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Make no mistake: Getting a hysterectomy is an intimidating prospect, especially if you think it might kick you into early menopause.
A hysterectomy, which about 600,000 people assigned female at birth receive each year in the United States, is a surgical procedure that removes the uterus. Although hysterectomies aren’t usually the first suggested treatment, the procedure may ultimately be recommended for:
- Cancer prevention
- Abnormal or heavy vaginal bleeding
- Severe pelvic pain
- Uterine fibroids and other noncancerous tumors
- Severe endometriosis
- Cervical, ovarian, or uterine cancer
- Uterine prolapse that can lead to urinary or fecal incontinence
- Conditions affecting the lining of the uterus, such as hyperplasia or adenomyosis.
- Serious childbirth complications like uterine rupture.
While you won’t be able to get pregnant or have a menstrual period after a (total) hysterectomy, that doesn’t necessarily mean you will be in menopause, or that you’ll even experience any symptoms of menopause until you reach a certain age. The average age when people reach menopause in the United States is 51.
If you’ve had a hysterectomy, but not an oophorectomy — which is the removal of one or both ovaries — then you probably won’t experience menopause symptoms earlier than expected.
If you’ve had both a hysterectomy and an oophorectomy, however, then you can expect to enter surgical menopause almost immediately, regardless of your age.
But just because your ovaries are still intact, that doesn’t mean everything is going to feel the same post-hysterectomy. Or that you’ll even be able to tell when you’re in menopause! That’s why it’s so important to understand the differences in your reproductive organs, and how their removal (or non-removal) can affect your health.
Hysterectomy-only: menopause will still depend on your age
What’s tricky about determining menopause after a hysterectomy — even if you still have your ovaries — is that you won’t have a menstrual cycle. “Menopause, by definition, is having a year without a period,” says Jessica Ryniec, M.D., reproductive endocrinologist and infertility specialist at CCRM Fertility in Boston. “Having a hysterectomy takes away the withdrawal bleed as a marker for menopause.”
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Although you’ll no longer have a period to help you gauge when you’ve entered menopause, “the hormonal symptoms can and likely will still be present,” says Dr. Ryniec.
Unfortunately, she continues, “there is no blood test that can define when you have reached menopause post-hysterectomy, because hormone levels can fluctuate widely even through the perimenopausal stage.”
Even without a uterus — but with your ovaries — you can still expect the usual menopause symptoms once you reach a typical menopausal age:
- Hot flashes
- Night sweats
- Sleep disturbances
- Cognitive changes like difficulty concentrating/remembering
- Mood swings, including irritability, anxiety, and depression
Remember, having a hysterectomy without an oophrectomy doesn’t kick your body into early menopause (like it does if you’ve also had an oophrectomy), but it can cause you to hit menopause a little earlier than average.
To be clear, you may still experience monthly bleeding if you’ve had a supracervical (partial) hysterectomy (to treat conditions like fibroids or prolapse). But you won’t get your period anymore if you’ve had a total hysterectomy.
Since you have your ovaries, however, “you still have a cyclical follicular and luteal phase, as long as you are still ovulating until you go through menopause,” says Dr. Ryniec.
Translation: You won’t get your period anymore, but your ovaries will continue to release eggs and make hormones regularly. So you may still experience premenstrual syndrome (PMS) symptoms like cramps and bloating.
Oophrectomy + hysterectomy = surgical menopause
“If you also had an oophorectomy at the time of hysterectomy, you would be in surgical menopause from the time the ovaries were removed, no matter your age,” explains Dr. Ryniec. “The symptoms will still be present and often can be more extreme since there is such an abrupt change in your hormones.”
Surgical menopause simply means that your body goes into menopause due to surgery (e.g. the removal of ovaries) as opposed to your age.
When that happens, you can expect to experience typical symptoms, even if you’re much younger than the average age for menopausal women: hot flashes, mood swings, night sweats, vaginal dryness, trouble concentrating, infertility, etc.
Post-hysterectomy menopause treatment options
No matter when you experience symptoms of menopause after a hysterectomy, “treatment options for perimenopausal and menopausal symptoms are the same whether you have had your uterus removed or not,” says Dr. Ryniec. The only difference, she points out, is if you’re doing hormone replacement therapy (HRT): “You do not need the progesterone component of hormone replacement therapy since that is typically included to protect the lining of the uterus,” she explains. “Nonhormonal options are the same whether you have had a hysterectomy or not and include things like SSRIs and gabapentin.”
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist dedicated to reporting on women's health, parenting, mental health, TV, and pop culture. Her work has appeared in HuffPost, Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. Subscribe to her Substack, the Critical Communicator, and follow her on Instagram, BlueSky, or Threads.