A hysterectomy is a surgery to remove a woman’s uterus. It is a major procedure that causes permanent changes to the female body. There are a few key ways that a hysterectomy impacts a woman’s health and quality of life.
What is a hysterectomy?
A hysterectomy is the surgical removal of a woman’s uterus. It is a common treatment option for various gynecological conditions including:
- Fibroids – noncancerous growths in the uterus
- Endometriosis – tissue that normally lines the uterus grows outside of it
- Uterine prolapse – when the uterus drops from its normal position
- Cancer of the uterus, cervix, or ovaries
There are a few different types of hysterectomies:
- Partial hysterectomy – the upper part of the uterus is removed but the cervix is left in place.
- Total hysterectomy – the entire uterus and cervix are removed.
- Radical hysterectomy – the uterus, cervix, and surrounding tissue are removed.
The ovaries and fallopian tubes may or may not be removed during a hysterectomy depending on the woman’s condition. Leaving at least one ovary intact allows a woman to continue producing estrogen.
How does a hysterectomy impact hormones?
One of the biggest effects of a hysterectomy is on a woman’s hormone levels. The ovaries are the main source of the hormones estrogen and progesterone in women. These hormones regulate the menstrual cycle and have effects throughout the body.
If the ovaries are removed during a hysterectomy (called an oophorectomy), this causes surgical menopause. Menopause is when a woman stops having menstrual periods permanently as her hormone levels drop. Surgical menopause has some key differences from natural menopause:
- It occurs suddenly rather than gradually.
- The drop in estrogen is more abrupt and severe.
- Symptoms like hot flashes may be more intense.
Even if the ovaries are left in place, a hysterectomy may cause hormone changes like:
- Lower estrogen levels since the uterus was the source of some estrogen production.
- Earlier onset of menopause by 1-3 years.
To help manage symptoms, hormone therapy (HT) medications may be given after surgery. HT typically involves taking estrogen and progestin supplements daily.
How does a hysterectomy affect the menstrual cycle?
Obviously, a hysterectomy means a woman will no longer have periods or be able to get pregnant. The timing depends on the type of surgery:
- After a partial hysterectomy, periods may continue but be lighter and more irregular before stopping completely.
- With a total hysterectomy, periods stop immediately.
For women nearing perimenopause, having a hysterectomy may simply hasten the inevitable end of menstrual periods. But for younger women, this loss of fertility can be emotionally difficult.
Does a hysterectomy end pregnancy permanently?
Yes, a hysterectomy means permanent sterility for a woman. Since the uterus is removed, there is no place for a fetus to develop. Women scheduled for a hysterectomy who want to preserve fertility have a few options:
- Harvest eggs – Eggs can be surgically retrieved and frozen for possible future use.
- Embryo freezing – Create and freeze fertilized embryos using a partner’s sperm or from a sperm donor.
- Surrogacy – Have another woman carry a pregnancy created from the eggs.
However, these options can be expensive and are not successful for all women. Adoption is another possibility for building a family after a hysterectomy.
What are the risks of a hysterectomy?
Hysterectomy is considered major surgery, so there are some risks, including:
- Infection at the incision site.
- Blood clots.
- Damage to nearby organs like the bladder or bowels.
- Excessive bleeding or blood transfusion.
- Breathing or heart problems from anesthesia.
Risks are reduced by choosing an experienced surgeon and following postoperative care instructions closely. Vaginal and laparoscopic hysterectomies involve smaller incisions than abdominal hysterectomies and typically have shorter recovery times and fewer complications.
How is recovery from a hysterectomy?
Recovering from a hysterectomy takes time. Most women need 4-6 weeks to feel back to normal but may have lingering effects for months.
| Recovery Timeline | Experience |
|---|---|
| First 1-2 weeks |
|
| 2 weeks to 2 months |
|
| 2-6 months |
|
Tips for recovering well:
- Get lots of rest.
- Increase activity slowly.
