At the age of 48 I had a total hysterectomy with removal of my ovaries which meant I went straight into menopause, also known as surgical menopause. I was sent home from hospital with very little information on what to expect symptom-wise and it took me five years to realise I needed help. Now, at 60 I want to share my story of post menopause after hysterectomy.
In 2009, after a couple of years experiencing periods of heavy bleeding and stomach cramps I ended up in hospital after a week of particularly bad pains and body temperature spikes. It took the doctors seven days to discover I had a pelvic abscess and needed an operation to remove it. I was advised that the surgeon may have to do a hysterectomy depending on how bad the situation was. When I came round from the anaesthetic I was informed they had just removed the abscess and everything would now be fine.
A year went by with no change in my period problems and in 2010 I was told I needed a hysterectomy. I had a total hysterectomy (TAH) and a bilateral salpingo-oophorectomy (BSO) which meant they removed my uterus, cervix, both ovaries and fallopian tubes. The results from the hysterectomy revealed I had endometriosis. “Endometriosis is a condition where tissue similar to the lining of the womb grows in other places, such as the ovaries and fallopian tubes which can cause heavy periods and pain.” NHS. I remember wondering why this wasn’t picked up during the pelvic abscess surgery!
At the time of my hysterectomy I wasn’t really aware of the menopause stages. I just thought menopause was when you your periods got further apart before stopping and you had hot flushes. People didn’t realiy talk about periods and menopause as freely as they do now.
Here’s a brief overview of how I understand the 3 stages of menopause after doing some research. I have found the information available about these stages to be quite confusing so please speak to a medical professional if you want further clarification.
Perimenopause:
Meaning ‘around menopause’, this is when your levels of oestrogen start to decrease and symptoms begin to occur. Symptoms of perimenopause can include:
Irregular periods
Night sweats
Hot flushes
Mood changes
Vaginal dryness
Joint pain
Weight gain
Anxiety
Panic attacks
Brain fog
Urinary tract infections
Heart palpitations
Headaches
Sleep problems
This list of symptoms is not exhaustive as there are apparently more than 30 symptoms of perimenopause. Symptoms will also vary from woman to woman and hopefully you won’t experience all of them. The average age for perimenopause is 47 and women can have perimenopausal symptoms for up to four years (Lloyds Pharmacy)
Menopause: When you haven’t had a period for 12 months you have reached menopause. This usually occurs by the age of 55 (NHS). The term menopause means ‘the end of your menstrual cycles”. Menopause and Perimenopause are used interchangeably on the NHS website and it states that you can experience the above symptoms during each stage.
Post Menopause: This is the term for after your menstrual cycles have ended. “At this point a woman‘s transition into her non-child-bearing years is complete, post-menopause lasts the rest of a woman’s life but symptoms will gradually decrease.” (Menopause & Me).
I’d always thought ‘menopause’ was the term for the symptoms that happened leading up to your periods stopping. (I’ve only started hearing the word ‘perimenopause’ in the last 5 years.) So are they saying the stage of ‘menopause’ is actually only the date, 12 months after a woman’s last period?
As I had a TAH and BSO this meant my period stopped immediately and according to the National Institutes of Health (NIH) there is “a more rapid decline in hormone levels that causes more severe vasomotor symptoms (hot flashes, night sweats) and higher rates of mood disorders, sleep disturbances, sexual dysfunction, arthralgias, and reduced quality of life.”
I was catapulted straight into surgical menopause / post menopause without any information on what I could expect to experience.
Whilst it was a relief to not have periods any more I started to experience menopausal symptoms such as hot flushes, night sweats, mood changes and vaginal dryness.
My symptoms post menopause
Hot Flushes & Night Sweats
These post menopause symptoms were probably the most troublesome for me, especially when I was out and about. I’d be looking around a shop and all of a sudden I’d feel really hot, then I’d start sweating. It was so bad the drops of sweat would just trickle down my face which meant any makeup I’d applied was ruined. It also meant lots of damp patches on my clothes. I started to carry a fan around with me to try and cool myself down, which did help a little. I felt I didn’t want to go out for dinner or for drinks as I just knew the hot flushes would spoil my enjoyment. The night sweats were also quite bad. I’d wake up through the night with my sheets and duvet cover soaking wet. I was used to sleeping naked but I started to wear shorts and t-shirt in bed to see if that would help. But it just meant they were also soaking wet! As well as being uncomfortable for me, it wasn’t very pleasant for my husband either, although he was supportive about it.
Mood Changes
Before the hysterectomy I did experience bouts of depression but I put this down to my period problems most of the time. However looking back, maybe I had started perimenopause. After the hysterectomy it seemed to happen more often, but for shorter periods of time. I’d wake up in a low mood for no reason whatsoever, I’d snap at people and found it hard to concentrate which really affected my daily life. I’d cry at the smallest thing and didn’t really know why I was crying. These feelings would last a couple of hours and then I’d be all bouncy and motivated. It got very exhausting and the more times I felt like this the more I was becoming depressed about feeling like that, it became a vicious circle. My family never knew which ‘me’ they were going to get.
