A hysterectomy is a surgical procedure involving the removal of the uterus. In some cases, it may also include the removal of the ovaries and fallopian tubes. This relatively common procedure is often recommended for women, particularly those between 40 and 50 years old, as a treatment for chronic pain or various diseases. While the surgery itself isn't a direct cause of weight loss, many women experience changes in their weight following a hysterectomy. This article explores the reasons behind these weight fluctuations, potential side effects, and lifestyle adjustments to promote a healthy recovery.
What is a Hysterectomy?
A hysterectomy is the removal of the uterus, sometimes including the ovaries and fallopian tubes. It is a relatively common procedure in the United States, especially for women between 40 and 50 years old and can be the best treatment for chronic pain or disease. Some conditions that may require a hysterectomy include:
- Uterine fibroids: These noncancerous growths in the uterus can cause heavy periods, prolonged bleeding, and lower back or pelvic pain. Obesity and a family history of fibroids are risk factors. This is the most common reason for a hysterectomy.
- Endometriosis: This condition involves uterine tissue growing outside the uterus, typically in the lower pelvic region but potentially anywhere in the body. This tissue thickens and bleeds during the menstrual cycle, causing pain.
- Uterine prolapse: This occurs when the uterus slips down into or protrudes out of the vagina.
Weight Changes After Hysterectomy
Many women experience weight fluctuations after a hysterectomy. While the surgery itself doesn't directly cause weight loss, it can influence appetite and activity levels, leading to changes in weight.
Weight Loss After Hysterectomy
Weight loss isn’t a direct side effect of a hysterectomy. If you experience a few days of nausea following a major surgery, this can be a result of pain or a side effect of the anesthesia. For some, this can make it hard to keep food down, resulting in temporary weight loss.
Some women may experience weight loss after a hysterectomy, but it’s not the operation itself that causes it. Removing the uterus and the alleviation of subsequent pain may lead to a decrease in appetite, resulting in weight loss. Losing weight after a hysterectomy is fairly common, but if you were underweight before the surgery or experience rapid weight loss afterward, consult your doctor.
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Nausea is a common side effect after a hysterectomy, making it difficult for many women to eat in the days following the procedure. This can also lead to a loss of appetite during the healing process. If you aren’t able to eat or are constantly vomiting, however, you should consult with your doctor. The process of throwing up may cause more pain and affect the healing of your hysterectomy. If you aren't able to eat, you may not be getting the nutrients your body needs to heal.
Hysterectomy is also a common treatment for several kinds of cancer. Cancer itself can cause weight loss simply due to the effects of the disease.
The misconception that a hysterectomy leads to weight loss may be linked to the use of hysterectomies to treat several types of cancer, including cervical, uterine, ovarian, and endometrial cancer. In some cases, this surgery is used in conjunction with chemotherapy, which has side effects like nausea, vomiting, and weight loss.
Hysterectomies also help reduce chronic pain and heavy bleeding caused by fibroids, endometriosis, and other conditions. When these symptoms resolve after surgery, you might find that you have a lot more energy for physical activity, potentially leading to weight loss.
If you’ve recently had a hysterectomy and lost a lot of weight, follow up with your doctor, especially if you can’t think of any other factors that may be causing it.
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Weight Gain After Hysterectomy
For women who had a loss of appetite and nausea before their hysterectomy as a side effect of their medical condition, removing the uterus may alleviate nausea and increase their appetite. These women may be able to eat more or may find eating more pleasurable now that they aren’t experiencing chronic pain or discomfort. Women who were used to an active lifestyle may gain weight after a hysterectomy, especially if the procedure was performed as an abdominal surgery rather than a vaginal hysterectomy. Regardless of the circumstances, if your activity level has decreased, but you’re eating the same number of calories, you will likely gain weight. If you notice you’re gaining weight, keep a close eye on the calories you consume, focusing on whole, healthy foods, especially lean meats and colorful fruits and vegetables. These foods also have plenty of nutrients to help your body heal.
Another reason for weight gain after a hysterectomy may have to do with your condition before the surgery. Some of the health conditions that require a hysterectomy for treatment may be aggravated by obesity (BMI of 30 or greater). Obese women may have certain habits, such as poor diet or a sedentary lifestyle, that encourage weight gain. As part of your pre-surgical consultation, your doctor may recommend that you lose weight, not only to minimize surgical complications or complications from anesthesia, but also to give you a jump-start on healthy habits that can help you lose weight after a hysterectomy. Women who have had weight fluctuations throughout their life may also experience weight gain after a hysterectomy. Compared to women who begin menopause with their ovaries and uterus intact, premenopausal women who have had their uterus removed (without their ovaries removed) have a higher incidence of weight gain during menopause. If you have a total or radical hysterectomy that removes your ovaries, you’ll experience menopause immediately after your operation, regardless of your age.
