find the individualised treatment pathway you need to move forward with confidence and clarity.