Hysterectomy at 40: the Good and the Bad

What to Expect

One woman's odyssey through the Trump presidency. My focus is centered on the many issues affecting women--but what doesn't? There's a new post every week.

Antonia has had a varied career. She started out working in museums and then began her own business, first as an exhibition designer and most recently managing the career of a very successful artist.

Her job requires frequent international travel and, when they are not in school, her sons have been lucky enough to travel with her, making them very sophisticated young men. But things were not always easy–far from it. She had a difficult pregnancy with the twins that ended in a traumatic Caesarian, followed by a serious cancer scare, all of which had a huge effect on her body…
My name is Antonia and I’ve just turned 54. My profession is creative visual and literary media management. Where I am on the menopause scale is difficult for me to evaluate because I’ve prolonged and shortened it by having a total hysterectomy at the age of 40.

I don’t recall anything that made me overly conscious or aware of the process of menopause when I was growing up, though my mother had serious migraines and relatively severe temper flare-ups—it was something I’d characterize as her being extremely stressed in her middle years. We only truly become aware of our parents as people in our late teens or early twenties, when we begin to notice aspects of their personalities that are different from other parents—before that, they’re just kind of our parents, and we’re not overly cognizant of much else having to do with them beyond that fact. My mother was always fairly tightly wound, but her menopause coincided with my father dying of pancreatic cancer so I’m not certain we could separate any of that out as far as cause and effect were concerned. But she suffered terribly with migraines that were probably directly associated with her changing body chemistry. She’s 78 now and rarely has them any longer, which would be an indication to me that it was something of the time. I did have one aunt who stopped using alcohol very suddenly, and that may have had something to do with menopause or her particularly sensitive disposition, or a combination of the two. She’d been a noticeably heavy drinker for a while, possibly brought about by losing her first son when he was young, but she stopped cold turkey one day without ever talking to anyone about it. That generation never shared their feelings about personal matters, and one of them was definitely menopause—it was considered to be an embarrassing condition that signified you were aging and losing your femininity. My husband once read an article from that era propounding the received wisdom that men would light up in the company of women who were still having their periods and feel especially attracted to them, and that kind of prevailing mentality would have further constrained women from talking about reproductive issues whenever possible. That world probably still exists somewhere to this day, but certainly not among the people I hang around with.

It was a relief, because I’d had such heavy per heavy periodsiods after my twins were born—I’d lose so much blood and be totally incapacitated and horribly ill…

I was rather upset about having to lose my womb in terms of its link to my identity, especially after having given birth, not to speak of the fact that it represented a large material part of my insides. I’m not sure I was planning on having more children, but you never want that kind of decision to be made that way. And I was anticipating I’d feel like that part of me was gone, because it was uterus, cervix and ovaries—everything gone. But in some respects it was a relief, because I’d had such heavy periods after my twins were born—I’d lose so much blood and be totally incapacitated and horribly ill—and then right away I no longer dreaded it, and that was the biggest plus in the end. On the other hand, I didn’t sleep at all, and early on I lost a huge amount of weight and felt agitated and restless. I was determined not to take any drugs for it, but that resolution lasted for about two months and then I broke down, tried a number of medications, and ended up on Estradiol. I’ve never been a good sleeper, and with the onset of this I became very much of an insomniac—I could easily stay wide awake all night, and had to devise a whole variety of tricks to make myself sleep better, like moving around to different bedrooms. And my husband arranged our family schedule to avoid morning activities so I could grab a few hours of rest then if necessary, which was often the case. And of course there was a big change in my weight, which came on as soon as I healed from my hysterectomy surgery, and that was very tough to take. I had never been above a size four—the old size four which is now a zero—and it was a rude awakening to grow into a size eight in the following years.

We were making contingency plans as to what would happen in case my husband ended up as a widower with young twins.

The best way for me to explain my general feeling in menopause would be that it was the opposite of how I felt in puberty—menopause left me stressed and feeling exhausted and nauseous from lack of sleep. And I felt much older than I’d ever felt before going through it, and much less likely to exercise and be active. I’ll say though that most of those negatives were tempered by finding out I didn’t have cancer, which I’d been warned was a very real possibility before undergoing my surgery—at the time all those problems seemed minor by comparison to the prospect of having cancer. And I had two four-year-old boys by then, and we were making contingency plans as to what would happen in case my husband ended up as a widower with young twins, how would he manage the day-to-day implications and practical aspects of going through that. But hearing that I didn’t have major uterine cancer really put things into perspective, and it wasn’t until considerably later that I realized how greatly I was impacted by the hysterectomy itself.

