Related Topics: Hysterectomy, Menopause

Twice The Risk of Earlier Menopause With Hysterectomy In Younger Women

This was first commented on by Dr John Lee at one of his seminars in London many years ago, but how could it affect you?

AnnA Rushton

Hysterectomy is a common treatment for many conditions, including fibroids and excessive bleeding but younger women need to be made aware that this is a potential risk of the surgery that can have long-term health consequences.

Many obstetricians and gynaecologists have long linked the two events, as even the most careful hysterectomy can leave a woman with non-functioning ovaries within a few years, if they are left at all.

What’s the evidence?

A study by Duke University researchers in the USA was the largest analysis to track over time the actual hormonal impact of woman who had hysterectomies and compare them to women who had not.

The study involved nearly 900 women ages 30 to 47 at two hospitals and was followed up with blood tests and questionnaires for five years.   Half the women (the control group) had no surgery, while the remainder women underwent hysterectomies that spared at least one ovary.

Preserving the ovaries while removing the uterus is a strategy designed to allow a woman’s hormone production to continue, which has health benefits, but doctors have long known that early menopause ­– either from surgery or from other factors that halt egg production — can increase a woman’s risk of osteoporosis, heart disease, and other ailments.

However, despite preserving the ovaries, the Duke team found that 14.8 percent of women in the study who had hysterectomies experienced menopause over the course of the study, compared to 8 percent of women who had no surgery.

The risk for early menopause was highest among women who had one ovary removed along with their uterus, but it remained elevated even when both ovaries stayed in place. The Duke team’s analysis estimated that menopause occurred approximately two years earlier in the women who underwent hysterectomy.

Although it is not known exactly what triggers the ovaries of some women to shut down after a hysterectomy there are several theories. Women often mistakenly believe if they have one ovary remaining that it will continue to function long-term, but this is not often the case.

One theory as to why they stop functioning is that surgery disrupts the blood flow to the ovaries. This means that the surgery leads to early ovarian failure. Another theory is that it’s not the surgery, but the underlying condition preceding the surgery that causes it.

Regardless of the cause, this finding provides women and their doctors with concrete information about a potential risk for future health problems.

Patricia G. Moorman, PhD, MSPH, lead author of the study, commented that “This could potentially change practice because women who are considering hysterectomy for fibroids or other problems may want to explore other treatment options for their condition if they know they may go through menopause earlier.”

Helpful information:

One of the options that doctors might like to look at more closely is the relationship between oestrogen and fibroids and the increased risk of osteoporosis.

These conditions are linked to high oestrogen levels and low progesterone levels, oestrogen dominance, and can often be helped by supplementing with bio-identical natural progesterone.

This is something Dr John Lee, the pioneer of bioidentical progesterone cream usage,  spoke about to his fellow doctors whenever he could, but it still seems to be falling on deaf ears.

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New comments are now closed on this article
Comments 10
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AnnA Rushton | 6:32 pm, March 5th, 2016

Tracy a combination such as 20-1 is recommended after a hysterectomy to replace both lost hormones – see this article for more information:

tracy Craven | 5:34 pm, March 3rd, 2016

hi i had a complete hysterectomy at 34 removal of my ovaries to i have the cream 20-1 will this cream be ok for me to use i suffer with hot flushes and night sweats and i have weight gain also very low libido will the ream help me thanks

AnnA Rushton | 8:17 pm, February 26th, 2016

Phyllis it is the oestrogen in HRT which means you are unable to have it, but bioidentical progesterone can certainly help and is safe for the heart. You will find this article helpful:

phyllis richardson | 7:12 am, February 26th, 2016

I had a necessary hysterectomy aged 37. I have had hot flushes since then, I am now 80.I could not have HRT because of thrombosis and DVT and am not on any form of medication. It has been and still is a nightmare. I am at my wits end to find something to combat this.

AnnA Rushton | 7:34 pm, August 26th, 2015

You need to replace both hormones Angela so a combination cream such as 20-1 will help as this article by Dr Jeffrey Dach explains.

angela moodley | 4:21 pm, August 26th, 2015

Hi I had a hysterectomy plus bilateral salpingo oopherectomy I’m 48 in menopause now but not taking any meds,have terrible hot flushes plus weight gain after surgery an doing the ryt things but to no avail.some help on this pls | 4:42 am, June 8th, 2013

Hello, just wanted to say, I loved this post. It was helpful. Keep on posting!

wellsprings | 10:40 am, March 7th, 2012

Sue – we always recommend coming off HRT slowly as suddenly stopping can bring on severe menopausal symptoms.

This article by Dr Tony Coope explains why this is so here:

sue | 2:10 am, March 7th, 2012

Hello, I have been on Premurim for some years now, I had a hysterectomy that also the ovaries were removed, I’m almost 50 now, so can I come of the hormone tablets slowly so I take no tablets at all safely?


Joan Tunis | 10:00 pm, November 28th, 2011

Spot on with this write-up, I truly suppose this web site needs rather more consideration. I?ll probably be once more to learn far more, thanks for that info.

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