Hysterectomy and Menopause

Hysterectomy, which is the removal of the uterus, is the second most common surgery among women in the United States. In fact, with 600,000 performed every year, it is only by cesarean section deliveries. The uterus, or womb, is the organ in the lower abdomen where a baby develops when a woman is pregnant, and it is the uterus that is removed during a hysterectomy. The ovaries, which produce eggs and female hormones like estrogen, may also be removed. This combination is called a hysterectomy and oophorectomy. A doctor decides that a hysterectomy should be performed for a number of reasons. In only ten percent of cases, the procedure is done to treat cancer of the reproductive organs. The remaining 90 percent of hysterectomies are performed for noncancerous conditions. Among them is endometriosis, where uterine tissue grows outside of the uterus, often leading to chronic pain. A woman who has had a uterine prolapse, wherein her uterus has slipped into the vagina, may also require a hysterectomy. Women who have fibroids, which are noncancerous tumors on the womb, often need hysterectomies as well, because the condition may cause severe pain or bleeding. In fact, fibroids are the leading cause of hysterectomy in the United States. But whatever the reason for a hysterectomy, the removal of the uterus itself will NOT trigger the start of menopause. This is confusing for many patients because menopause is technically defined as the cessation of the menstrual cycle for twelve consecutive months. Yet women who undergo hysterectomies will stop menstruating immediately after the procedure. However, menopause actually occurs when the body�s ovaries begin to produce less and less of the female hormones estrogen and progesterone. This natural reduction in hormones is the reason for many of the symptoms of menopause, such as hot flashes, insomnia, and vaginal dryness. Because women who have hysterectomies alone still have their ovaries, they will not undergo menopause until their hormone production slows naturally as they age. Having a hysterectomy may actually speed this process by two or three years, but does not trigger an immediate onset of menopause. Researchers theorize that this may be due to a reduction in blood supply to the ovaries, which in turn diminishes their ability to make estrogen and maintain a normal reproductive cycle. It�s important to understand that women who have had an oophorectomy are in a different situation. When the ovaries are removed along with the uterus, hormone production will stop and menopause will begin immediately after the surgery. If your doctor decides that you are a good candidate for a hysterectomy, or a hysterectomy and oophorectomy, make sure you discuss the procedure�s short and long-term effects on your body.