Hysterectomy refers to surgical removal of the uterus, which by itself does not affect female hormone levels in premenopausal or postmenopausal women. However, the ovaries might also be removed as a companion procedure to a hysterectomy, if medically necessary. In premenopausal women, removal of the ovaries during a hysterectomy leads to a sudden drop in the levels of the ovarian hormones estrogen and progesterone -- a situation known as surgical menopause. In postmenopausal women, removal of the ovaries with a hysterectomy does not significantly affect hormone levels as the ovaries have already become largely inactive.
The symptoms and long-term effects of surgical menopause are the same as with natural menopause. These effects are due to dramatically reduced levels of estrogen and, to a lesser extent, progesterone. Because hormone levels drop abruptly with surgical menopause, short-term symptoms are often more severe than with natural menopause, when hormone levels fall gradually. While hormone replacement therapy can alleviate short-term menopausal symptoms and long-term effects, this treatment may not be an option for some women and is not without its own risks, including a slightly increased risk of breast cancer and possibly heart disease.
Hot Flashes and Mood Swings
Hot flashes often occur in women who experience surgical menopause just as they do in women going through natural menopause. The feeling of heat sweeping over your body can be intense. You may become nauseous, dizzy or develop a headache, and your heart may race.
Just as some women go through emotional changes when hormones fluctuate during the menstrual cycle, women who have hysterectomies with removal of the ovaries can experience sadness, anxiety and mood swings, which can be severe. This is due to the sudden drop in female hormone levels after the surgery.
Difficulty sleeping is often a side effect of surgical menopause. In addition, you may have less REM sleep -- the dream stage of sleep characterized by rapid eye movement. REM sleep is a necessary part of quality sleep, and lack of it can leave you feeling tired. Low hormone levels also commonly lead to night sweats that can make it difficult to fall asleep or might awaken you during the night.
Vaginal Dryness and Pain During Sex
Loss of hormones after surgical menopause leads to thinning of the vaginal tissue and reduced vaginal moisture production, which is often problematic during sex. Over-the-counter vaginal lubricants can help with dryness, but you may still experience pain during sex due to thinner vaginal tissue. Prescription estrogen cream inserted directly into the vagina can help counteract thinning and alleviate the associated pain.
Reduced Bone Density
Estrogen affects bone density by inhibiting bone resorption. Menopause at any age, with the subsequent loss of estrogen, increases your risk of developing osteoporosis because it leads to weaker, less-dense bone. Early menopause brought on by the removal of your ovaries during a hysterectomy performed during your childbearing years can result in bone loss beginning much earlier in life, increasing your risk for early and possibly more osteoporosis.
Increased Cardiovascular Disease Risk
According to the Centers for Disease Control and Prevention, heart disease and stroke were responsible for 28.2 percent of all deaths among women in 2013, the most recent year for which data is available. Risk increases with both natural and surgical menopause. A multi-ethnic study published in the October 2012 issue of the journal "Menopause" concluded that women who reported experiencing menopause before age 46 -- including menopause as a result of removal of the ovaries -- had a moderately higher risk of coronary heart disease and stroke. This held true even after adjusting for other cardiovascular disease risk factors.
- Merck Manual Professional Version: Osteoporosis
- FamilyDoctor.org: Menopause Symptoms
- Centers for Disease Control and Prevention: Leading Causes of Death in Females United States, 2013 (current listing)
- Menopause: Early Menopause Predicts Future Coronary Heart Disease and Stroke: The Multi-Ethnic Study of Atherosclerosis (MESA)