A hysterectomy is the removal of the uterus. It may include removing the ovaries and fallopian tubes as well. It’s a relatively common procedure for women in the United States, especially those between 40 and 50 years old, and may be the best treatment for chronic pain or disease. Some of the conditions that may require a hysterectomy are:
- Uterine fibroids, which are noncancerous growths that appear in the uterus. These can cause heavy periods and prolonged bleeding. Fibroids can also cause lower back or pelvic pain. The causes for fibroids aren’t completely known, although a family history of the condition and obesity are risk factors. This is the most common reason for a hysterectomy.
- Endometriosis, which is a condition where uterine tissue grows outside the uterus. In endometriosis, the uterine tissue typically grows in the lower pelvic region, although it can grow anywhere in the body. This tissue thickens and bleeds during the menstrual cycle, just like the uterine tissue inside the uterus, and can be very painful.
- Uterine prolapse or pelvic support problems. Uterine prolapse is when the uterus slips down into or protrudes out of the vagina. This can be a dangerous condition and may lead to problems with the bowel and bladder.
- Abnormal uterine bleeding
- Chronic pelvic pain due to a combination of the above conditions
- Cancers of reproductive organs, including ovarian and uterine cancers
Once you’ve had a hysterectomy, you can no longer become pregnant, and you’ll no longer have periods.
Although some women may experience weight loss after a hysterectomy, it’s not the operation itself that causes weight loss. It may be that removing the uterus and any subsequent pain may result in a decrease in appetite, resulting in weight loss. Losing weight after a hysterectomy is fairly common, but if you were underweight to begin with or experience rapid weight loss after a hysterectomy, you may wish to speak with your doctor.
Nausea after a hysterectomy is also sometimes a side effect, and many women have a hard time keeping food down in the days following the procedure. You may also experience a loss of appetite during the healing process. If you aren’t able to eat or are constantly vomiting, however, you should consult with your doctor. The process of throwing up may cause more pain and affect the healing of your hysterectomy. If you aren't able to eat, you may not be getting the nutrients your body needs to heal.
Hysterectomy is also a common treatment for several kinds of cancer. Cancer itself can cause weight loss simply due to the effects of the disease. A hysterectomy may also be performed in conjunction with chemotherapy, which also has side effects of nausea and loss of appetite.
For women who had a loss of appetite and nausea before their hysterectomy as a side effect of their medical condition, removing the uterus may alleviate nausea and increase their appetite. These women may be able to eat more or may find eating more pleasurable now that they aren’t experiencing chronic pain or discomfort.
Women who were used to an active lifestyle may gain weight after a hysterectomy, especially if the procedure was performed as an abdominal surgery rather than a vaginal hysterectomy. Recovery time for a hysterectomy can be around six to eight weeks, and your doctor may recommend that you wait a bit longer after your recovery before engaging in the level of exercise that you did before the surgery.
Regardless of the circumstances, if your activity level has decreased, but you’re eating the same number of calories, you will likely gain weight. If you notice you’re gaining weight, keep a close eye on the calories you consume, focusing on whole, healthy foods, especially lean meats and colorful fruits and vegetables. These foods also have plenty of nutrients to help your body heal.
Another reason for weight gain after a hysterectomy may have to do with your condition before the surgery. Some of the health conditions that require a hysterectomy for treatment may be aggravated by obesity (BMI of 30 or greater). Obese women may have certain habits, such as poor diet or a sedentary lifestyle, that encourage weight gain. As part of your pre-surgical consultation, your doctor may recommend that you lose weight, not only to minimize surgical complications or complications from anesthesia, but also to give you a jump-start on healthy habits that can help you lose weight after a hysterectomy.
Women who have had weight fluctuations throughout their life may also experience weight gain after a hysterectomy. Compared to women who begin menopause with their ovaries and uterus intact, premenopausal women who have had their uterus removed (without their ovaries removed) have a higher incidence of weight gain during menopause.
If you have a total or radical hysterectomy that removes your ovaries, you’ll experience menopause immediately after your operation, regardless of your age. This is known as a surgical menopause.
The average weight gain for women after a hysterectomy is 5 pounds.
As with any surgery, you may experience a reaction to anesthesia, infection, pain and soreness at the surgical site, and fatigue. The side effects from the surgery will depend on which procedure, vaginal or abdominal, you had. Other short-term effects may include:
- Pain, bleeding, and soreness in your lower abdomen or vagina
- Low libido
- Blood clots in the legs or lungs
- Bladder problems such as not being able to empty the bladder completely or losing the feeling of having to urinate
Some side effects from a hysterectomy are long term, developing months or even years after the procedure. Some long-term side effects include:
- Lymphedema, which is a buildup of lymph fluids in the legs or abdomen. If lymph nodes are removed along with your uterus, you may have a higher risk of developing this condition. It’s characterized by swelling and soreness and may not occur equally in both legs or on both sides of the abdomen. Women who are obese have a higher risk of developing lymphedema, which may be another reason your doctor encourages you to lose weight.
- Weakened pelvic floor or weakening of the muscles that support the bowels, vagina, bladder, and rectum
- Adhesions or scar tissue blockages of the intestines
Your physician will recommend good lifestyle habits to follow to ensure a healthy recovery from a hysterectomy and reduce long- and short-term side effects. In general, these will include following a healthy diet, including whole foods, and avoiding refined sugar and processed foods. If you aren’t sure how to lose weight after a hysterectomy, ask your doctor or a dietitian to help you with meal plans.
In addition to lean meats and fresh fruits and vegetables, include whole grains and make sure to get plenty of calcium. Women who enter menopause, and those who have completed menopause, are at a higher risk of osteoporosis. Getting enough calcium before menopause can help reduce your risk of brittle bones.
Your physician will recommend good lifestyle habits to follow to ensure a healthy recovery from a hysterectomy and reduce long- and short-term side effects.
Good exercise habits are another component of weight loss after a hysterectomy. Follow your doctor’s orders for physical activity, and begin with lower-impact exercises, such as pool workouts, to avoid straining your body as it heals. You may also find added health benefits from meditation or other stress-management techniques.
Finally, some women experience grief and loss after having their uterus removed. This is very normal, and if you have these feelings, you may benefit from an individual counselor or group therapy.
A hysterectomy is a common procedure, and many women can have happy, healthy, and pain-free lives after the procedure. To ensure that you heal well and reduce your risk of complications, follow your doctor’s instructions and make sure to follow a healthy diet and exercise regularly.