Hysterectomy and How it's Linked to Menopausal Weight Gain

There are a few types of hysterectomies that a woman can have, and they're all done for different reasons. A hysterectomy happens when the uterus is surgically removed, but in some cases, fallopian tubes, ovaries, and the top part of the vagina are also surgically removed (usually in cases of cancer). Half of the women who have a hysterectomy performed also have their ovaries removed - this is to reduce the risk of ovarian cancer.

Reasons for removing a uterus can include:

  • Endometriosis
  • Adenomyosis
  • Cancer
  • Uterine prolapse
  • Fibroids

The removal of the ovaries is called an oophorectomy, and it triggers menopause.A hysterectomy without the removal of ovaries will NOT trigger menopause, but it might give you some hot flashes and other menopausal symptoms for some time following the surgery.

This is due to a disturbance in the blood flow to the ovaries caused by the removal of the uterus - as everything heals, the blood flow to the ovaries will return, and any menopause symptoms you may have will subside. Women who have undergone a hysterectomy have a higher chance of early-onset menopause.

How does hysterectomy (oophorectomy) trigger menopause?

The onset of menopause happens rather slowly (even though way too quickly for a lot of women!). The changes come in waves, and it takes a period of 12 months to confirm that indeed, menopause is upon us.

When you have a bilateral oophorectomy, both of your ovaries get removed and your estrogen production is stopped in its tracks. This can be a rather jarring experience, and the symptoms of menopause you experience right after surgery are often exaggerated, severe, and quite unpleasant. After all, it's like cruising at normal speed and suddenly hitting a brick wall, instead of a slow and measured stop.

Bilateral oophorectomy is sometimes called "surgical menopause". The symptoms associated with it are:

  • Premature menopause
  • Severe hot flashes
  • Severe night sweats
  • Menopausal weight gain

A study of women who have undergone early menopause suggests that they have much lower chances of developing certain cancers, including breast cancer. While the long-term consequences of a hysterectomy and oophorectomy are beneficial, the immediate and short-term symptoms can be uncomfortable and even harmful - women who have had a hysterectomy are more likely to get depressed because of their symptoms, are more likely to experience menopausal weight gain, and bone density loss.

Why do we gain weight during menopause?

Menopause causes weight gain for several reasons. They are age-related, lifestyle-related, and hormone-related.

First of all, the fat tends to concentrate around your belly, rather than in your arms, thighs, or behind. Why is that? No one really knows for sure - but if it makes you feel better, it's true for men as well. After a certain age, the tummy loves to put on that flub no matter your sex.

Many women who go through menopause are busy, stressed, and unable to concentrate on a healthy diet and regular exercise. Lifestyle is to blame - too often, menopausal women are pulled in a hundred directions, juggling demanding careers, grown-up kids (who have grown-up sized problems they need help with), aging parents who also need help and caring, pets, spouses, community involvement...

It seems that when menopause hits, we happen to be the most responsible adult in the room, but this leaves us very little time for mental recovery and self-care. Both this and the associated stress can affect our weight. Going through the stress and sudden changes in hormone production can affect weight gain post-hysterectomy quite a bit.

Hysterectomy, menopausal weight gain, and mental health

A hysterectomy that includes oophorectomy is associated with depression and anxiety. In fact, the studied mental health consequences of a hysterectomy and oophorectomy are greater than any weight gain. Weight gain around menopause has been long associated with lifestyle changes, rather than physical changes caused by the hormone shift.

In fact, the only thing about the weight that menopause changes directly is the location of the accumulated fat - it all starts to shift towards the middle.

What really affects your weight are the things associated with menopause - less movement, fewer calories burned, poor sleep, stress, feeling too tired to exercise. Once you get this ball rolling, it's hard to stop.

It takes about 8 weeks to recover from a hysterectomy if you had open surgery. This is quite a lot of time to be gentle with yourself. After the surgery, women are advised to rest a lot and refrain from strenuous physical activity and heavy lifting.