- Avoid lifting over 10 lbs for 6-8 weeks.
- Eat a high fiber diet and stay hydrated to avoid constipation.
- Attend all follow-up appointments.
Call your doctor if you have signs of infection like fever, foul-smelling vaginal discharge, or severe bleeding.
Does a hysterectomy cause weight gain?
It’s a common myth that hysterectomies inherently lead to weight gain. In reality, there are a few factors that influence weight changes after surgery:
- Slower metabolism – Drop in estrogen can lower metabolic rate by up to 7%.
- Inactivity – Limits on exercise during recovery can cause muscle loss.
- Emotional changes – Some women eat more to cope with depression or grief over fertility loss.
- Hormone effects – Progestin therapy may increase appetite or fluid retention.
Many women do gain a few pounds after a hysterectomy. However, weight gain is NOT inevitable. Staying active after you’ve recovered and watching your diet can help maintain a healthy weight.
How does a hysterectomy affect sex drive?
For some women, sex drive and enjoyment of sex improves after a hysterectomy. This can occur if the surgery was done to treat a condition causing pain or heavy periods that interfered with sex.
However, hysterectomies also have potential to worsen sexual function. Possible causes include:
- Reduced estrogen leads to vaginal dryness and discomfort.
- Lower testosterone levels may decrease libido.
- Pain or numbness from nerve damage during surgery.
- Negative emotions about the procedure.
Using vaginal lubricants or estrogen creams can help manage dryness. Testosterone supplementation may improve libido as well. For some women, counseling helps overcome negative feelings interfering with arousal.
Open communication with your partner and giving yourself time to heal are important after a hysterectomy. Many women find their satisfaction with sex improves once they adjust to the changes.
Does a hysterectomy cause depression?
Depression is not directly caused by removing the uterus. However, there are factors related to a hysterectomy that can trigger mood changes for some women:
- Coping with loss of fertility
- Hormone fluctuations
- Fatigue and pain during recovery
- Changes to sex life
- Pre-existing mental health conditions may worsen
Up to 10% of women report increased depression and anxiety after a hysterectomy. Support groups, counseling, and medication can help manage mood disorders. Any new or worsening depression after surgery should be reported to your doctor.
Positive effects of a hysterectomy
While hysterectomies do lead to substantial physical and emotional adjustments, many women report an overall improvement in their well-being. Benefits can include:
- Relief from chronic pelvic pain or excessive bleeding
- No more symptoms from uterine fibroids or endometriosis
- Decreased risk of certain cancers
- Higher satisfaction with sex due to pain reduction
- No more anemia from heavy periods
- Improved bladder function if uterus prolapse repaired
For women with severe uterine conditions, the benefits of a hysterectomy often outweigh the risks. Being well-informed helps women have appropriate expectations about the procedure.
Keeping healthy after a hysterectomy
While a hysterectomy is a major surgery, it does not prevent women from having full and active lives afterwards. Some tips for protecting long-term health include:
- Controlling other risk factors for cancer, heart disease, and osteoporosis.
- Eating a balanced diet high in calcium and vitamin D.
- Doing regular exercise tailored to your fitness level.
- Seeing your doctor for recommended health screenings.
- Taking hormone therapy as advised to prevent bone loss.
- Seeing a gynecologist annually for a well-woman exam.
Prioritizing self-care helps manage any emotional and physical side effects. Support from loved ones facilitates healing. While challenging at first, most women feel positive about their choice to have a hysterectomy in the long run.
Conclusion
A hysterectomy is a major surgery that impacts multiple aspects of a woman’s health. The most significant changes are to the hormone system, fertility, menstrual cycle, and sexual function. While substantial, these changes are manageable for most women. Taking time to recover and working closely with your medical team can help smooth the transition. There are also many benefits that come for women who undergo a hysterectomy to resolve underlying gynecological disorders. While it takes time to adjust to a new normal, a hysterectomy does not prevent living a full and rewarding life.