Early menopause after a hysterectomy? Why it happens

Author: Aunt Vadge
Qualified Naturopath | BHSc(N)

Last reviewed: July 7, 2026

Dear Aunt Vadge,

I had a hysterectomy at 25. They let me keep my ovaries so I wouldn’t go into menopause early. Now I’m having severe night sweats several nights a week, and my energy and drive have really dropped. I’ve also noticed it’s hard to hold my bladder – not that it’s full, but I leak, and sometimes it feels like I’ve wet myself.

Is this normal, or is there more going on? I thought I had at least 10 more years before menopause.

Thank you,
Confused
Age 40, USA

Dear Confused,

You’re not imagining this, and the pieces fit together more neatly than you’ve been led to believe.

The part nobody seems to have told you: keeping your ovaries at hysterectomy usually does preserve hormone production, but removing the uterus can quietly compromise the ovaries’ blood supply, and it’s well recognised that retained ovaries often start declining earlier than they otherwise would, sometimes by several years.

So having ovarian symptoms at 40, after a hysterectomy at 25, is a real and documented thing, not bad luck you’ve invented.

And your two symptoms may share one cause. Night sweats and a flagging libido and energy are classic signs of dropping oestrogen (peri or early menopause), and so is the bladder leakage – the ‘genitourinary’ part of genitourinary syndrome of menopause means low oestrogen also thins and weakens the urethral and bladder-support tissue, which causes exactly the leaking and ‘gotta-go’ feeling you describe. One root, two symptoms.

So go armed. Ask for hormone tests – FSH and oestradiol (FSH climbs as the ovaries wind down) – and tell your doctor about the hysterectomy, asking specifically about early ovarian decline after surgery; ask for a thyroid check in the same blood draw too, since night sweats and fatigue can also be thyroid.

This really matters to pin down, because early menopause is one situation where replacing oestrogen until the natural menopause age actually protects your bones, heart and brain – it’s not just about comfort – and for the bladder specifically, local oestrogen plus pelvic floor work can make a big difference, with some women exploring phyto-oestrogens alongside.

So no, you’re not crazy, and you don’t have to just put up with it – go in with the right questions, because you deserve real answers and real treatment.

Warmest regards,
Aunt Vadge

This is general information based on current research and our clinical experience, not a substitute for personalised medical advice.