You probably expect physical changes after a hysterectomy, but don't ignore the emotional ones. Generally, a hysterectomy won't cause emotional problems in an otherwise psychologically healthy woman. And because the surgery often eliminates a chronic source of pain, you may find that you feel happier. Still, some women do become depressed after the procedure. Don’t look for the “right” response; just pay attention to how you feel.

An End to Childbearing

Any major surgery can trigger depression, and a hysterectomy qualifies. After all, it represents an end to your childbearing years. Facing the reality of such as change may prove challenging. Even women with children--or those who never wanted any--may feel sad about this loss. Additionally, if you consider your femininity and your fertility inexorably linked, the loss of fertility could affect your self-esteem and your sense of yourself as "feminine."

Menopause and Estrogen Loss

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A hysterectomy may cause a gradual decline in estrogen levels. If one or both ovaries remain intact, your body continues to produce the hormone but usually at a slower rate. With both ovaries removed, however, estrogen production stops and you enter menopause immediately, without the gradual transition most women get. Estrogen loss--especially a sudden one--can lead to mood swings, depression, crying jags, insomnia and irritability.

Pre-existing Issues

Your likelihood of experiencing psychological and emotional problems after the hysterectomy appear related to whether you suffered from such problems before the surgery. If you faced depression or anxiety before the surgery, you have a higher risk of facing them after surgery. Many women in midlife face major career and family changes. A hysterectomy--especially one that results in menopause--may exacerbate that stress.

Treatment

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Fortunately, many of your negative feelings may pass as you recover from the surgery. Give it time. If they persist, talk to your health-care professional. She can address your concerns or point you to the appropriate counselors or support groups. If the surgery removed your ovaries, resulting in menopause, your clinician may suggest estrogen therapy. She can also help determine whether your emotional changes relate to factors other than the surgery, such as a thyroid condition or clinical depression.

Positive Changes

Of course, a hysterectomy can bring about positive emotional changes. Often, women who have endured chronic pain for years become pain free. And not having to deal with menstruation certainly has its benefits--especially if you experienced heavy bleeding and serious cramps. A hysterectomy can give you that enhanced sense of well-being that accompanies a good sex life. In fact, a Netherlands study reported in the British Medical Journal found that sexual pleasure often improves after a hysterectomy 1.