If you have a hysterectomy that involves removing your ovaries, you will have a more sudden menopause. You may have more severe symptoms, and it may increase your risk for some health conditions. Treatment options can help.

Menopause generally occurs when menstrual cycles stop for at least 12 months. If you have a hysterectomy, the surgical removal of your uterus, your periods will also stop, but depending on the type of hysterectomy you have, you may not be in menopause.

Read on to learn more about menopause after hysterectomy, what to expect, and what you can do to relieve any symptoms you may have.

Yes, it can. It depends on which type you have. Your periods will stop following a hysterectomy, but you may still have hormonal cycles.

These are the main types of hysterectomy:

  • Partial hysterectomy (also called subtotal): In this procedure, your uterus is removed, but your ovaries and cervix are left in place.
  • Total hysterectomy: In this procedure, your uterus and cervix are removed. Your ovaries may or may not be removed depending on your condition and diagnosis.
  • Radical Hysterectomy: In this procedure, your uterus, cervix, part of your vagina, and possibly some surrounding tissue is removed. This is usually done as cancer treatment. You may have your ovaries and fallopian tubes removed as well.

The main thing that will determine if you have menopause immediately following your hysterectomy is whether your ovaries are removed or not. When your ovaries are removed, it’s called an oophorectomy.

If you have both ovaries removed, your hormones will abruptly stop, and you will be in menopause. If this occurs, you may have more severe symptoms.

If your ovaries are not removed, research suggests you may have menopause earlier than you would have if you hadn’t had a hysterectomy.

If you have menopause following a hysterectomy, it is sometimes called surgical menopause. Following a hysterectomy with ovary removal, you are likely to experience a rapid and abrupt drop in your estrogen and progesterone levels, so you are likely to experience rapid and more severe menopause symptoms.

These symptoms are similar to those of individuals who have not had a hysterectomy, and may include:

If your ovaries are not removed, menopause symptoms may still develop earlier than expected, or sometimes not at all. Some individuals experience “silent ovarian failure,” also called primary ovarian insufficiency (POI), where hormone levels drop without noticeable symptoms, making it challenging to recognize the onset of menopause.

There are health risks from the sudden onset of menopause, hysterectomy can cause, especially for individuals 45 and younger. You may be at a greater risk of having conditions like:

  • Bone loss or osteoporosis: If you have your ovaries removed before the age of 45, you may be at a greater risk of developing osteoporosis and fractures due to the loss of hormones for a longer period of your life.
  • Cardiovascular disease: Research suggests that individuals who have early ovarian removal without hormone replacement therapy may be at a 40% increased risk of developing cardiovascular disease.
  • Cognitive function disorders: Early surgical menopause may increase the risk of developing dementia, Alzheimer’s disease, or Parkinson’s.
  • Sexual dysfunction: Individuals who experience early menopause due to hysterectomy with ovary removal may experience decreased libido, difficulty having an orgasm, and loss of interest in sexual activity.
  • Survival: Removing ovaries before 50 years old and not having HRT may increase your risk of dying younger.

There are things you can do to help manage menopause symptoms and reduce your risk of the associated health conditions. These options include:

  • Hormone replacement therapy (HRT): There are risks associated with HRT for some people, and it may not be right for everyone. However, it is recommended that individuals who experience menopause (either from hysterectomy or other reasons) have HRT to minimize the risk of osteoporosis, heart disease, and cognitive decline. If you have a history of hormone-sensitive cancer, you may not be able to have HRT.
  • Lifestyle measures:
    • getting regular exercise
    • eating a balanced diet that includes calcium and vitamin D
    • stopping the use of tobacco products, especially smoking
    • vaginal moisturizers and lubricants
    • counseling to help manage mood changes, depression, and sexual function changes

If you have a hysterectomy that includes the removal of your ovaries, you are likely to have immediate menopause. This means you will likely experience menopause symptoms with a more sudden onset, and that your symptoms may be more severe than if you’d had a typical menopause progression.

If you have a hysterectomy with menopause before you are 45 to 50 years old, you may be at a high risk of developing conditions like cardiovascular disease, osteoporosis, and others. Talk with your doctor about hormone replacement therapy and other options to help relieve any menopause symptoms you may have.