While a hysterectomy isn’t directly linked to weight loss, it may be related to weight gain in some people. A 2009 prospective study suggests that premenopausal women who’ve had a hysterectomy without the removal of both ovaries have a higher risk for weight gain, compared with women who haven’t had the surgery. More research is needed to fully understand the potential link between hysterectomies and weight gain.
If you do have your ovaries removed during the procedure, you’ll immediately enter menopause. This process can last for several years, but women gain an average of 5 pounds after going through menopause.
You might also gain some weight as you recover from the procedure. Depending on the approach your doctor uses, you’ll need to avoid any strenuous activity for four to six weeks. You can still move around during this time, but you’ll want to hold off on any major exercise. If you’re used to exercising regularly, this break could have a temporary impact on your weight.
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Weight gain after a hysterectomy is common and can be attributed to several physiological and lifestyle factors. One primary reason is a slower metabolism, particularly if the ovaries were removed during the procedure, as this induces surgical menopause and reduces estrogen production. This hormonal shift not only decreases metabolic rate but also leads to fat redistribution, often resulting in increased abdominal fat storage. Additionally, the necessary recovery period significantly limits physical activity levels, creating a calorie imbalance that promotes weight gain. The combination of these factors creates a perfect storm for weight management challenges.
The loss of estrogen affects how the body processes insulin and stores fat, while reduced activity during healing slows calorie expenditure. Poor sleep quality, a common postoperative issue, exacerbates these effects by altering hormone balance and energy levels.
Other Side Effects of a Hysterectomy
As with any surgery, you may experience a reaction to anesthesia, infection, pain and soreness at the surgical site, and fatigue. The side effects from the surgery will depend on which procedure, vaginal or abdominal, you had. Other short-term effects may include:
- Pain, bleeding, and soreness in your lower abdomen or vagina
- Infection
- Low libido
- Blood clots in the legs or lungs
- Constipation
- Bladder problems such as not being able to empty the bladder completely or losing the feeling of having to urinate
Some side effects from a hysterectomy are long term, developing months or even years after the procedure. Some long-term side effects include:
- Lymphedema, which is a buildup of lymph fluids in the legs or abdomen. If lymph nodes are removed along with your uterus, you may have a higher risk of developing this condition. It’s characterized by swelling and soreness and may not occur equally in both legs or on both sides of the abdomen.
A hysterectomy can have several side effects that aren’t related to your weight. If you still had your period before your hysterectomy, you’ll stop getting it after your surgery. You also can’t get pregnant after a hysterectomy. The loss of both fertility and mensuration is a benefit to some. But for others, it can cause a sense of loss.
If you go into menopause after the procedure, you might also experience:
- Insomnia
- Hot flashes
- Mood swings
- Vaginal dryness
- Decreased sex drive
The procedure itself can also cause short-term side effects, such as:
- Pain at the incision sites
- Swelling, redness, or bruising at the incision site
- Burning or itching near the incision
- A numb feeling near the incision or down your leg
These should gradually decrease and eventually disappear as you recover.
Lifestyle Tips After a Hysterectomy
Your physician will recommend good lifestyle habits to follow to ensure a healthy recovery from a hysterectomy and reduce long- and short-term side effects. In general, these will include following a healthy diet, including whole foods, and avoiding refined sugar and processed foods. If you aren’t sure how to lose weight after a hysterectomy, ask your doctor or a dietitian to help you with meal plans.
To reduce your risk of gaining weight after a hysterectomy, ask your doctor about the safety of physical activity. Depending on your recovery from the procedure and your overall health, you may be able to start doing low-impact exercises after a few weeks. Swimming and water aerobics are ideal exercises that can usually be resumed within two to three weeks, provided that vaginal bleeding and discharge have stopped. If you build up gradually, you can expect to be back to previous activity levels within four to six weeks. Other examples of low impact exercises include:
- Yoga
- Tai chi
- Walking
- Cycling
- Rowing
- Pilates
It’s also important to focus on your diet after a surgery - both to avoid weight gain and to support your body as it heals. Try to limit junk foods while you recover. When possible, swap them out for:
- Whole grains
- Fresh fruits and vegetables
- Lean protein sources
Also keep in mind that a hysterectomy is major surgery, so try to cut yourself some slack and focus on your recovery. You’ll be feeling better within a few weeks, even if you gain a few pounds in the process.
In addition to lean meats and fresh fruits and vegetables, include whole grains and make sure to get plenty of calcium. Women who enter menopause, and those who have completed menopause, are at a higher risk of osteoporosis. Good exercise habits are another component of weight loss after a hysterectomy. Follow your doctor’s orders for physical activity, and begin with lower-impact exercises, such as pool workouts, to avoid straining your body as it heals. You may also find added health benefits from meditation or other stress-management techniques.
