Menopause and Hysterectomy

When you hear the term, "surgical menopause", this is actually a reference to an occurrence of hysterectomy menopause. When a woman has a hysterectomy, one or both of her ovaries will be removed, as well as the uterus and fallopian tubes. When this happens, the woman is thrust abruptly into menopause, which can bring on devastating symptoms immediately. In fact, women who deal with hysterectomy menopause are hit much harder by the symptoms of menopause than women who go into menopause naturally. The hot flashes are much more intense, the night sweats more frequent while lasting longer, the level of depression significant, and so on. In addition, surgical menopause places a woman at greater risk of osteoporosis and heart disease. Interestingly, the exact reasons for this increase in symptom severity are simply not known.

We know that when just one ovary is removed, the woman will start into menopause naturally. In addition, if the uterus is removed but the ovaries remain, the monthly menstrual cycle will stop while other menopause symptoms typically experienced during menopause will begin to appear at an earlier age. Some experts believe this is caused by the reduction in blood flow associated with the ovaries because of the surgery. In summary, there are many differences between hysterectomy menopause and natural menopause. Simply put, with natural menopause, the ovaries stop producing eggs every 28 days or so, which results in the menstrual cycle ceasing. At this point, the woman is no longer capable of having children. The normal process involves post menopause, which becomes official after the cycle has been stopped for a full 12 months. In most cases, natural menopause begins anywhere between the ages of 47 and 51 at which time the production of estrogen and progesterone stops being produced.

Now, on the other side, there is surgical menopause. As mentioned, if both ovaries are removed, the woman is immediately into post menopause with significant symptoms. Keep in mind that if you have already gone through menopause and then have a hysterectomy, you will not feel any differences caused by hormonal change. However, if you have not yet gone through menopause and have a hysterectomy, you will literally wake up from surgery in post menopause. The body will immediately stop the production of both hormones – estrogen and progesterone. Then what happens is that in an attempt to make contact with the ovaries that have been removed, the follicle stimulating hormone also called FSH skyrockets. In reality, the woman wakes from surgery to find that she is going through estrogen withdrawal, which is sudden and intense.

For women going through hysterectomy menopause, it is crucial that the hospital understand the importance of providing the right treatment upon waking from surgery. This will help calm the woman down and help her to feel better. Typically, if estrogen is not administered right away, the woman will awaken to an overwhelming sense of depression and anxiety, rapid heart beat (palpitations), hot flashes, sweating, irritability, uncontrollable crying, difficulty with sleeping, unbelievable fatigue, lapses in memory, electrical shock sensation under the skin, itchy skin, headache, and more. Obviously, having gone to sleep in the operating room feeling normal and then waking to this is more than most women can handle. Therefore, hospitals will start the woman on hormone replacement therapy (HRT) upon waking. Now keep in mind that not all women can tolerate HRT and may eventually need to go off to try natural remedies but in the beginning, HRT will help with the symptoms and calming them down.

With a hysterectomy, the results include physiological, emotional, psychosocial changes, which is both expected and normal. In most cases with natural menopause, the woman has time to adjust but with surgical menopause, this is not an option. This luxury is ripped away, making the woman face some very difficult times. However, again with proper medical treatment and a sound support system, she will adjust and go on to live a normal and healthy life.