A hysterectomy is the surgical removal of the uterus. A hysterectomy can be partial, with just the uterus removed, or total, with the ovaries and fallopian tubes also removed. Because female hormones such as estrogen are produced in the ovaries, removal of the ovaries in a total hysterectomy will cause menopausal effects. The sudden drop in hormones in surgical menopause can be more severe than natural menopause, according to Linda Bernhard, R.N., of Ohio State University.
Vasomotor Changes
According to the Merck Manual, more than 75 percent of all menopausal women experience vasomotor changes, changes that cause dilation or constriction of blood vessels. These include hot flashes, the most common menopausal symptom, which are often accompanied by flushing, sweating, rapid heartbeat and night sweats, according to the North American Menopause Society (NAMS).These are related to the lack of estrogen, and tend to last longer and be more severe in surgical than natural menopause.
Central Nervous System and Psychological Symptoms
Sudden lack of sufficient estrogen can be especially traumatic when coupled with the loss of reproductive organs and recovery from major surgery. Psychological symptoms related to decreased estrogen include mood swings, crying for no reason, irritability, difficulty sleeping and problems with memory. Headaches can also occur from changing estrogen levels.
Genito-Urinary Symptoms
Lack of estrogen can cause vaginal dryness and atrophy, or shrinkage, of the vagina. The labia, clitoris and vulva may also atrophy. This can lead to pain during intercourse, irritation, itching, burning and pain, according to NAMS. Urinary incontinence related to pelvic floor muscle relaxation and overactive bladder can be related to menopause. The urethra may also shrink due to lack of estrogen, which, along with the change in vaginal pH from acidic to alkaline, leads to an increase in urinary tract infections. Libido can also decrease.
Hair and Skin Changes
The decrease in estrogen changes the estrogen/androgen (male hormone) ratio. The androgen increase causes thinning hair on the head and increased facial hair. Skin thins and loses elasticity. Fat patterns can also change after menopause; abdominal fat increases and breast tissue decreases, according to the Mayo Clinic.
Bone Mass Loss
Lack of estrogen leads to loss of bone mass, either osteopenia, a decrease in bone mass, or osteoporosis, a loss of bone mass associated with increased fracture risk. Bone loss is most severe in the first two years of estrogen deprivation, according to the Merck Manual, and averages three to five percent a year, according to the Baylor College of Medicine.
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