Medical Health Encyclopedia

Long-Term Complications. Women who have had a total hysterectomy are at higher risk for the following long-term complications:

• Muscle weakness in the pelvic area.
• Prolapse (descent) of the bladder, vagina, and rectum if the muscle’s walls are overly weakened. (This may require further surgery.)
• Bowel problems may develop if adhesions (extensive scarring) have formed and obstruct the intestines, sometimes requiring additional surgery.
• Shortening of the vagina is a possible complication specific to vaginal hysterectomy. It can cause pain during intercourse.

Such complications are uncommon. In one study of 43 women, satisfaction was high, and none reported significant problems in the bladder or intestinal tract following hysterectomy.

Treating Menopausal Symptoms and Premature Menopause after Hysterectomy

After hysterectomy, women may experience hot flashes, a symptom of menopause, even if they retain their ovaries. Surgery may have temporarily blocked blood flow to the ovaries, therefore suppressing estrogen release. If both ovaries have been removed in premenopausal women, the procedure causes premature menopause. Symptoms come on abruptly and may be more intense than those of natural menopause. Symptoms include hot flashes, vaginal dryness and irritation, and insomnia. A significant number of women gain weight.

Text Continues Below

---

The most important complications occur in women who have had their ovaries removed. This causes estrogen loss, which places women at risk for osteoporosis (loss of bone density) and a possible increase in risk for heart disease. Women have typically taken taking hormone replacement therapy (HRT) after surgery if their ovaries have been removed. There have been concerns however about health risks, including the risk for breast cancer and stroke, that have now limited its use. Such risks in premenopausal women have not yet been clarified. Fortunately, a number of other agents are available that can help protect both bones and heart.