So I’ve talked a lot about my hysterectomy in April 2022 and how my life has been since then. My pain and bleeding went out the window with my uterus, and physically I have never felt happier with my body.
But there’s one thing that has been really different, in fact, shockingly different—my hormones after hysterectomy and my sex life.
I mentioned that my sex life has improved without my uterus and my breasts. But what’s the deal? My surgeon told me my hormones wouldn’t change since I would be leaving my ovaries, but that seems to be far from true.
Here’s how my hormones after hysterectomy have changed.
Before vs. After Surgery
Before my surgery, I was never super enthusiastic about sex. Sometimes I was, but most of the time, I wasn’t.
Which makes total sense when you think about the fact that I had a body I hated for my entire life that didn’t feel like mine, one that caused me immense pain and embarrassment.
Things started to change after I got my mastectomy. But it really changed when I got my uterus ripped out (ok so I wasn’t awake when they took it out, but I really like to imagine my surgeons ripping that thing out of my body and tossing it against the wall. And then maybe stomping on it?)
Suddenly, I was uninhibited by my body. I no longer had breasts which embarrassed me, felt wrong on my body, and made me self-conscious. I no longer had an organ that caused me terrible pain and heavy bleeding every month. I felt free.
But, more than that, I believe my hormones after hysterectomy actually changed, although I cannot prove this. I did not get my hormones tested prior to my procedure. I really wish I did, and I even thought about it, but I had so many things to do to prepare for that procedure and just didn’t get around to it. So I’ll never know if my hormones actually changed, but I’m certain they did.
Impact on Sex Life
Sex is way better than it has ever been for both me and my husband. Our time together is just better. I’m more present in my body, less inhibited, more free, and I feel more like myself.
It has been SO nice to have a body that I feel like represents me and is mine. It’s a feeling that I never thought I would have in my lifetime. I became so used to feeling depressed, embarrassed, and resentful of my body that I just didn’t think feeling any other way was possible.
Now that I know that it is, I cringe to think I lived that way for so long.
One of the only issues with sex after hysterectomy, for me, is that I would want sex so much that when I suggested it at odd times—like at 2 a.m. or right before we had to leave for a trip—it caused tension when my husband wasn’t on the same page (he usually was, though). I don’t know if this is a problem per se, but it has been weird to all the sudden just really want sex when it’s not a great time.
I’m Also Angier
The hormone changes felt almost instantaneous after my surgery. I remember my first “cycle” without my uterus. I got so angry that I slammed my fist against our glass front door, something that would be extremely unlike me before the surgery.
My emotions were all over the place—something I attributed to my hormones after hysterectomy. I became enraged, unhinged, and irritated very quickly when going through the ovulation and luteal phase of my cycle. It got to the point where both my husband and I felt it was a problem, so I scheduled an appointment with my herbalist.
My herbalist thought that since my uterus isn’t there to release progesterone during my “period”, my testosterone is running unchecked in my body and causing me to want sex more and also to be much more moody and angry. She recommended three different tinctures that I took during my luteal phase for a while, and they seemed to help.
However, when I finally talked to an OB/GYN doctor about this, she said the uterus doesn’t actually produce any hormones, just responds to the ones the ovaries produce. When I explained my symptoms to her and my belief that my hormones had changed, she seemed to have no clue why this would have happened and suggested that my hormones did not change, it’s just that my body isn’t so down and out with my period that now I’m just supercharged by the same hormones.
But research shows there’s more to the picture.
3 Reason Our Hormones After Hysterectomy Can Change
After digging deeper into this topic, I’ve learned there are several reasons why hormones after hysterectomy can change, even when ovaries are left intact. While my surgeon assured me nothing would change hormonally, and the OB/GYN I saw later told me it’s unlikely anything HAD changed, the reality seems more complex.
1. Vascular Changes Affect Ovarian Function
While ovaries receive their primary blood supply through the ovarian arteries, they also get collateral circulation from branches of the uterine arteries. Removing the uterus eliminates this secondary blood flow, and removing the fallopian tubes (which I had done) further reduces the interconnected vascular network.
What does the research say?
- Research using Doppler ultrasound shows measurable decreases in ovarian blood flow after hysterectomy, even when ovaries are preserved, which can impact hormone production.
- A large meta-analysis of over 1,400 women found clear evidence that hysterectomy damages ovarian function even when ovaries are preserved, with women showing lower hormone levels and signs that their ovaries were aging faster than expected.
- However, there are other studies showing conflicting results—likely because they measure only basic hormone levels in blood tests rather than the complex symptoms many of us actually experience, and may not follow women long enough to capture all changes.
2. Hormonal Feedback Loops Get Disrupted
The reproductive system relies on complex paracrine signaling—local chemical communication between nearby organs that doesn’t go through general circulation. The hypothalamic-pituitary-ovarian axis evolved expecting feedback from the uterus as it responds to hormonal signals. Without the uterus in this regulatory loop, the precision timing and intensity of hormone release can shift, potentially explaining the dramatic changes many of us experience.
What does the research say?
- Research shows that ovaries communicate with the brain through intricate feedback mechanisms involving multiple hormones that fine-tune cycle timing and intensity—but this system developed expecting the uterus to be a key participant in the conversation.
- Additional research found that reproductive organs constantly produce local chemical messengers (neuropeptides, growth factors, cytokines) that work alongside hormones to regulate everything from ovulation to menstruation, meaning removing the uterus eliminates its contribution to this complex local communication network.
3. Progesterone Processing Shifts
Apparently the uterus acts like a giant sponge, soaking up progesterone each cycle. Without that sponge, progesterone behaves differently in our system, potentially allowing testosterone to have more influence. This could explain both the increased libido and anger that I experience after my surgery.
What does the research say?
- Research shows that the uterus has abundant progesterone receptors (PR-A and PR-B) throughout all its tissues (endometrium, myometrium, and cervix) that actively bind to and respond to progesterone, demonstrating that the uterus is indeed a major target organ that normally processes significant amounts of circulating progesterone.
The Good News? Our Bodies Adapt Over Time
The encouraging news is that most of these changes seem to settle down as your body finds its new equilibrium. My symptoms were most intense in the first 1-2 years and have gradually normalized (for the most part, ha). It appears our bodies are remarkably good at adapting to these changes and finding a new balance.
Final Thoughts
Hear me out: exchanging the massive pain and bleeding I experienced every month for 20 years for these crazy hormones after hysterectomy is a trade I am MORE than happy to live with and would make again in a heartbeat if given the opportunity. While I’m liking being more engaged in sex, the hormone thing has been challenging, but it’s nothing that I feel I can’t handle, especially with help from my herbalist.
Looking back, I wish my surgeon had mentioned that some patients experience hormonal adjustments during the first couple of years, even with ovary preservation. But maybe they didn’t know this?
Have your hormones after hysterectomy changed? Please let me know your experience!