This is the period of time when women gain the most weight, and when their mental state declines as a result of post-surgery stress and recovery. It's important to follow post-op recommendations, but it's also important to monitor your mood and be aware of any changes. If you think you might be getting depression, talk to a therapist. This is a good time to put a lot of love and effort into your healing process. Following a hysterectomy procedure, a lot of women can feel a sense of loss, or that they're not quite "themselves". This is normal, and talking to other women who have had hysterectomies is often very helpful when it comes to powerful emotional support.

Picture of a woman

Physical activity

It takes up to 8 weeks to fully recover after hysterectomy surgery. If you can, discuss a laparoscopic procedure with your doctor, because it's less invasive and the recovery time is much shorter: as short as 4 weeks for some women.

After you are cleared for physical activity by your doctor, you should get to work. Weight gain after a hysterectomy is often associated with inactivity, stress, anxiety, and poor sleep. It's time to focus on physical activity as a remedy to all of these weight gain causes.

Take it slow - you will be more tired and exhaust more quickly. In the beginning, you should try walking, working up to more strenuous cardio. Upon your discharge, a lot of hospitals will recommend that you start walking after your procedure through the recovery period. This will help with blood flow and healing. 

You should consult your health provider about the types of exercises you should be doing right after you get discharged. Some women get a personal trainer who is highly specialized in hysterectomy exercises that will not only aid your body in full recovery but help you gain strength and tone.

As your wounds heal, you will switch from recovery exercises to more strenuous exercises to boost your metabolism. Because of the invasiveness of this procedure, we recommend you follow all recommendations from your health provider or physical therapy specialist when it comes to post-recovery weight loss and continuing with your weight goals with the right type of diet and exercise.

Mindfulness practice

Mindfulness is a wonderful tool that lets you "get out of your head" and rise above the stress in your life. If you had a hysterectomy procedure, you could probably use a hand with rising above your stress, anxiety, and worry.

Post-hysterectomy weight gain starts mostly in your head and during your recovery period. If your mind is in the right place and your mental health is taken care of, those extra pounds won't ambush you. This is especially true for women who have a potential stress eating problem - weight loss is sabotaged by stress and feeling down because that often leads to a certain level of dopamine-releasing snacks.

Mindfulness practice helps you focus on what you're doing at the moment and it may be especially helpful to those women who can't exercise yet - but are used to burning their calories by exercising or dealing with stress by exercising. Here is a great beginner's guide to simple mindfulness you can start on today.

Diet, vitamins, and menopause supplements

Diet and healthy nutrition are very important after a hysterectomy. Eating right will help you keep the pounds off after your surgery and will help you lessen the risk of other postmenopausal conditions like osteoporosis.

After your hysterectomy, it's important to eat a diet that includes vegetables, protein and whole grains, and lots of fiber. This will help with conditions like constipation right after your procedure, but also ward off weight gain caused by sugar and processed grains. If you can, stay away from alcohol as well. It will slow down your recovery.

Healthy supplements and vitamins also play an important role in patients recovering from a hysterectomy. Your body can use some probiotics and prebiotics for better digestion and a lot of women find that extra fiber has a positive effect on their digestion. If you have problems with constipation, these can help to prevent any unpleasant problems after your procedure.

Final words

A hysterectomy is a deeply personal and often life-changing experience. There are a lot of factors that can influence our weight gain at this time. Our temporary loss of mobility can be a starting point for some extra pounds being accumulated here and there, but with the support network of your partners, doctors, and physical therapy you should be able to get back into the swing of things fairly quickly. 

When it comes to post-hysterectomy weight gain, it’s all mind over matter. Even if you have a full oophorectomy and the sudden drop in estrogen starts playing tricks on your body, weight gain is mostly attributed to related factors like stress, anxiety and depression. While your doctor will most likely work out a proper hormone therapy with you, you should work on creating some anxiety and stress reducing habits, and talk to a therapist in order to put your mind at ease.