Hysterectomy, early menopause, and weight loss

doodletoodles

I’m 36 and need a hysterectomy. Timing is up to me (within reason - should happen within next two years). I’d like to get it done sooner rather than later (I’ve already met my $7k deductible for the year with a surgery). It will be a total hysterectomy with taking both ovaries as well, so I’ll go into immediate menopause. I’m curious if anybody out there has had a hysterectomy in their mid-30s and had it affect their weight loss? If it’s going to make weight-loss super difficult, I’ll probably opt to do it later. Anyone had this experience?

kshama2001

Presumably you've had a second opinion who agreed this is medically necessary.

Weight loss could be affected by ANY major surgery.

How much weight do you have to lose? If you are morbidly or super-obese, then statistically speaking, your surgery will go better if you lose weight first.

https://www.medpagetoday.org/meetingcoverage/sgo/31870
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/01/gynecologic-surgery-in-the-obese-woman

kshama2001

@AnnPT77 - I believe you were somewhat older than the OP when you went into chemically induced menopause?

doodletoodles

Thanks for the quick replies! I’ve had surgeries to clean up endometriosis, so this isn’t my first rodeo (although I know that hysterectomy will be more involved). I’ve lost some weight already, and my doctor isn’t concerned with where it’s at for surgery purposes. I think any surgery comes with increased risk when you are overweight. That is already informing my decision. I’m curious to know if there any women who have experienced hysterectomy and menopause in their 30s and how it’s affected their weight loss, so I can make a more informed decision as to timing. Looking forward to hearing women’s experiences!

AnnPT77

I experienced menopause at 44, but not from hysterectomy/oophorectomy. It was chemotherapy induced, very quickly, and then I was put on anti-estrogen drugs for a total of 7.5 years, which tends to aggravate menopausal symptoms in most women who go through that. (After ovaries stop producing estrogen, other tissues do so through a process called aromatization. For 2.5 years, I was taking a drug that blocked normal estrogen uptake by some cellular processes, then 5 years was an aromatase inhibitor, to stop that estrogen creation process.) These drugs have a reputation for triggering weight gain, among users. I have no idea how similar this is to oophorectomy.

FWIW: I didn't gain weight. I was already class 1 obese (just over the line into obese BMI), and stayed about the same weight. At first, I was more vigilant about eating - not so much about calories, but about increasing veggies/fruit for better nutrition post-cancer, which may have had a slight calorie reduction effect, enough to avoid gain, but not enough to cause noticeable loss. Later, I became very active (but stayed obese), so clearly I was eating more, but staying around the same weight.

Like I said, I'm not trying to suggest that my experience applies to you. It was different, in cause. Whether it was different in effect is anyone's guess, and I'm not a health professional.

I will say this: When people gain weight from something like this, it tends to have one of 3 causes.

1. Increased water retention. This increases scale weight, but is not fat.
2. Increased appetite. Usually, if someone's appetite increases, they eat more, perhaps subtly so, and can gain weight gradually. Increasing eating by 100 calories a day (above maintenance calories) adds about 10 pounds in a year. It's pretty easy to eat 100 calories more without noticing, for most people.
3. Reduced activity. This can occur if the drug causes fatigue; interferes with sleep; causes body aches, stiffness, or other movement-disadvantaging symptoms; or even by causing cognitive fog that interferes with enthusiasm for daily life activity or exercise. This can also be quite subtle, too. Moving 100 calories less daily has the same "10 pounds in a year" effect. (Research has shown fidgetiness to burn up to a couple of hundred calories daily, IMU, so 100 calories less movement can be pretty unnoticeable.)

I'm not necessarily saying those are the only possibilities, but they're very important ones. Something like calorie counting plus attention to the scale can limit or eliminate #2 or #3 as reasons for weight gain. Conscious attention to daily life movement, as well as exercise, can help with #3. In my experience, #3 is a risk in general for any of us who goes through major surgery, chemotherapy, or something like that. The treatment/recovery period can be long enough to wire in some habits of reduced movement, or cause physical changes (stiffness, reduced fitness, etc.) that can lead us in that direction.

BTW, I don't know what your doctor says about this, but I'd encourage you to go to or at least near maintenance calories for a few weeks or a month after surgery, keeping good nutrition, to maximize healing. I *didn't* do that after a minor laparoscopic surgery (gallbladder) during weight loss, and came to wish I had. I healed OK, thankfully, but there was a fatigue/weakness penalty.

Wishing you a very smooth surgical experience, speedy recovery, and a positive aftermath!

doodletoodles

Thank you @AnnPT77 . I appreciate how thorough and informative your response is. I have hope that I’ll have more control over my weight during menopause than I originally thought I would.

I hope you came through chemo and your treatments okay. Sounds like it was a long time.

AnnPT77

AngBabee wrote: »

Thank you @AnnPT77 . I appreciate how thorough and informative your response is. I have hope that I’ll have more control over my weight during menopause than I originally thought I would.

I hope you came through chemo and your treatments okay. Sounds like it was a long time.

Thank you for the good wishes!

Chemo (for stage III breast cancer) was over 20 years ago. Getting active soon thereafter (to get my strength/vitality back, basically, after surgery, 6 months of chemo, 6 weeks of radiation) had a huge payoff (I way overshot "getting back" 😆), even though I stayed obese until 2015. Thanks to MFP, I've been at a healthy weight since then, and think I'm doing pretty darned well for a 65 y/o woman who was a latecomer to healthier lifestyle. 😊 Advice: Don't let preconceptions - your own or others' - become limitations. You can surprise yourself with what you achieve, just keep chipping away at progress.

Wishing you great outcomes!

BarbaraHelen2013

I’m in the UK, so I appreciate medical protocols may be somewhat different here, but when I had a total hysterectomy (uterus, ovaries and cervix) at age 51 I was automatically put on conjugated oestrogen HRT.

It did surprise me, due to my age. I’d expected to have to go through a surgically induced menopause after the surgery. I’d had no menopausal symptoms yet. It was considered to be better to manage the sudden loss of oestrogen, by giving HRT and very very slowly stepping down the dose over years.

The only thing that had any effect on my weight throughout the process was the lower activity for a period following surgery. It takes a while to bounce back!

kalakimatra

AnnPT77 wrote: »

I experienced menopause at 44, but not from hysterectomy/oophorectomy. It was chemotherapy induced, very quickly, and then I was put on anti-estrogen drugs for a total of 7.5 years, which tends to aggravate menopausal symptoms in most women who go through that. (After ovaries stop producing estrogen, other tissues do so through a process called aromatization. For 2.5 years, I was taking a drug that blocked normal estrogen uptake by some cellular processes, then 5 years was an aromatase inhibitor, to stop that estrogen creation process.) These drugs have a reputation for triggering weight gain, among users. I have no idea how similar this is to oophorectomy.

I had my second round of BC in 2020 and oopherectomy Dec 2020 at 40, I was managing for the first year while going into surgically induced menopause with mostly food/calories, but the last couple months I've started working out and gaining weight. I'm desperate for change, and had narrowed it down to sugar increases/changes as I've been messing with new workout shakes and coffee options. Thank you for sharing openly and Congratulations on 20 years!