Understanding the Link Between Hysterectomy and Menopause

BY CAROL WHITELY

Has your doctor suggested a hysterectomy for treatment of a debilitating illness or condition? In the absence of cancerous or another life-threatening situation, hysterectomies are elective surgical procedures. Besides the risks of undergoing surgery, the biggest question many women have involves the link between having a hysterectomy and the subsequent onset of menopause. All hysterectomies involve the removal of the uterus. In addition, other reproductive organs may also be removed. There are three types of hysterectomy, and menopause relates differently to each of them:

1. Subtotal Hysterectomy: This involves the surgical removal of only the upper portion of the uterus. The cervix is not removed, and the fallopian tubes and ovaries may or may not be left in tact. 2. Total Hysterectomy: Both the uterus and the cervix are removed. The fallopian tubes and ovaries may or may not be removed. 3. Radical Hysterectomy: Usually performed only in the case of cancer, this surgery involves removal of the entire uterus. The fallopian tubes and ovaries are generally removed as well. Depending on the situation, other organs may also be removed to prevent the spread of cancer.

Following any hysterectomy, menstruation ceases and a woman is unable to have children. If a woman has not already passed through menopause, symptoms will likely set in. The degree of physical and mental effects of surgically induced menopause vary considerably as they do among women experiencing natural menopause. These symptoms are also influenced by the type of hysterectomy performed.

The ovaries are responsible for the production of ova (eggs), but they also produce important reproductive hormones. These hormones are responsible for much more than the regulation of a woman’s monthly menstrual cycle and pregnancy. They regulate secondary sexual characteristics, promote a healthy sex drive, and help protect against heart disease and osteoporosis.

If the option is available, many women elect to leave their ovaries intact during a hysterectomy. Although there is the risk of a woman developing ovarian cancer if they are not removed, the risk is slight under most circumstances. Many doctors and patients believe the potential benefits of leaving the ovaries in tact far out ways potential risks.

Although the stresses of having a hysterectomy and menopause following shortly thereafter can be taxing, many women experience a marked sense of relief, as well. This results from the absence of further discomfort due to the condition that initiated the hysterectomy, and menopause symptom alleviation through HRT. For many women, Hormone Replacement Therapy reduces or eliminates the most stressful and uncomfortable side effects characteristic of decreased hormone production.

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