Last checked September 2026 against 19 sources · Editorial policy
Does a hysterectomy cause menopause?
A hysterectomy can cause menopause straight away, but only if both ovaries are removed. This is called surgical menopause, and symptoms are usually sudden and severe. If you keep one or both ovaries, your periods stop but you're not in menopause, because your ovaries keep making hormones. Menopause may still come earlier: 3.7 years earlier in one study of women who kept their ovaries.
Only if your ovaries are removed: then menopause starts immediately. Keeping your ovaries can still bring menopause a few years earlier. Symptoms and HRT.
Hysterectomy and menopause: expectation vs reality
What people often expect
“Having a hysterectomy means you're in menopause”
What the evidence shows
It depends on your ovaries, not your uterus. Removing the uterus ends periods and the chance of pregnancy, but your hormones come from the ovaries, and if they're kept they keep working. They can wear out sooner, though. In a US study of women aged 30 to 47, 14.8% of those who had a hysterectomy with ovaries kept reached ovarian failure within 4 years, compared with 8.0% of women who hadn't had surgery.
How a hysterectomy affects menopause
Does a hysterectomy cause menopause?
Only if both ovaries are removed. Menopause happens when the ovaries stop making estrogen and progesterone, not when the uterus is removed. After a hysterectomy you'll no longer have periods and can't get pregnant, whatever your age. If both ovaries are removed at the same time, you go through menopause immediately. If one or both are kept, you're not menopausal, but you may reach natural menopause sooner than you would have otherwise.
Surgical menopause: when both ovaries are removed
Removing both ovaries causes surgical menopause right after the operation, regardless of age. Hormone levels drop quickly rather than over years, so symptoms are usually severe: hot flashes, sweating, anxiety, weepiness and a lower sex drive. The ovaries also produce testosterone, which plays a part in sexual desire and pleasure and normally continues for up to 20 years after natural menopause, so removing them lowers testosterone too.
Menopause after a hysterectomy with ovaries kept
Keeping your ovaries avoids surgical menopause, but natural menopause often comes sooner. In a New Zealand study, women with low FSH levels before hysterectomy reached menopause 3.7 years earlier than women who didn't have surgery, and 20.6% reached menopause within 5 years, compared with 7.3%. In a US study, hysterectomy nearly doubled the risk of ovarian failure (hazard ratio 1.92). It isn't clear whether the surgery or the condition that led to it is responsible.
Hysterectomy with one ovary removed
Keeping one ovary is better than none for hormone levels, but it raises the risk of earlier menopause more than keeping both. In the New Zealand study, 35.7% of women who had one ovary removed along with the uterus reached menopause within 5 years, 4.4 years earlier than women who kept both ovaries. In the US study, the risk of ovarian failure was 2.93 times higher than in women who didn't have surgery.
How to tell you're in menopause after a hysterectomy
Without periods, you lose the most obvious sign that menopause is coming. If you're 45 or over, NICE advises that doctors diagnose menopause after a hysterectomy based on the type and pattern of your symptoms, such as hot flashes and night sweats, without blood tests. Between 40 and 45, or under 40, an FSH blood test can help confirm it. Other signs are vaginal dryness, trouble sleeping, mood changes and brain fog.
Learn more →Should the ovaries be removed at hysterectomy?
NICE advises removing healthy ovaries only if there's a significant risk of disease, such as a family history of ovarian or breast cancer. In the Nurses' Health Study of 29,380 women who had a hysterectomy for a benign condition, removing both ovaries cut the risk of breast and ovarian cancer but raised the risk of death from all causes (hazard ratio 1.12) and of heart disease (1.17). Before 50, the extra risk was seen in women who never used estrogen.
HRT after a hysterectomy
If you've had a total hysterectomy, you can take estrogen-only HRT, every day, without a progestogen to protect the uterus. If you've had surgical menopause, you should be offered HRT, and if both ovaries were removed it's important to continue until at least the usual age of menopause, 51. You may need to try different doses before one feels right. HRT isn't recommended after a hormone-dependent breast cancer.
Learn more →Long-term health after surgical menopause
When both ovaries are removed before natural menopause, the early loss of estrogen affects the heart, bones, brain, mood and sexual health, and is linked with earlier death. Women whose ovaries are removed are at higher risk of osteoporosis. Estrogen replacement lessens some of these risks, which is why reviews by Mayo Clinic researchers recommend hormone therapy until the age of expected natural menopause, as for premature ovarian insufficiency.
