A hysterectomy is a surgical procedure that involves the removal of a person’s uterus. This article explains how this surgery impacts the body’s ability to produce eggs, and whether egg production continues after the procedure.
What a Hysterectomy Involves
A hysterectomy is a surgical procedure that removes the uterus, also known as the womb. The uterus is where a fetus develops during pregnancy and where menstrual bleeding originates. The extent of the surgery can vary depending on the medical reason.
A supracervical or subtotal hysterectomy removes only the upper part of the uterus, leaving the cervix. A total hysterectomy removes the entire uterus and cervix. In some cases, such as for cancer treatment, a radical hysterectomy may be performed, which removes the uterus, cervix, surrounding tissues, and potentially the fallopian tubes and ovaries.
The Ovaries and Egg Production
The ovaries are small, oval-shaped glands positioned on either side of the uterus. They are essential to the female reproductive system, producing and storing eggs (ova or oocytes).
Beyond egg production, the ovaries also generate hormones like estrogen and progesterone. Each menstrual cycle, one ovary releases a mature egg in a process known as ovulation. These eggs are housed within tiny sacs called follicles, which develop under the influence of hormones like follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
The Key Distinction: Ovaries Removed or Not
Whether a person continues to produce eggs after a hysterectomy depends entirely on whether the ovaries were removed during the surgery. The removal of one or both ovaries is a separate procedure called an oophorectomy, which may be performed at the same time. If the ovaries remain, they will continue producing hormones and releasing eggs each month.
When ovaries are left intact, released eggs simply dissolve and are reabsorbed by the body, as there is no uterus for them to implant into. This means that while egg production continues, menstruation ceases due to the absence of the uterine lining. If both ovaries are removed during the hysterectomy, egg production stops immediately. This halts the monthly release of eggs, as the organs responsible for this process are no longer present.
Implications for Fertility and Hormones
A hysterectomy impacts fertility, regardless of whether the ovaries are removed. Since the uterus is no longer present, natural pregnancy becomes impossible, even if the ovaries continue to produce eggs. The uterus is necessary for a fertilized egg to implant and grow. However, if ovaries remain functional, egg retrieval for in-vitro fertilization (IVF) and surrogacy may be an option.
The hormonal implications differ based on ovarian preservation. If the ovaries are removed, a person will experience surgical menopause, characterized by a sudden drop in estrogen and progesterone. This abrupt hormonal change can lead to symptoms such as hot flashes, night sweats, mood swings, and vaginal dryness, often necessitating hormone replacement therapy (HRT) to manage these effects. If the ovaries are kept, they continue to produce hormones until natural menopause occurs, typically between ages 45 and 55, avoiding the immediate onset of surgical menopause symptoms.