Finally, some women experience grief and loss after having their uterus removed.
Nutritional Strategies for Weight Management
Following a hysterectomy, adopting a nutrient-rich diet is essential for optimal healing, hormone balance, and weight management. Prioritize lean proteins such as chicken, fish, and tofu, which provide essential amino acids to support tissue repair and maintain muscle mass-especially important as metabolism may slow post-surgery. Incorporate whole grains like quinoa and brown rice for sustained energy and fiber, which aids digestion and helps regulate blood sugar levels. Load up on a variety of vegetables and fruits, as their antioxidants reduce inflammation and speed recovery, while their fiber content promotes fullness and gut health. Staying well-hydrated is equally crucial; water not only supports metabolism but also helps flush excess fluids, reducing post-operative bloating. On the other hand, it’s best to avoid excessive caffeine and alcohol, as these can disrupt hormone balance and interfere with restorative sleep-a key factor in recovery and weight regulation.
To maintain a healthy weight after a hysterectomy, a strategic approach to nutrition is vital. Emphasize high-protein meals, such as eggs, legumes, and lean meats, to preserve muscle mass and keep metabolism active, counteracting the potential slowdown caused by hormonal changes. Fiber-rich foods, including leafy greens, berries, and whole grains, enhance digestion, stabilize blood sugar, and promote satiety, preventing overeating. Don’t shy away from healthy fats-avocados, nuts, seeds, and olive oil support hormone production and provide long-lasting energy. At the same time, limit processed sugars and refined carbohydrates, which can spike insulin levels and worsen hormonal weight gain, particularly around the abdomen. Reducing sodium intake is another key step, as it helps decrease water retention and bloating, which are common post-surgery.
Exercise and Physical Activity
When it comes to exercise after a hysterectomy, it’s important to start slow with gentle activities like walking and light stretching until your doctor gives clearance, which typically takes 6-8 weeks. Once approved, incorporating strength training becomes valuable to help offset muscle loss that can occur due to hormonal changes and aging.
Hormone Replacement Therapy (HRT)
For optimal hormonal support after a hysterectomy, it’s important to consult your doctor about hormone replacement therapy (HRT) if your ovaries were removed, as this can help regulate metabolism and ease menopausal symptoms.
Personal Stories
Many women experience weight changes after hysterectomy. To all the women reading this - I want you to know that this is your chance to become your strongest self no matter how scary it seems right now. I’ve spent almost 10 years struggling with heavy periods. My periods have negatively impacted my ability to make a living. The heavy bleeding is affecting my mental health. I’m stuck in the house for at least a week every month - often longer - and the isolation and inability to do anything, including training, leaves me feeling disheartened and depressed. It’s taken a huge toll on my relationship because at first it was about not being able to do anything but then it became more about my moods when I was stuck at home. I started to envy and resent that my partner could have a life when I was stuck at home all the time. I got annoyed when he said he was too tired to go to the gym when I was dying to be able to train. Chronic low iron is also affecting my physical health. I worry mostly about the impact on my heart (over time low iron can have some negative effects on your heart). My iron is so low that any intense cardio is a complete no-go for me. I usually only take shorter, slower walks so as to not put extra stress on my body. I have to take time off from training every month and I also can’t train hard. I’ve lost weight and muscle in the past year. It all sucks. It made me realize just how bad it has been. People who care about me have been silently watching my energy and life stolen away from me and hoping I’ll do something about it. Yet I clung to my uterus and the idea that I could manage it. I never, ever, ever wanted a hysterectomy.
One day a client gave me a motherly lecture telling me I needed to get myself sorted out. As luck would have it, her partner was a well-respected doctor and I didn’t have a good doctor at the time. I avoid doctors if possible. Two weeks later I found myself getting an ultrasound for what I thought was one or maybe a few fibroids. However, as the sonographer explained my uterus now had innumerable fibroids. I had so many fibroids she didn’t even know where to start in terms of measuring them for her report. There was no other option. I had so many fibroids the only option was going to be a hysterectomy. If I kept my uterus, I was going to be in big trouble and I don’t think I had much time. I was starting to be able to feel the pressure from the fibroids in my pelvic area and the bleeding was out of control. So, actually, I guess I didn’t really choose to get a hysterectomy. Not having a choice was probably the best possible outcome in my case. Otherwise, I would have delayed surgery and tried to find other alternatives. I asked my doctor to designate my case as urgent and immediately contacted a surgeon (I had private insurance which meant I could move faster). There was less than three weeks between getting the ultrasound and my hysterectomy. And that was good because I’m highly anxious about doctors, hospitals and especially surgery. The short turn around meant I was so busy organizing my life that I had less time to worry.
