A partial hysterectomy is a surgery that removes the uterus but leaves the cervix and ovaries intact. It is usually done to treat conditions like fibroids, endometriosis, or abnormal bleeding. When possible, the ovaries are typically left in place to avoid the side effects of a full hysterectomy, such as early menopause and hormone imbalance. However, many individuals undergoing a partial hysterectomy are not warned that it can still lower the age of menopause even when the ovaries are preserved.
This fact first entered the discourse in 2011, when a study showed that women undergoing ovary-sparing hysterectomy had a roughly two-fold increased risk of ovarian insufficiency (1). Since that time, further research has confirmed these findings. According to a 2021 systematic review, partial hysterectomy with ovary preservation is associated with earlier menopause and premature ovarian insufficiency (2).
The exact mechanism behind this is not clear, but some possible explanations are:
- Removing the uterus may affect the blood supply or nerve connections to the ovaries, causing them to age faster.
- The uterus may have a role in regulating the hormonal feedback loop between the brain and the ovaries.
- The underlying condition that lead to hysterectomy may be independently associated with earlier menopause
Undergoing early menopause can have a monumental impact on one's health and quality of life. One study showed that hysterectomy increased the risk of osteoporosis regardless of ovary preservation, and the risk was the highest in the youngest patients (3). Hysterectomy with or without oopherectomy (ovary removal) has been associated with worse hot flashes, night sweats, vaginal dryness, and even depression compared to those without hysterectomy (3,4,5).
So, what can you do if you are considering a partial hysterectomy or have already had one? Here are some tips:
- Monitor your menstrual cycle and any changes in your body or mood. Keep a journal or use an app to track your symptoms and patterns.
- Consider hormone therapy or other treatments to manage your menopause symptoms and prevent health problems like osteoporosis.
- Adopt a healthy lifestyle that includes a balanced diet, regular exercise, stress management, and good sleep habits. If you smoke or drink heavily, seek support to help you quit.
Lastly, don't allow your healthcare providers to dismiss your concerns if you believe that you are entering early menopause after hysterectomy with ovary preservation. Many do not realize that this association exists. You can show them this article if you'd like, with citations below. You deserve access to treatment for your symptoms if you are experiencing hot flashes, night sweats, genital irritation, depression, or other symptoms related to menopausal transition. We are here to help you through this phase of life.
Ready to feel like your best self again?
Sources:
Moorman, P. G., Myers, E. R., Schildkraut, J. M., Iversen, E. S., Wang, F., & Warren, N. (2011). Effect of Hysterectomy With Ovarian Preservation on Ovarian Function. Obstetrics & Gynecology, 118(6), 1271–1279
Madueke-Laveaux, O. S., Elsharoud, A., & Al-Hendy, A. (2021). What We Know about the Long-Term Risks of Hysterectomy for Benign Indication—A Systematic Review. Journal of Clinical Medicine, 10(22), 5335
Choi, H. G., Jung, Y. J., & Lee, S. W. (2019). Increased risk of osteoporosis with hysterectomy: A longitudinal follow-up study using a national sample cohort. American Journal of Obstetrics & Gynecology, 220(6), 573.e1-573.e13
Wilson, L. F., Pandeya, N., Byles, J., & Mishra, G. D. (2016). Hot flushes and night sweats symptom profiles over a 17-year period in mid-aged women: The role of hysterectomy with ovarian conservation. Maturitas, 91, 1-7.
Farquhar, C. M., Sadler, L., & Stewart, A. W. (2008). A prospective study of outcomes five years after hysterectomy in premenopausal women. Australian and New Zealand Journal of Obstetrics and Gynaecology, 48(5), 510-516
Commentaires