PCOS after hysterectomy: Causes, symptoms and treatment

In a nutshell

Hysterectomy is not usually recommended to treat polycystic ovaries syndrome (PCOS) because you can still suffer from symptoms of PCOS after a hysterectomy. It is possible to develop PCOS after a partial hysterectomy where the ovaries remain in place, and it is rare to develop PCOS for the first time after a total hysterectomy.

Polycystic ovaries syndrome (PCOS) is an endocrine disorder that affects up to 13% of women of reproductive age. It is one of the leading causes of infertility, and many women do not find out they have PCOS until they start fertility treatment after struggling to get pregnant.

Though PCOS is such a common condition, our understanding of the causes, symptoms, and management of this disorder remains incomplete. Scientists continue to explore the condition in the hope of improving the quality of life for women affected by PCOS.

The symptoms of PCOS are far-reaching. Many women find themselves desperately wondering, ‘Can a hysterectomy cure PCOS?’ Unfortunately, a hysterectomy won’t cure PCOS, though it may deal with some of the symptoms, such as heavy periods. It is not generally recommended as a treatment option for women with PCOS because symptoms can continue afterward.

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Treatment options for PCOS

PCOS is a chronic condition, and, as such, there is no known cure. However, it can be managed by lifestyle changes, which help reduce symptoms. Lifestyle changes include weight management, regular exercise, a low glycemic diet to avoid the blood sugar spikes associated with PCOS, and stress management. Your doctor may also prescribe medication to manage the condition.

Unfortunately, the effects of PCOS can be far-reaching. Many women struggle with fatigue, weight gain, low self-esteem, and depression. PCOS is associated with other health conditions, such as obesity, type 2 diabetes, and cardiovascular disease. Understandably, many women are desperate to find a way of curing the condition and ending their discomfort.

Does a hysterectomy cure PCOS?

No, hysterectomy won’t cure PCOS. While it may get rid of your period problems and reduce the risk of certain cancers, it won’t solve the hormonal imbalance at the heart of PCOS.

You may still suffer symptoms of PCOS and would still have an increased risk of conditions such as diabetes and cardiovascular disease. There are also potential side effects associated with hysterectomy that must be considered, such as bowel and bladder damage, vaginal problems, and early menopause.

The exact cause of PCOS is unknown, but it’s thought insulin resistance may play a part. Women with PCOS are likely to suffer from insulin resistance and high blood sugar. Women with PCOS also have an increased risk of inflammation in the body, putting them at risk of other health conditions. A hysterectomy would not address these issues, and the accelerated loss of estrogen associated with hysterectomy could actually make them worse.

What is a hysterectomy?

A hysterectomy is a surgical procedure to remove the uterus. In a partial hysterectomy, the ovaries would be retained. In total or radical hysterectomies, doctors will also remove the ovaries, fallopian tubes, and other parts of the reproductive system.

Hysterectomies are performed to treat health conditions, including painful periods, ovarian cancer, and long-term pelvic pain. It is a major surgery and should only be considered after other treatment options have been exhausted.  After a hysterectomy, you will no longer have periods or be able to get pregnant.

Can you have PCOS after a hysterectomy?

Yes, you can still suffer from PCOS after having a hysterectomy, even if you have your ovaries removed. However, if you’ve had a hysterectomy that involved the removal of the ovaries, you are unlikely to develop PCOS for the first time after this. If you had a hysterectomy without ovary removal, there’s a small chance you could develop PCOS for the first time afterward.

If you are experiencing symptoms of PCOS for the first time after a hysterectomy, speak to your doctor for advice. They may be able to prescribe hormone treatment to help.

Will removing ovaries stop PCOS?

While not all women have their ovaries removed during a hysterectomy, it is possible to have your ovaries removed as part of the procedure. While you may think this would cure a condition called polycystic ovaries syndrome, it may not. Despite its name, PCOS may not actually be related to the ovaries. Men can suffer from male equivalent PCOS despite their lack of ovaries.

While one of the characteristics of PCOS is high androgen (male hormone) levels, and the name implies these originate in the ovaries, your adrenal glands also produce androgens. Therefore, removing your ovaries may not prevent the excess androgens associated with PCOS, meaning you could still suffer from excess facial and body hair, acne, and thinning hair. A 2023 research review published in Human Reproduction Update found that high androgen levels persisted after menopause in women with PCOS, so it is not a problem that goes away after your periods stop.

Symptoms of PCOS after hysterectomy

You can still experience symptoms of PCOS after a partial hysterectomy. Symptoms of PCOS include missed or irregular periods, excess facial and body hair, thinning hair on the scalp, acne, weight gain, and difficulty getting pregnant.

After a partial or total hysterectomy, you would no longer suffer from period problems. However, you may still experience excess body and facial hair, thinning hair on the scalp, acne, and weight gain, thanks to the underlying hormonal imbalance.  

How to treat PCOS after hysterectomy

Treatment options to manage PCOS symptoms after hysterectomy include:

Exercise

Physical activity is beneficial for women with PCOS and can alleviate symptoms. Cardio and strength training exercises are great ones to start with.

A healthy diet

Insulin resistance is associated with blood sugar spikes, which can worsen your symptoms. Eat a low-glycemic diet to avoid blood sugar spikes. Eat a diet rich in fresh fruit and vegetables, whole grains, lean proteins, and healthy fats.

Take supplements

According to a 2022 article published in Endocrine Regulations, Omega-3 supplements can help to balance hormones and reduce insulin resistance. A study published in Cureus found that inositol supplementation lowers insulin resistance in women with PCOS.

Manage your stress levels

PCOS puts the body under a lot of stress. Many women suffer emotional stress as a result of the symptoms of PCOS. Managing your stress levels can help to alleviate symptoms. Mindfulness, yoga, and cognitive behavioral therapy (CBT) can help you manage stress.

Hormone therapy

Your doctor may prescribe hormone therapy to balance your hormones and manage your symptoms. Speak to your doctor to see what hormone treatments may be right for you.

When to speak to your doctor

If you are struggling to manage the symptoms of PCOS, it’s time to speak to your doctor. They are best placed to offer tailored health advice to help you get your PCOS under control. They may prescribe medication to help you manage the symptoms or have suggestions for other things you can try from home.

Summary

PCOS is associated with various health problems, including obesity, fatigue, depression, type 2 diabetes, and cardiovascular disease. If left untreated, PCOS can increase your risk of endometrial cancer. Though there is no cure for PCOS, the condition can be managed to reduce symptoms and improve quality of life.

Hysterectomy is not a good treatment option for women with PCOS. Though a hysterectomy would get rid of painful and heavy periods, it wouldn’t tackle other PCOS symptoms. The exact cause of PCOS remains unknown, though experts think it is connected to hormonal imbalances, insulin resistance, and metabolic dysfunction. Post-hysterectomy, you may still experience PCOS symptoms, including facial hair, acne, thinning hair on the scalp, and weight gain.

Speak to your doctor for other treatment options. They may prescribe medication to reduce insulin sensitivity to alleviate your symptoms. Lifestyle changes, such as daily exercise, eating a healthy diet, and taking supplements, may also help reduce the impact of PCOS on your daily life.