I thought I would feel sad for losing my uterus. Over the years I have held on so hard to it and never wanted a hysterectomy. Instead I felt sadness for what I had endured for the last couple of years. For the last ten years or so. It’s been so exhausting being knocked down month after month. I’ve been stuck in the house for the past year because I’m bleeding so much. I feel uncomfortable in my own body most of the time now. I feel unattractive and like I’ve lost my femininity. I wear black clothes and long loose shirts all the time. One of the worst things has been not being able to train. Fortunately I have my own training space because the gym is often not an option. Even when I do work out, because of my chronically low iron, I can’t train hard and I’m losing muscle. I don’t have a lot of hobbies and other activities so not being able to set goals in the gym, train hard and be consistent has very negatively impacted my quality of life. My fibroids have literally been sucking the life out of me and the rest of my body.
In the lead up to my surgery I stayed out of forums and off Google for the most part but I let myself read or watch one positive hysterectomy story everyday. As I write this blog post I am three weeks post surgery. I’m feeling reasonably good and hopeful. In my initial meeting with my surgeon he said that about three months after my hysterectomy I’m going to have an epiphany about how amazing I feel compared to how it’s been. I’m already rocking colored tights again and I’ve thrown out the pads and granny undies. Even though I’m still recovering, I feel more feminine and energetic than I did when I was having periods. Deciding to have a hysterectomy is deeply personal and I am not trying to sway you in either direction.
Anique’s Story
Anique is a real Flo member. She was pregnant with her first son when she was diagnosed with uterine fibroids in 2001. She was serving in the Navy at the time, and she finally understood why she'd been struggling to keep her weight at a certain threshold: it wasn't her diet or her fitness - it was the fibroids.
For years after that, she had incredibly heavy, painful periods. Every month it was like cleaning up a crime scene. She used those big hospital pads, and she was still scared of the bleeding. She had to keep running back and forth to the bathroom to check on it. But she didn't seek medical care because she thought it was normal, and she was focused on raising her two kids, having a family.
Then her husband passed away suddenly from a brain aneurysm at age 34. That year, the pain from the fibroids became unbearable, maybe from the stress and grief. She came to realize that she was the only parent her sons had left, and it was her responsibility to take care of her health. When her boys were 12 and 14 years old, she finally decided to pay attention to herself.
She didn't have health insurance at the time because her husband had been their family's provider. So, she waited until she got a new job working at the University of Memphis, and then she went to her gynecologist. She walked right into the room and told her, “I need a hysterectomy." Her doctor was surprised, but when she lay down on the table and she touched her stomach, she said, "Yeah, you're a great candidate." Her doctor could tell just from an external exam how bad her fibroids were. She told her the pain was getting to be too much. There was a family connection - her mom and both of her sisters had fibroids as well. Her twin sister had gotten a hysterectomy a few years back, and she’d urged her to get one. She kept ignoring her, telling her she’d be fine, but the fibroids were getting bigger and she knew it was time. After 17 years, she couldn’t be in pain anymore.
She scheduled the surgery for October 2018. Right afterward, she could feel the difference in her body. Her gynecologist told her she had seven to eight fibroids, and she’s a tiny person, 5 feet 3 inches. She didn’t know how she’d lived like that. It was like she’d been eight months pregnant. For years, she’d been working out with a trainer, getting into great shape, but she still couldn’t lose weight or reach her fitness goals. She would do sit-ups with her trainer, but the pain was horrible. Now she can do core workouts without pain. She can finally see her abs! And she doesn’t have to worry about monthly crime scenes. Her granny panties are in the landfill, along with the hospital pads.
But the first weeks after the surgery were pretty rough. She wasn't able to work out, and she lost a lot of muscle. She was dealing with painful stitches because she’d had an abdominal hysterectomy. The surgeon cut her open like a fish - the fibroids were so big it was the only way to remove them. One downside was she still felt like she was having her period. She had all the symptoms: PMS, bloating, moodiness, body temperature changes. Eventually her hormones found their balance, but it took months. She still has her ovaries, although everything else is gone.
She tells women who are scheduling a hysterectomy to have everything planned out ahead of time. Make sure you have snacks next to your bed in a cooler, lots of water, books, movies and pillows to support you when you’re coughing post-surgery. You’ll need a friend or family member to help out, because there will be things you won’t be able to do initially - like get out of bed. She was blessed to have her teenage sons help her during her recovery and a great support system of friends.
She talks openly about her hysterectomy because women don’t talk about these things. There’s a taboo around female bodies, and she’s tired of the taboo. We need to speak honestly about our uteruses - they’re a part of our womanly experience. Getting the hysterectomy was the best decision she’s ever made. It’s been almost two years, and she’s in the best shape of her life. She’s training hard and competing in Spartan races in honor of her husband, who was a fitness junkie. He was training for a Spartan race before he died, and he encouraged her to challenge herself. Since he passed, her perspective has changed. Everything that she’s afraid to do, she’s going to do it.
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