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Vaginal Dryness
For a couple of years before the hysterectomy, sex had become a problem due to period problems and pain. So I was looking forward to me and my husband becoming intimate again Unfortunately sex was still problematic due to vaginal dryness. The more we tried, the more tense we both got and eventually we stopped trying. What I didn’t realise, was that it’s the decline in oestrogen during perimenopause that causes the symptoms stated above, but having had my ovaries removed too meant I wasn’t producing any testosterone either. As testosterone plays an important part in sexual desire it’s no surprise that sexual intimacy became a problem. It would have helped so much if this had all been explained to me post-hysterectomy.
Sleep Problems
I had always been a fairly light sleeper but my transition into post menopause came with more broken sleep. I was waking up due to the night sweats, but even on the nights I didn’t sweat I still seemed to still suffer from sleep disturbance. I’d wake up every couple of hours and once I was awake it was difficult to get back to sleep. I started taking naps during the day as I was so tired. Luckily I am self-employed and work from home so this wasn’t too much of an issue, but it’s not a nice feeling to be sitting at your desk and feeling so tired you can’t keep your eyes open.
Finding HRT
I’d spoken to my GP briefly about hormone replacement therapy not longer after the hysterectomy but was advised not to take it due to an increased risk of breast cancer. She advised that I use vaginal pessaries to help with the vaginal dryness. I tried these a couple of times but because of the dryness it was even hard to use the pessaries. After suffering with these symptoms of menopause for five years I decided enough was enough and went back to my GP. I explained that I was prepared to take the risks that taking HRT had. Which in fact were quite small in my case as I do not have a family history of breast cancer. She agreed to prescribe me Premarin, an oestrogen tablet to be taken once a day. Within one month my symptoms had improved.
After six months the hot flushes and night sweats had almost stopped and the vaginal dryness was slightly better, which meant the good news was our sex life improved but it was still a little uncomfortable. Luckily there are some good lubricant products on the market that help enormously. One of these is the In2mate Natural Lubricant. This is a perfume-free product that is applied internally for lubrication and rejuvenates vaginal skin for better flexibility, making sex so much more pleasurable. The In2mate range also includes a Natural Vaginal Wash and a Natural Vaginal Moisturiser making it a feminine hygiene range that as well as protecting against bad bacteria can also help improve your sex life during and after menopause.
Do you ever feel good again after menopause?
It’s now been 12 years since the hysterectomy and symptoms of the menopause (or post menopause) started. Although the hot flushes, night sweats and vaginal dryness are well under control, my emotional symptoms and sleepless nights are still a slight issue, but manageable.
I no longer burst into tears for no reason whatsoever, although I do still sometimes cry at the slightest thing during a film, but I can cope with that. I occasionally wake up with a low mood but I’ve learned to just go with it. If I know there’s nothing in particular I’m worrying about then I know it will pass. And I consciously try not to snap at people, counting to 10 in my head usually helps with this. (Unless of course they warrant a snapping at!). My GP did offer me antidepressant medications at one point but I preferred not to take another tablet if I could cope without it. Obviously if anyone feels the need to take antidepressants then this is their choice and there is no reason for anyone to think they shouldn’t.
I still have broken sleep on most nights but I don’t ‘toss and turn’ anymore. I try some deep breathing techniques or put on some sleep sounds to see if I can nod off again, but if this doesn’t work after 30 minutes I get up. Even if it’s 2am, I’ll make a cup of herbal tea and read a chapter of a book, preferably one that is soothing and not too complicated. Sometimes this wakes me up completely and I stay up, other times I’ll be able to to go back to bed for another 3 or 4 hours sleep. I’ve come to the conclusion that I just don’t need as much sleep as I did when I was younger. And as it’s not affecting my daily life it’s not a big problem.
So yes you can feel like yourself again after menopause, it just takes a little bit of knowledge and a little bit of help.
I feel my post menopause experience could have been eased somewhat by my doctors talking to me about what to expect after hysterectomy, what treatment options were available for my symptoms and maybe pointing me towards a post menopause support group. This is an important phase of life for women which I still feel has a lack of awareness in 2024. Even the different terms of perimenopause, menopause and post menopause could be clarified better on medical websites, such as the NHS site, as they are really confusing.
Luckily there is a lot more awareness around menopause now and the NHS website does have a link to a list of NHS and private menopause specialist help available. So hopefully by the time younger women reach menopausal age they’ll be equipped with everything they need to know about menopause.
If you’ve had a surgical menopause I’d be very interested to hear what your experience of it was. Let me know in the comments.
The conversation has definitely increased around menopause over the past 12 years but there is still so much women are unaware of and frighteningly so much the NHS are unaware of in terms of supporting women through and post menopause naturally or with HRT. It sounds like you are in a good place but don’t give up trying to feel amazing x
Let’s hope it gets better Sue! Thanks for reading x
Gosh we have a lot to deal with as women don’t we! I’m not there yet, but this is such a useful post for gaining information and understanding of what’s to come!
Hopefully information will be a lot better when you get to that stage Steph x