Hysterectomy and menopause, the words seem to go together like salt and pepper. In truth, hysterectomy doesn’t necessarily lead to menopause. Even if the type of hysterectomy a woman has does initiate menopause, there are many things which can be done to help alleviate its symptoms. A woman should investigate the possible outcomes of a hysterectomy prior to the procedure. Knowing what to expect after her surgery will help any woman to be more comfortable before her surgery.

Hysterectomy by definition is removal of the uterus. Without a uterus a woman will no longer menstruate or have the ability to carry a child. Many people assume that when these things happen menopause automatically follows; that assumption is incorrect. Menopause occurs as the production of the hormones estrogen and progesterone diminishes with age. Removal of the uterus in and of itself will not cause the onset of menopause. The ovaries are the main source of estrogen and progesterone; if they are left in place and continue to function menopause comes along at just about the same time as it would have without a hysterectomy.

Many times doctors try to leave at least one ovary with the intent of forestalling menopause. Sometimes, however, even when the ovaries are not removed menopause symptoms may begin. Hysterectomy, obviously, is traumatic. The operation can change the blood flow to the ovaries in which case they may not produce hormones in the same quantity as before; decreased hormone production will result in the beginning of menopause. Additionally, the ovaries may fail, again resulting in the onset of menopause.

Sometimes medical circumstances dictate the removal of all the reproductive organs including both ovaries. When this happens, so called surgical menopause starts immediately. For a variety of reasons, the symptoms accompanying surgical menopause many times are more severe than those which accompany natural menopause. This severity is partially due to the abrupt way in which surgical menopause comes about and also because a woman is dealing with recovery from a major operation at the same time. For many women the months leading up to and after a hysterectomy are confusing and emotional times; these feelings may exacerbate a woman’s menopause symptoms.

A woman who enters menopause as a result of her hysterectomy will experience the same menopausal indications as a woman who enters it naturally. Studies show though that the signs associated with surgical menopause may hit a woman harder than those of ordinary menopause. Women who experience surgical menopause may also be at greater risk for osteoporosis, heart attacks and some forms of cancer. However, not all of the evidence is in on these areas of concern.

Treatments for menopause following hysterectomy are basically the same as those for common menopause. For some women hormone replacement therapy (HRT) will be appropriate; others may treat the symptoms with vitamins and herbal therapies. Either course of action should be discussed with the woman’s physician and monitored by same on a regular basis. Both courses of action will benefit from being coupled with proper diet and exercise.

In sum, menopause is not a routine response to hysterectomy. When a woman’s ovaries are left in place she may experience menopause on only a slightly earlier schedule. Even if menopause does begin as a result of a hysterectomy a woman has many options open to her for dealing with the symptoms. Knowing those options and feeling in control of the situation will help any woman deal with whatever hysterectomy may throw at her.

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The recovery time required after a hysterectomy will vary according to the type of hysterectomy that was performed, the condition for which the hysterectomy was prescribed and, of course, the woman herself. Vaginal hysterectomy usually takes the least amount of time in the operating room and generally has the shortest recovery time. Laparoscopic procedures take a little longer to perform. Because the laparoscope and other surgical instruments are inserted through abdominal incisions the recovery time for this method of hysterectomy is also slightly longer. Abdominal hysterectomies are the most physically invasive, especially so if a woman’s ovaries are also removed. They require the longest time in surgery and the longest rehabilitation period. Recovery in which there are no complications may take as long as two months.

Assuming there are no complications, what can a woman expect after her body has healed from having a hysterectomy? Again, the answers vary widely depending upon the type of operation and the malady that caused it. If a woman had a hysterectomy to get rid of small/medium fibroids, to eliminate chronic endometriosis or to stop heavy bleeding then she probably underwent a less radical procedure than is recommended for other problems. The doctor may have recommended a total hysterectomy in which the uterus and cervix are removed. In recent years laparoscopic supracervical hysterectomies have become more widely used. In this hysterectomy the cervix is not excised. Because both of these methods of surgery leave the ovaries intact menopause will not automatically ensue; although diminished blood flow may cause some menopausal symptoms. If the cervix is not taken out, there is also less risk of vaginal dryness and lost sexual sensation.

Large fibroids in the uterus or ovaries, adhesions to other organs, severe endometriosis or malignancy may call for more extensive surgery. In these cases a bilateral salpingo oophorectomy may be done along with the hysterectomy; this long medical simply refers to removing both of the fallopian tube and both of the ovaries. When this is done menopause will immediately take place. Doctors often try to leave at least one ovary. With even one ovary a woman may not experience menopause symptoms for several years. However, in cases of rampant disease this choice is not always an option.

All of these words sound pretty bleak: Vaginal dryness, lost sexual sensation, surgically induced menopause. It would be unfeeling to treat cavalierly any of the things that may happen to a woman after hysterectomy. This is true even without addressing the fact that hysterectomy renders a woman unable to bear a child; that extremely personal result is best handled by the woman, her medical team and whatever counseling they feel may be required. The other problems which may come along after a hysterectomy are more easily discussed and even alleviated.

The keys to thriving after hysterectomy are knowledge and treatment. Some women may choose hormone replacement therapy (HRT) to ease the signs which may appear after the uterus is removed. Others may treat the symptoms with vitamins, herbs and creams. Whatever course of treatment a woman chooses she will benefit from exercise and proper diet. Meditation, visualization and other forms of mental exercises may also prove effective; as may attending a support group.

