If the engine is gone, what's generating the heat?

August 29, 2015 10:35 AM

I'm three weeks post-op from a complete abdominal hysterectomy, perfomed at age 61, so I'm well past menopause. Everything is going very well. Here's my question. Since my ovaries are gone, and this hysto is not an artificially induced menopause, why am still having (extremely mild) hot flashes?

I was so looking forward to a hot flash-free fall and winter, as I'm a lover of wool sweaters and down coats, and was looking forward to being cozy and not hot in these garments.
Don't hot flashes need a signal from the ovaries to "spark?"
Please note, they are only fleeting, and at most, mildly annoying, so I have that to be grateful for.
I know you're not a doctor. But for the sake of this post, pretend, okay?

posted by BostonTerrier to Health & Fitness (6 answers total)

I can't answer the why part of your question, but I can suggest that taking an evening primrose oil and a black cohosh capsule daily has helped me dial down the frequent hot flashes to rare occurrences. Perhaps that would help you?
posted by Lynsey at 11:04 AM on August 29, 2015 [1 favorite]

FWIW my mother had a hysterectomy for cancer about 2 years ago. She's 70ish and still has regular hot flushes. She's resigned to having them long term.
posted by derbs at 12:03 PM on August 29, 2015

Even in menopause, your ovaries still produce trace amounts of estrogen, just not nearly as much as they did pre-menopause. Mild hot flashes and other mild menopause-like symptoms may occur as your body adjusts to the lack of those small amounts of estrogen.

Since you're already post-menopausal, this should pass relatively quickly and you'll be wearing wool sweaters and scarves and sipping hot drinks comfortably this winter. If it keeps bothering you, though, I've got plenty of anecdotal evidence from older friends and family that Lynsey's suggestion of evening primrose oil and black cohosh supplements do indeed help with this sort of thing.
posted by erst at 12:24 PM on August 29, 2015 [1 favorite]

This is a huge oversimplification, but in general menopause symptoms are brought on by changes in hormone levels as the ovaries stop working. Taking both ovaries out in someone pre-menopausal will actually induce menopausal symptoms, not avoid them. Depending on where you were in your menopause process before your surgery, your symptoms could actually get worse now that your ovaries are gone.

Explaining post-hysterectomy symptoms should have been a big part of your preoperative teaching. It sounds like maybe you didn't get as much information as you needed? Please call your physician and ask for more details about this! S/he should absolutely be prepared to explain this to you.
posted by jesourie at 12:31 PM on August 29, 2015 [2 favorites]

This is maybe not a reliable source, sorry, but possibly there is some truth in the numbers - this site (John Lee/Virginia Hopkins linked, authors of the What Your Doctor May Not Tell You About Peri/Pre/Menopause books) says

Estrogen levels decline at menopause, but not to zero. Estradiol falls generally to about 15 percent of premenopausal levels, and estrone falls only 40 to 50 percent of premenopausal levels. Androstenedione, a hormone made in the ovary long after menopause, is converted in body fat into estrone, which is partially converted in the gut and liver into estradiol.

So there is, in theory, still a fair amount of estrogen production difference between a post-menopausal woman and a post-menopausal woman who's just had her uterus and ovaries out.
posted by you must supply a verb at 4:04 PM on August 29, 2015 [1 favorite]

Echoing above, even after menopause your ovaries continue to produce hormones but in a lower amount than pre-menopause. After your hysterectomy you lost that "buffer" level.
If your symptoms are mild, black cohosh capsules may help. My internist recommended them for me and I had some success but I ended up going on 1mg estradiol daily since I was also having a bit of unnecessary rage over things like people being nice to me.
Friends of mine have said that their more mild symptoms have faded as they got further along in their recoveries. As health care workers, we just love to exchange our signs & symptoms! Best of luck for a speedy, flash-free recovery!
posted by notaninja at 9:29 AM on August 30, 2015