If you are a woman approaching the age of menopause, you may or may not know the exact definition and reasons for a hysterectomy. To explain, a hysterectomy is a surgical removal of the entire womb or uterus, which will induce something called “surgical menopause”. Many times in addition to the uterus one or both of the ovaries are also removed during the same operative procedure. There are many reasons why this is necessary, although it will vary for each woman’s circumstances. Hopefully your doctor will explain the reasons to you in detail, as this is an important consideration.
For a woman in whom the ovaries are left intact, although they no longer have monthly periods, will not experience menopausal symptoms or the effects of hormonal deprivation. In other words as long as the ovaries continue to function normally, or until natural menopause begins, she will not necessarily experience the effects of a typical menopause. However in a large percentage of women the ovaries will become dysfunctional after several years following the surgery. Most doctors agree that it is better to preserve the function of the ovaries as long as possible, however, as the alternative can be rather severe.
In cases where both of the ovaries are removed the source of estrogen and testosterone is lost. This sudden drop in hormone levels is severe, and causes great physical and mental distress in many women. This is quite different from natural circumstances, when menopause decline in estrogen levels may be more gradual. Of course this “normal’ path of menopause can still be a life-changing experience, but is much preferred in that it takes several years for these hormones to dissipate in production naturally.
A women’s health study published 1983 in the Journal of the American Medical Association (JAMA) revealed a significantly higher death rate among women between the ages of 40-50 who had had a hysterectomy and who did not have any estrogen replacement, as compared to those who were given estrogen treatments. For those women who only had their uterus removed, the rate was 3 times higher. For those who also had both ovaries removed as well, the rate was nearly 8 times higher! This is incredibly strong evidence towards HRT treatment in women that have a hysterectomy.
Luckily, most of the routinely prescribed programs of HRT are at least somewhat effective in preventing the long-term side effects of hormone deficiency and maintaining quality of life. Although in most cases HRT is effective, there are still a small percentage of women that don’t respond to this treatment as expected. The reasons for this are not clear, but each persons body and chemistry are unique, and it is thought that genetics play some role in this response as well.