A hysterectomy and removal of the ovaries are not the same operation, and they do not have the same effect on menopause. The NHS says a hysterectomy removes the womb. If the ovaries are removed as well, menopause can begin immediately. This article explains that distinction and the symptoms the NHS associates with the sudden drop in oestrogen.
This is general information, not a personal medical assessment. The decision to remove or keep the ovaries depends on a person's medical history and the advice of their clinician.
Hysterectomy and ovary removal are separate decisions
On its hysterectomy overview, the NHS explains that the operation removes the womb. Pregnancy is not possible afterward, and periods stop if the person had not already reached menopause.
The NHS considerations page adds that the cervix or ovaries may also be removed. That choice depends on personal views, medical history and a doctor's advice. One listed type of hysterectomy removes the womb, cervix, fallopian tubes and ovaries. A radical operation can also remove nearby tissue, part of the vagina and lymph glands.
The ovaries are the small organs beside the fallopian tubes that release an egg. Removing them is therefore a different decision from removing the womb alone.
What “surgical menopause” means
The NHS states that if a total or radical hysterectomy also removes the ovaries, menopause starts at once, regardless of age. It calls this a surgical menopause.
That timing is the key difference. Menopause linked to aging usually develops over time. Surgical menopause, as the NHS describes it, begins immediately because the ovaries have been removed.
The NHS also says that leaving one or both ovaries in place can still bring menopause earlier than it otherwise would. Keeping the ovaries does not guarantee that menopause will arrive at the age it would have without surgery.
Symptoms linked to low oestrogen
The NHS considerations page says a lack of oestrogen causes menopausal symptoms and lists:
- hot flushes
- depression
- vaginal dryness
- insomnia
- fatigue
- night sweats
These are symptoms the NHS associates with that hormone change. They are not a prediction of exactly what one person will experience, or how severe or long-lasting the symptoms will be.
The NHS menopause-symptoms page gives more detail about several of these experiences in menopause generally. It says hot flushes are when the face, neck and chest suddenly feel very hot or cold. They may include sweating, a racing heartbeat, anxiety or dizziness, and they can happen during the day or as night sweats lasting several minutes. Sleep problems may be worse when night sweats are also present.
That page also says mood swings, low mood or depression can occur, as can poorer memory or concentration. It describes genital dryness, burning, irritation or itching, which can make sex painful. It also lists more urinary tract infections, or urinary symptoms that feel similar, among possible menopause symptoms.
The menopause page is careful about variation: perimenopause and menopause are different for everyone. Its statement that symptoms often last seven to nine years, and sometimes longer, describes menopause generally. It should not be read as a measured duration for every person who has had both ovaries removed.
What may happen if the ovaries stay
The NHS says healthy ovaries may be left in place when the risk of disease is small. It explains that they make hormones that help protect against weak bones, or osteoporosis, and that support desire and pleasure.
It also says that after menopause, ovaries that were left in place can still make testosterone for up to 20 years and can make small amounts of oestrogen. This is another reason the NHS distinguishes between removing the womb and removing the ovaries.
A person who wants the ovaries kept should say so clearly, according to the NHS. They may still be asked to consent to removal if an abnormality is found during the operation.
Hormone replacement therapy
The NHS says hormone replacement therapy, or HRT, may be offered after the ovaries are removed. Its purpose, as described there, is to replace some of the hormones and ease symptoms. The hysterectomy overview says a person should be offered HRT after surgical menopause.
The considerations page says doses and brands often need adjustment. It also says HRT is not advised after hormone-dependent breast cancer or when a person has liver disease. If both ovaries have been removed and HRT is suitable, the NHS describes treatment as important until the usual age of menopause, which it gives as an average of 51.
Those statements are general NHS guidance, not a statement that HRT is appropriate for everyone. A GP, gynecologist or menopause specialist can explain the options and the reasons it may or may not be suitable.
Questions to raise before surgery
The NHS frames ovary removal as a decision involving personal views, medical history and medical advice. Useful questions include:
- Are my ovaries being removed, or only my womb?
- What is the reason for recommending removal or for recommending that they stay?
- If they are removed, what symptoms should I know about?
- Will HRT be offered, and is there a reason it may not be suitable for me?
- If the ovaries stay, could menopause still happen earlier?
- Who should I contact if symptoms begin or become difficult after surgery?
Key takeaways
- The NHS says a hysterectomy removes the womb. Removing the ovaries is a separate part of the decision.
- If the ovaries are removed, the NHS says menopause starts immediately at any age. This is surgical menopause.
- Keeping one or both ovaries can still be followed by earlier menopause.
- The NHS links low oestrogen after ovary removal to flushes, depression, vaginal dryness, insomnia, fatigue and night sweats.
- HRT may be offered, but the NHS says it is not advised in some situations, including hormone-dependent breast cancer and liver disease.
Sources
- NHS, “Hysterectomy,” overview, last reviewed 11 October 2022: https://www.nhs.uk/conditions/hysterectomy/
- NHS, “Considerations – Hysterectomy,” last reviewed 11 October 2022: https://www.nhs.uk/conditions/hysterectomy/considerations/
- NHS, “Symptoms of menopause and perimenopause,” last reviewed 19 May 2026: https://www.nhs.uk/conditions/menopause/symptoms/
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