Weight Gain After a Hysterectomy: What to Expect and How to Manage It

Overview of a hysterectomy

A hysterectomy is the surgical removal of your uterus, sometimes including the elimination of your cervix, ovaries, and fallopian tubes. Generally performed between the ages of 40 and 50, 1 in 3 American women have had a hysterectomy by the time they’re 60.

Without a uterus, you will no longer get monthly periods (regardless of whether you’ve entered menopause), or be able to get pregnant. Your doctor might recommend a hysterectomy if you’re experiencing any of the following medical conditions:

• Uterine fibroids
• Endometriosis
• Pelvic support problems (e.g., uterine prolapse)
• Gynecologic cancer
• Placenta accreta
• Chronic pelvic pain
• Abnormal uterine bleeding

Does a hysterectomy cause weight gain?

There has been a lot of speculation in the medical community about hysterectomy and weight gain. It’s a fairly prevalent post-op side effect, even in the absence of adjustments to diet or physical activity level. 

A Journal of Women’s Health study concluded that there is indeed a greater chance of weight gain after a hysterectomy, especially in the first year. Those who’ve struggled with their weight in the past appear particularly susceptible. Such is also the case for premenopausal patients undergoing a hysterectomy without eliminating both ovaries. This means that smart lifestyle changes could be very helpful immediately following surgery.

Weight gain and full hysterectomy vs. partial hysterectomy

A partial or subtotal hysterectomy removes your uterus, but leaves your cervix intact. In contrast, a full or radical hysterectomy removes your uterus, ovaries, and cervix, triggering menopause regardless of age. This is what’s known as surgical menopause. 

On average, women gain 5 pounds after entering menopause, a process that naturally lowers your body’s estrogen levels and causes weight gain. The elimination of your ovaries via a hysterectomy has essentially the exact same effect.

Uterus removal and weight gain

Depending on your doctor’s approach and the type of hysterectomy chosen, you may be advised to avoid strenuous activity. Generally speaking, most patients are instructed to take six weeks of rest following the operation. All sexual activity, heavy lifting, and physical strain of any kind should be off-limits.

If you normally follow a routine exercise regimen, this recovery break could have a significant impact on your overall weight.

How to manage weight after a hysterectomy

You can take precautionary steps to plan for the post-op period and reduce your chances for weight gain after a hysterectomy. Consider trying the following techniques, but with an eye towards maintaining your health and safety.

Physical activity

Consult with your doctor about the possibility of engaging in light exercise. Participate in low-impact activities, like yoga or swimming. Note that this is only appropriate for certain patients who’ve had certain types of surgery. Lastly, walking is a great alternative for battling stress and enjoying some form of physical stimulation.

Nutrition

Given the limitations on physical activity, you may feel more in control of your weight by focusing on diet and nutrition. Getting the proper nutrients can even help your body heal more quickly. 

Eat whole grains, fresh fruits and vegetables (namely, dark, leafy greens), and lean proteins. Swap out high-calorie foods for low-calorie substitutes during your rest period. Avoid alcohol since it’s high in calories and doesn’t aid the recovery process. Furthermore, shrink your portion sizes until you resume your regular workout routine. 

Keep in mind, once you’ve entered menopause (and are most likely over the age of 40), it becomes harder to lose weight. And yet, it’s an especially critical time to get all the vital nutrients your body needs to remain strong and healthy.

Ultimately, however, nothing is more important than embracing body positivity and feeling good about yourself. A negative mindset won’t help you meet recovery goals or get you back to where you want to be. 

Other side effects of a hysterectomy

As with any medical procedure, side effects vary greatly from one individual to the next. Whether it was a full or partial hysterectomy, and your current state of health, will determine the outcome as well. 

Short-term side effects occur immediately after or in the early weeks of recovery. They’re almost always temporary, and might include: 

• Pain and discomfort
• Infections
• Bladder problems (i.e., frequent urination or inability to empty your bladder)
• Bleeding
• Constipation
• Blood clots in the lungs or legs
• Pneumonia
• Vaginal discharge
• Painful sexual intercourse

Note that bladder issues can go from being a short-term symptom to a long-term condition. If you worry about any effect, contact your doctor.

The long-term side effects of a hysterectomy occur in the months or years following surgery. Some last for a while, while others appear permanent, and may include: 

• Infertility 

As expected, the removal of your uterus means you cannot become pregnant again. 

• Vaginal shortening and dryness

Aside from feeling continuously dry, your vaginal canal might be slightly shorter in length after a full hysterectomy, which eliminates your cervix. 

• Buildup of lymph fluid 

For patients with lymphedema (i.e., when your pelvic lymph nodes are taken out), this accumulation tends to happen in the legs or abdomen. 

• Muscle weakness

The ligaments and muscles that support your vagina, bladder, and rectum could be compromised. 

• Intestinal blockage

This is the result of adhesions, or bands of scar tissue, formed after surgery.

• Emotional issues and low libido

Sadness, depression, and reduced sex drive are all potential post-op symptoms. 

• Surgical menopause

It affects premenopausal patients who undergo a radical hysterectomy, and comes with many of its own side effects. 

If you observe any of the above long-term problems, be sure to see your doctor who can recommend treatments to alleviate symptoms. 

Takeaway

When it comes to weight gain after a hysterectomy, individuals who were very active prior to surgery, or who’ve previously struggled with weight, seem particularly vulnerable. 

But you can beat the odds with a carefully designed post-op plan. Doctor-recommended light exercises and a well-balanced diet will get you back on track. However, your number one priority should always be to ensure a healthy and speedy recovery.