Learn more →Recovery after hysterectomy and when menopause symptoms start
After surgical menopause, symptoms start straight after the operation and are usually severe. HRT can be given after surgery as an implant, injections or tablets. Recovery from the operation itself takes about 6 to 8 weeks after an abdominal hysterectomy and is often shorter after a vaginal or laparoscopic operation. Some women also feel a sense of loss or sadness afterwards, especially if they hadn't finished having children.
Hysterectomy and menopause by the numbers
From the studies on this page
earlier menopause after hysterectomy with ovaries kept, in a New Zealand study
3.7 years
Bar scaled to a 12-year reference span
the risk of ovarian failure after hysterectomy in a US study of women aged 30 to 47
1.92x
Relative odds vs comparison group (1× = same odds)
of women in the Nurses' Health Study who had a hysterectomy for a benign condition also had both ovaries removed
55.6%
51
Hysterectomy is most common in women aged 40 to 50. How much it brings menopause forward varies, and it's unclear how much is due to the surgery rather than the condition that led to it.
Types of hysterectomy and what each means for menopause
Total hysterectomy, ovaries kept
Good for
The uterus and cervix are removed, but the ovaries keep making estrogen, progesterone and testosterone, so there's no surgical menopause. Periods and pregnancy stop, and you no longer need cervical screening. This is the most common type of hysterectomy.Watch
Natural menopause may come earlier: about 1.92 times the risk of ovarian failure in one study. Without periods, symptoms are how you'll recognize perimenopause and menopause.Subtotal (partial) hysterectomy, ovaries kept
Good for
Only the main body of the uterus is removed and the cervix stays. The ovaries keep working, so a partial hysterectomy doesn't cause menopause.Watch
You still need regular cervical screening. As with any hysterectomy, menopause may come sooner. If you later take HRT, NICE's advice to use estrogen-only HRT applies to total hysterectomy, so ask whether you need a progestogen as well.Hysterectomy with one ovary removed
Good for
The remaining ovary keeps making hormones, so there's no immediate menopause.Watch
The risk of earlier menopause is higher than with both ovaries kept: menopause came 4.4 years earlier in one study, and the risk of ovarian failure was 2.93 times higher in another.Hysterectomy with both ovaries removed
Good for
Called total hysterectomy with bilateral salpingo-oophorectomy. It removes the risk of ovarian cancer and lowers breast cancer risk, and may be recommended if you have a strong family history of ovarian or breast cancer, or are already near menopause.Watch
Causes immediate surgical menopause at any age, usually with severe symptoms. Without estrogen, removal before 50 was linked with higher death rates, so HRT until at least 51 is advised unless you can't take it.Radical hysterectomy
Good for
Used for cancer. The uterus and surrounding tissues are removed, including the fallopian tubes, part of the vagina, the ovaries, lymph glands and fatty tissue.Watch
Because the ovaries are removed, it causes surgical menopause. Whether you can take HRT depends on the type of cancer: it isn't recommended after a hormone-dependent breast cancer, for example.
When to see a doctor after a hysterectomy
Urgent: Heavy bleeding, clots or strong-smelling discharge after surgery
Contact your doctor promptly. Some bleeding and discharge is normal for up to 6 weeks, but these signs aren't.
Severe menopause symptoms after ovary removal
Ask about HRT. After surgical menopause you should be offered it, and the dose can be adjusted.
More →Menopause symptoms before 45 after a hysterectomy with ovaries kept
See a doctor. It may be early menopause, which needs hormone treatment to protect your bones and heart.
More →Low mood or sadness that doesn't lift
Talk to your doctor. If you have thoughts of self-harm, call or text 988, or call 911 in an emergency.
Menopause after a hysterectomy: questions women ask
Does a hysterectomy cause menopause?
Only if both ovaries are removed. That causes surgical menopause immediately, at any age. If you keep one or both ovaries, you won't have periods or be able to get pregnant, but you're not in menopause, because your ovaries still make hormones. Natural menopause may come a year or two earlier.
Will a partial hysterectomy cause menopause?
No. A partial or subtotal hysterectomy removes the main body of the uterus and leaves the cervix and ovaries. Your ovaries keep working, so you won't go into menopause from the operation, although natural menopause may come sooner than it would have. You'll still need cervical screening.
