Hormones After Hysterectomy. What Happens If Your Ovaries Stay?

In Part 1 of our menopause series, we talked about how hormone changes affect much more than hot flashes. One question deserves a closer look: If you have a hysterectomy but keep your ovaries, will your hormones stay the same?

The answer is: your ovaries usually continue making hormones, but their function can change after surgery.

First, a point of terminology. A partial hysterectomy removes the uterus but leaves the cervix. It does not tell us whether the ovaries were kept. If both ovaries are removed before menopause, estrogen levels fall abruptly. If the ovaries remain, there is usually no immediate surgical menopause.

Even when the ovaries stay, some people experience changes in ovarian function sooner than expected. A change in blood flow to the ovaries is one possible explanation, although research has not established that this happens to everyone or that it is the only cause. In one prospective study, ovarian failure occurred within four years in 14.8% of women who had a hysterectomy with ovarian preservation, compared with 8.0% of women who had not had surgery. 

Experiences vary from person to person. 

Some notice little change. Others develop symptoms months or years later. Without menstrual periods, it can also be harder to recognize the transition into perimenopause or menopause.

Changes in estrogen and progesterone may show up as hot flashes, disrupted sleep, mood changes, vaginal dryness, or a shift in energy. Estrogen also plays a role in bone health. Those symptoms deserve attention, but they don't automatically mean hormones are causing them. 

If you have had a hysterectomy and something feels different, tell your clinician whether one or both ovaries were removed, when your symptoms began, and how they affect your daily life. A review of your symptoms and health history can guide whether hormone testing or another evaluation would be useful. A single hormone level does not always explain symptoms, particularly while hormone levels fluctuate during perimenopause.

You do not have to dismiss years of poor sleep, low energy, or feeling unlike yourself simply because you were told your ovaries were left in place. At Sunny Health DPC, we take time to look at the whole picture and make an individualized plan.

Sunny Health DPC | Family Medicine & Hormone Care