When a woman experiences hysterectomy she must not buy into the old wives’ tales. These myths would have her believe that her life – particularly her sex life – has been forever changed for the worse; this is not true. Today there are myriad therapies which will help a woman to live a complete and fulfilling life after hysterectomy.

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The recovery period post hysterectomy will vary depending upon the type of operation that was performed and the reason it was performed. Rehabilitation may take as little as a few days and as long as two months. During this period, a woman will stay in close contact with her doctor. She should refrain from heavy lifting and make sure to get lots of rest. Back and/or leg pain as well as pain during urination should be reported to her physician. Swelling, nausea, fever, dizziness and incision leakage also merit immediate calls to the doctor. Should a woman experience consistent depression she needs to discuss this with her doctor as well.

Assuming that a woman is now free of disease she will be able to resume work at the end of the recovery period. However, it is after her body has healed from the actual surgery that a woman may first feel ongoing physical and mental changes post hysterectomy. A hysterectomy in which only the uterus was removed (known as a supracervical or laparoscopic supracervical hysterectomy) commonly produces the fewest side effects. There may be some decrease in orgasm and some laxity in the pelvic area but few other post hysterectomy symptoms have been noted. A vaginal hysterectomy removes both the uterus and the cervix (referred to as a total hysterectomy). Loss of the cervix may result in vaginal dryness and decreased sexual desire. Since in these operations the ovaries and sometimes the cervix remain post hysterectomy, it is important for women who have undergone these types of procedures to strictly adhere to testing for ovarian and cervical cancer.

A hysterectomy performed abdominally may be either a total hysterectomy or it may be a hysterectomy during which other reproductive organs are removed. When an ovary and fallopian tube are removed the operation is called a salpingo oophorectomy (if both are taken out it becomes a bilateral salpingo oophorectomy). Abdominal hysterectomies may cause a larger array of post operative symptoms. If even one of the ovaries was left intact, surgical menopause may not be induced. However, post hysterectomy the blood flow to the remaining ovary or ovaries may diminish which can lead to ovarian failure which will bring on menopause. If a bilateral procedure was called for surgical menopause begins immediately.

The symptoms of surgically induced post hysterectomy menopause are much the same as those of natural menopause: Hot flashes, night sweats, weight gain, vaginal dryness, decreased sexual desire and orgasm, depression, fatigue. They may even be slightly more severe when menopause occurs as a result of hysterectomy. Post hysterectomy women may also be more prone to osteoporosis and cancer. For that reason they should remain in close contact with their physicians. Just reading the list of symptoms can make a woman disheartened. The additional sadness a woman may feel at no longer being able to bear a child is best addressed by the woman’s medical team and whatever support group they may feel she requires.

Despite whatever symptoms a woman may feel post hysterectomy it is important to remember that most of the signs will fade away over the next two to three years. In the meantime, there are many therapies which may alleviate some of a woman’s post hysterectomy indications. Hormone replacement therapy (HRT) may be an option for some women. Other women may choose natural remedies for their post hysterectomy symptoms. Many women believe that a regimen of vitamins, herbs and natural hormones delivered via creams is helpful. All women can receive some degree of relief from appropriate exercise and proper diet. Life post hysterectomy will be different; that does not mean it has to be worse.

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The simple act of having a hysterectomy will not automatically cause hot flashes to happen. Hot flashes generally indicate the onset of menopause but there again having a hysterectomy does not automatically cause menopause to happen. In some hysterectomies only a woman’s uterus is removed. Theoretically if the ovaries are left intact menopause will begin at about the same time as it would have if there had been no hysterectomy; this is true even if only one ovary is spared. There are cases though when the signs of menopause show themselves even if the ovaries have not been taken out. Doctors theorize that this occurs because the blood flow to the ovaries may have been diminished in some way by the operation. Surgical menopause will be immediately induced if the ovaries are removed as part of the hysterectomy procedure.

Even medical professionals don’t know why natural menopause or surgical menopause causes hot flashes; obviously there is a connection between the diminished production of estrogen by the ovaries and the beginning of signs of menopause. However, the precise link between the specific symptom of a hot flash and decreased estrogen has not been determined. For some reason there is a momentary fluctuation in the part of the brain that regulates body temperature; when that happens a woman can feel as though she is almost feverish in what seems like seconds; this feeling usually lasts from three to thirty minutes. The hot flash may be accompanied by a red face or even red extremities, heat palpitations and drenching sweat. Sometimes a woman will wake up in the middle of the night with a severe hot flash accompanied by massive perspiration, this is called night sweat. All told, hot flashes generally occur off and on for anywhere from two months to two years.

Women find varying degrees of symptom relief from a wide variety of treatments. In the past, hormone replacement therapy (HRT) was almost universally prescribed. Serious side effects from some forms of HRT have arisen though and many women opt for other approaches to battle hot flashes. For some women twenty minutes or more a day of cardiovascular exercise such as brisk walking can be very helpful. Other women swear by herbal remedies such as black cohosh. Soy supplements may also alleviate the symptom as may B vitamins, vitamin C, magnesium and potassium. Lowering the intake of caffeine, spicy foods and alcohol can also decrease many menopause symptoms. Women may also want to dress in layers so they can take off a piece or two of clothing when a hot flash rears its ugly head.

Without a doubt, hot flashes are one of the most annoying aspects both natural menopause and surgical menopause. Their sudden and sometimes very evident onset can be embarrassing and highly inconvenient. Take heart, however, most all women experience hot flashes at some time during their lives; eventually they will taper off and finally disappear altogether.

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