What are the signs of menopause after a hysterectomy?
The same as for any menopause, minus the period changes: hot flashes, night sweats, vaginal dryness, trouble sleeping, mood changes, brain fog and a lower sex drive. If you're 45 or over, a doctor can diagnose menopause from these symptoms. Our 2-minute check shows which stage your symptoms fit.
Related →How soon after a hysterectomy does menopause start?
If both ovaries were removed, straight after the operation, usually with severe symptoms. If you kept your ovaries, there's no immediate menopause, but it may come earlier than it would have. In one study, 20.6% of women reached menopause within 5 years of hysterectomy, compared with 7.3% without surgery.
How long does menopause last after a hysterectomy?
If your ovaries were kept, menopause follows its natural course, with symptoms usually lasting 7 to 9 years. After surgical menopause, symptoms are often more intense, and HRT is advised until at least the usual age of menopause, 51, after which you and your doctor review whether to continue.
Related →Can you go through perimenopause after a hysterectomy?
Yes, if you kept your ovaries. They go through the same hormonal changes as they would otherwise, so you can get hot flashes, sleep problems and mood changes. You just won't see the change in periods that usually signals perimenopause, so symptoms are the main clue.
Related →What is the average age of menopause after a hysterectomy?
If both ovaries are removed, menopause happens at the age of the operation. If they're kept, there's no single figure, but menopause tends to come earlier: a year or two earlier according to the US Office on Women's Health, and 3.7 years earlier in a New Zealand study of women with low FSH before surgery.
Do you need HRT after a hysterectomy?
If both ovaries were removed before natural menopause, HRT is strongly advised until at least 51 unless you can't take it, because it protects your bones and heart. After a total hysterectomy, estrogen-only HRT is used. If you kept your ovaries, you only need HRT if menopause symptoms bother you.
Related →Can you still get hot flashes after a hysterectomy?
Yes. After surgical menopause, hot flashes and sweating are common and often severe. If you kept your ovaries, you can get hot flashes when you reach natural menopause, which may be earlier than it would have been. HRT is the most effective treatment, cutting hot flashes by about 75%.
Related →Is menopause worse after a hysterectomy?
After surgical menopause, it often is: hormone levels drop quickly instead of gradually, so symptoms tend to be sudden and severe. If your ovaries were kept, menopause itself is no different, although it may arrive earlier. HRT helps with both.
Sources
- NHS. Hysterectomy.
- NHS. Hysterectomy: recovery.
- Office on Women's Health, US Department of Health and Human Services. Early or premature menopause.
- Farquhar CM, Sadler L, Harvey SA, et al. The association of hysterectomy and menopause: a prospective cohort study. BJOG. 2005;112(7):956-62.
- Moorman PG, Myers ER, Schildkraut JM, et al. Effect of hysterectomy with ovarian preservation on ovarian function. Obstet Gynecol. 2011;118(6):1271-1279.
- NHS. Hysterectomy: considerations.
- NICE. Menopause: identification and management (NG23). Updated 2024.
- NHS. Symptoms of menopause and perimenopause.
- Parker WH, Broder MS, Chang E, et al. Ovarian conservation at the time of hysterectomy and long-term health outcomes in the nurses' health study. Obstet Gynecol. 2009;113(5):1027-1037.
- Parker WH, Feskanich D, Broder MS, et al. Long-term mortality associated with oophorectomy compared with ovarian conservation in the nurses' health study. Obstet Gynecol. 2013;121(4):709-716.
- NHS. Types of hormone replacement therapy (HRT).
- Faubion SS, Kuhle CL, Shuster LT, et al. Long-term health consequences of premature or early menopause and considerations for management. Climacteric. 2015;18(4):483-91.
- Rocca WA, Mielke MM, Gazzuola Rocca L, et al. Premature or early bilateral oophorectomy: a 2021 update. Climacteric. 2021;24(5):466-473.
- NHS. Osteoporosis.
- NHS. Early or premature menopause.
- Federal Communications Commission. 988 Suicide & Crisis Lifeline.
- National 911 Program. 911.gov.
- Crandall CJ, Mehta JM, Manson JE. Management of Menopausal Symptoms: A Review. JAMA. 2023;329(5):405-420.
- MedlinePlus, US National Library of Medicine. Menopause.
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