Most women approach menopause gradually–sometimes over several years. But those who undergo a hysterectomy and have their ovaries removed enter it in a matter of hours. This can prove disorienting.
Hysterectomy itself does not dramatically affect estrogen levels. If one or both ovaries are left intact, the body continues to produce estrogen. However, about half of American women who undergo a hysterectomy have both ovaries removed, throwing them into surgical menopause.
Even a hysterectomy alone can cause a gradual decline in estrogen, however. A hysterectomy with one ovary removed is associated with an even earlier onset of menopause, according to a paper published in BJOG: An International Journal of Obstetrics and Gynaecology.
Emotional Problems
Lack of estrogen, especially combined with the emotional and physical stress of a hysterectomy, can often lead to mood swings, irritability, depression and insomnia.
Skin and Vaginal Changes
Estrogen affects the body’s production of oil and collagen. Collagen creates the “stretch” in skin and muscle. As estrogen declines, so does oil and collagen production, leading to dryer, less elastic skin. The loss of collagen also contributes to vaginal dryness, referred to as vaginal atrophy. Without additional lubrication, sexual intercourse may become uncomfortable, even painful. A National Institutes of Health panel estimates 17 to 30 percent of menopausal women experience vaginal dryness.
Hot Flashes
Lack of estrogen causes some women to experience hot flashes; estimates vary, but these may affect from 30 to 80 percent of menopausal women. Some women call hot flashes "energy surges," but you'll probably just find them annoying and uncomfortable. Stay near the thermostat.
As with the loss of collagen and emotional changes, hot flashes often accompany menopause whether surgically induced or not. However, women who enter surgical menopause and do not receive estrogen replacement therapy appear more likely to experience hot flashes than those who enter menopause naturally, according to research from Johns Hopkins University published in the journal Fertility and Sterility.
Osteoporosis Risk
Loss of estrogen increases the risk of developing osteoporosis. Women can lose up to 20 percent of their bone mass in the five to seven years after menopause; this loss of bone density leaves them more prone to fracture. The likelihood of developing osteoporosis increases during aging, and surgical menopause appears associated with higher rates of osteoporosis than does natural menopause.
Dementia Risk
Research suggests a possible association between lack of estrogen and cognitive impairment. A study by W.A. Rocca and colleagues at the Mayo Clinic, published in the journal Neurology, showed that removal of one or both ovaries in a nonmenopausal woman was associated with an increased risk of cognitive impairment or dementia. Unlike the other effects, this appears related not to menopause itself, but to surgical menopause. The study showed only a correlation, not a causal relationship.