My relationship with my husband certainly changed. I went to my gynecologist frequently before, during and after that time, and I was one of those women who experienced a complete loss of sex drive. I felt badly about that but the bodily physical loss made for a profoundly distinct change there. I tried to find ways to get my libido back but sex became more of a duty than a pleasure, and that was a significant change both for me personally and in our marriage. Several of my physicians suggested to me that catastrophic childbirth—catastrophic in the sense that I was two months early, and I had C-section surgery while still essentially being in labor—is exceedingly traumatic, and it was brutal and violent and extraordinarily painful. And consequently I had internal bleeding and they had to open me up again the next day to cauterize a leaking vein—so all that could have been an added ingredient in my loss of sex drive.

It’s amazing that any of us live through all these realities and come out of them sane or even survive the way we do.

Going through something like that can fairly well shut you down, like a physiological mechanism of your body signaling your brain that having sex leads to babies and having babies could be existentially threatening to all of us. There’s a great deal of literature about the womb having a cellular memory, and the findings are that almost ninety per-cent of women who’ve had premature births tend to repeat that as a pattern, and certainly that has cumulative implications in life and relationships. There’s really not much you can do about it, though many physicians meekly suggest sticking with sexual intimacy so that just maybe it becomes more interesting. It’s amazing that any of us live through all these realities and come out of them sane or even survive the way we do.

As far as my professional life being affected or altered by menopause, certainly my insomnia has led me to start working from home; in my interactions professionally with other people no, I wouldn’t say there was any change in that. But again learning that you don’t have cancer redefines your priorities and you grow up a lot faster, and having the extreme and sudden change of less estrogen and progesterone coursing around inside probably does calm you down quite a bit. I didn’t have any more of those slightly weepy out-of-control feelings prior to the onset of my periods so I suppose in that respect I was less emotional than before. And I find that my ability to focus now is quite good, even after some of the fog and spaciness I had with being pregnant where my brain tuned-out a little and I could even fall sleep like a normal person for the fist time in my life. I have difficulty separating the sense of clarity and focus I have now from the compensations of maturity; on what level my lucidness has to do with menopause or post-menopause, or what it has to do simply with experience and maturity is not so cut-and-dried. I have razor-like focus when I need to and can multi-task with the best of them, but I don’t know precisely what that’s attributable to.

I have a lot of male friends now too, men who in earlier days I would have been hesitant to ring up and go out with because societally it’s thought to be a little odd for married women to approach men and ask them out for a drink.

If I’ve changed in any useful ways, though not useful to my husband, perhaps that’s happened with my friendships. When I was younger I didn’t look forward to meeting people or pursue opportunities to do that, but I think there’s part of the sisterhood that evolves where you begin to seek out female friends more than before. And I have a lot of male friends now too, men who in earlier days I would have been hesitant to ring up and go out with because societally it’s thought to be a little odd for married women to approach men and ask them out for a drink. But I do that all the time these days and I love it, and it’s partially an outcome of having a lower level of sexual desire and not responding to that part of myself as much anymore. It’s easier for me to not have temptation, and partly because of that I feel more independent and confident about myself in social situations.

Whenever I’ve spoken to anyone who has gone through menopause it’s been mostly with my mother or my mother-in-law. My mother said, well, you’re not going to miss your period at all. And my mother-in-law said, oh, don’t worry about that at all—nothing changes, and you’ll still want sex. That was basically the extent of it. And then when it shifted to trying to figure out a bearable way to live after the shock to my system of a hysterectomy I found out what worked and went along my way. I think menopause per se would be a much bigger deal for me now than it was then, because at the time it was only something relative to other potentially worse and scarier eventualities and it didn’t hold the place of a main event.

If I’m with a group of women and there are no men around—like in my Pilates class– and someone’s having a hot flash and has to stop and needs some water, menopause will come up and they’ll talk about a lot of the natural remedies, and I always find that interesting to hear. But since I’ve found my own balance with just a little bit of Paxil and a little bit of Estradiol I feel relatively chemically and hormonally like I did before, and I listen and wonder what it would have been like to go through it at the same time as these other women—how nice that would have been, because it’s pretty lonely out there the way it happened to me. Menopause is so singular it’s hard to give advice in the broader sense of the word, and most women seem to have had more experience with it than I did. Nevertheless nowadays menopause as a stigma is largely a thing of the past, and it’s actually acceptable to be an aging woman, and a more sympathetic and forgiving environment exists in our society for older women to function in productive and purposeful ways.

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