Generally, you are considered post-menopausal after you have stopped menstruating at least one year. Menopause usually begins for women between 45 and 50 years old. 

Menopause symptoms include:
  • Hot flashes/flushes
  • Night sweats
  • Sleep disturbances

These common menopause symptoms are caused by an estrogen decrease. Women have three estrogen compounds: estrone (E1), estradiol (E2) and estriol (E3). Hormone replacement therapy is typically recommended for postmenopausal women and those who have had hysterectomies.

Estrogen Replacement Therapy/Hormone Replacement Therapy
Doctors can administer hormone replacement therapy to address your symptoms. Estrogen can be taken alone or combined with another hormone known as progesterone (progestin). These hormones treat menopause symptoms. Multiple dosing regimens are used. 

Hormone therapy also comes in various forms — pills, skin patches, gels, intrauterine devices (IUD) or vaginal rings. You can pick a treatment to meet your needs. 

Although menopause is natural, it may occur early because of medical reasons. Removal of the ovaries to treat ovarian cancer stops E2 production. A hysterectomy also will cause menopause. Removal of the ovaries can lead to decreased sex drive. Your doctor may recommend estrogen hormone replacement therapy. 

A hysterectomy is a surgical procedure to remove your uterus, or womb. The fallopian tubes (the tubes that connect the ovaries to the uterus) and ovaries also may be removed during hysterectomy, depending on the reason for the surgery. 

Alternative names for hysterectomies include:
  • Vaginal hysterectomy
  • Abdominal hysterectomy
  • Supracervical hysterectomy
  • Radical hysterectomy
  • Removal of the uterus
  • Laparoscopic hysterectomy
  • Laparoscopically assisted vaginal hysterectomy (LAVH)
  • Total laparoscopic hysterectomy (TLH)
  • Laparoscopic supracervical hysterectomy
  • Robotically assisted hysterectomy

Reasons for Hysterectomies
There are many reasons for a hysterectomy. The procedure may be recommended if you have:
  •  Uterine Cancer (most often endometrial cancer)
  •  Cancer of the cervix or a precancerous condition called cervical dysplasia
  • Long-term (chronic) pelvic pain 
  • Severe endometriosis 
  • Uterine prolapse (the uterus is slipping into the vagina)
  • Noncancerous tumors in the uterus such as uterine fibroids

Types of Hysterectomy
Medical conditions requiring a hysterectomy often dictate how much tissue will be removed.
  • Supracervical hysterectomy - the upper part of the uterus is removed. The cervix remains.
  • Total hysterectomy - the uterus and cervix are removed.
  • Radical hysterectomy - the uterus, upper part of the vagina and tissue on both sides of the cervix are removed. This is most often done if you have cancer.

A hysterectomy may be performed through a surgical incision in the abdomen or vagina. Your doctor will recommend the hysterectomy best for you. The procedure depends on your medical history and reason for the surgery.
  • Abdominal hysterectomy - the surgeon makes a 5-to-7 inch incision in the lower abdomen. The incision may be vertical or horizontal just above your pubic hair, which is called a bikini cut
  • Vaginal hysterectomy - the surgeon makes an incision in your vagina and removes the uterus through the opening
  • Laparoscopic hysterectomy - a laparoscope is a narrow tube with a tiny camera on the end. Your surgeon will make three or four small abdominal incisions. The laparoscope and other instruments will be inserted through the incisions. The surgeon cuts the uterus into small pieces to be removed through the incisions
  • Laparoscopy-assisted vaginal hysterectomy - the surgeon removes the uterus through an incision made in your vagina. A laparoscope is used for the procedure.
  • Robotic hysterectomy - this procedure is similar to laparoscopic surgery, but a robot is used. Robotic surgery most often is used to for a hysterectomy if a patient has cancer or is overweight.

Generally, laparoscopic surgeries are less invasive than open surgeries, reducing recovery times.

After the Procedure
After surgery, you will receive pain medicine. A tube, or catheter, may be inserted in your bladder to allow you to pass urine. You will get up as soon as possible after surgery to prevent blood clot formation in your legs and speed recovery.


Our physicians at Houston Methodist specialize in managing menopause at the following convenient locations: