What is a hysterectomy?

A hysterectomy is a surgical procedure to remove the womb (uterus). You’ll no longer be able to get pregnant after the operation. If you haven’t already gone through the menopause, you’ll no longer have periods, regardless of your age. The menopause is when a woman’s monthly periods stop, which usually occurs from the ages of to 45 to 55. Around 30,500 hysterectomies were carried out in England in 2012 and 2013. It’s more common for women aged 40-50 to have a hysterectomy.

Why do I need a hysterectomy?

Hysterectomies are carried out to treat conditions that affect the female reproductive system, including:

Heavy periods

Chronic pelvic pain


Large ovarian cysts in post-menopausal women

Ovarian cancer, uterine cancer, cervical cancer or cancer of the fallopian tubes

A hysterectomy is a major operation with a long recovery time and is only considered after alternative, less invasive, treatments have been tried.

Why is a hysterectomy is necessary?

A hysterectomy is a major operation for a woman that’s only recommended if other treatment options have been unsuccessful.

The most common reasons for having a hysterectomy include:

Heavy periods – which can be caused by fibroids, for example

Pelvic pain – which may be caused by endometriosis, unsuccessfully treated pelvic inflammatory disease (PID), adenomyosis or fibroids

Prolapse of the uterus

Cancer of the womb, ovaries or cervix

Heavy periods

Many women lose a large amount of blood during their monthly periods. They may also experience other symptoms, such as pain and stomach cramps. For some women, the symptoms can have a significant impact on their quality of life. Sometimes heavy periods can be caused by fibroids, but in many cases there’s no obvious cause. In some cases, removing the womb may be the only way of stopping persistent heavy menstrual bleeding when:

  • Other treatments haven’t worked
  • The bleeding has a significant impact on quality of life and it’s preferable for periods to stop
  • The woman no longer wishes to have children

Pelvic inflammatory disease (PID)

A hysterectomy to remove the womb and fallopian tubes may be recommended if a woman has severe pain from PID and no longer wants children.


A hysterectomy may remove the areas of endometrial tissue causing the pain. However, it will usually only be considered if other less invasive treatments haven’t worked and the woman decides not to have any more children.


A hysterectomy may be recommended if you have large fibroids or severe bleeding and you don’t want to have any more children.


A hysterectomy can cure adenomyosis, but will only be considered if all other treatments have failed and you don’t want to have any more children.

Prolapse of the uterus

A prolapsed uterus happens when the tissues and ligaments that support the womb become weak, causing it to drop down from its normal position.

Symptoms can include:

  • back pain
  • a feeling that something is coming down out of your vagina
  • leaking urine (urinary incontinence)
  • difficulty having sex

A prolapsed uterus can often occur as a result of childbirth.

A hysterectomy resolves the symptoms of a prolapse because it removes the entire womb. It may be recommended if the tissues and ligaments that support the womb are severely weakened and the woman doesn’t want any more children. Mr Chattopadhyay will usually refer you to a specialist uro-gynaecologist if you require a vaginal hysterectomy with pelvic floor repair (http://www.nhs.uk/Conditions/Prolapse-of-the-uterus/Pages/Treatment.aspx).


A hysterectomy may be recommended for the following cancers:

How do I make a decision whether to have a hysterectomy?

If you have cancer, a hysterectomy may be the only treatment option. For other conditions, it’s a good idea to ask yourself the questions listed below before deciding to have the procedure.

  • Are my symptoms seriously affecting my quality of life?
  • Have I explored all other alternative treatment options?
  • Am I prepared for the possibility of an early menopause?
  • Do I still want to have children?

Don’t hesitate to ask Mr Chattopadhyay as many questions as you want. If you have a hysterectomy, as well as having your womb removed, you may have to decide whether to also have your cervix (neck of the womb) and your ovaries removed. Your decision will usually be based on your personal feelings, medical history and any recommendations your general practitioner (GP) and Mr Chattopadhyay may have. You should research the different types of hysterectomy and their implications.

What are the things to consider before having a hysterectomy?

If you have a hysterectomy, as well as having your womb removed, you may have to decide whether to have your cervix and your ovaries removed.

These decisions are usually made based on:

  • your medical history
  • your doctor’s recommendations
  • your personal feelings

It’s important that you’re aware of the different types of hysterectomy and their implications.

Removal of the cervix (total or radical hysterectomy)

If you have cancer of the cervix, ovarian cancer or womb (uterus) cancer, you may be advised to have your cervix removed to stop the cancer spreading. Even if you don’t have cancer, removing the cervix means there’s no risk of developing cervical cancer in the future. Many women are concerned that removing the cervix will lead to a loss in sexual function, but there’s no evidence to support this.

Some women are reluctant to have their cervix removed because they want to retain as much of their reproductive system as possible. If you feel this way, ask Mr Chattopadhyay whether there are any risks associated with keeping your cervix.

If you have your cervix removed, you’ll no longer need to have cervical screening tests. If you don’t have your cervix removed, you’ll need to continue having regular screening for cervical cancer (cervical smears).

Removal of the ovaries (salpingo-oophorectomy)

The National Institute for Health and Care Excellence (NICE) recommends that a woman’s ovaries should only be removed if there’s a significant risk of associated disease, such as ovarian cancer. If you have a family history of ovarian or breast cancer, removing your ovaries and fallopian tubes (risk reduction bilateral salpingo-oophorectomy) may be recommended to prevent cancer occurring in the future. Mr Chattopadhyay can discuss the pros and cons of removing your ovaries and fallopian tubes with you.

If you’ve already gone through the menopause or you’re close to it, removing your ovaries may be recommended regardless of the reason for having a hysterectomy. This is to protect against the possibility of ovarian cancer developing.

Some surgeons feel it’s best to leave healthy ovaries in place if the risk of ovarian cancer is small – for example, if there’s no family history of the condition. This is because the ovaries produce several female hormones that can help protect against conditions such as osteoporosis (weak and brittle bones). They also play a part in feelings of sexual desire and pleasure.

If you would prefer to keep your ovaries, make sure you’ve made this clear to Mr Chattopadhyay before your operation. You may still be asked to give consent to treatment in regards to having your ovaries removed if an abnormality is found during the operation.

Think carefully about this and discuss any fears or concerns that you have with Mr Chattopadhyay.

Surgical menopause

If you have a total or radical hysterectomy that removes your ovaries, you’ll experience the menopause immediately after your operation, regardless of your age. This is known as a surgical menopause.

If a hysterectomy leaves one or both of your ovaries intact, there’s a chance that you’ll experience the menopause within five years of having the operation.

Although your hormone levels decrease after the menopause, your ovaries continue producing testosterone for up to 20 years. Testosterone is a hormone that plays an important part in stimulating sexual desire and sexual pleasure.

Your ovaries also continue to produce small amounts of the hormone oestrogen after the menopause. It’s a lack of oestrogen that causes menopausal symptoms such as:

  • hot flushes
  • depression
  • vaginal dryness
  • insomnia (sleep problems)
  • fatigue
  • night sweats

Hormone replacement therapy (HRT) is usually used to help with menopausal symptoms that occur after a hysterectomy.

Hormone replacement therapy (HRT) (http://www.nhs.uk/conditions/Hormone-replacement-therapy/Pages/Introduction.aspx)

You may be offered HRT after having your ovaries removed. This replaces some of the hormones your ovaries used to produce and relieves any menopausal symptoms you may have.

It’s unlikely that the HRT you’re offered will exactly match the hormones your ovaries previously produced. The amount of hormones a woman produces can vary greatly, and you may need to try different doses and brands of HRT before you find one that feels suitable.

Not everyone is suitable for HRT. For example, it’s not recommended for women who have had a hormone-dependent type of breast cancer or liver disease. It’s important to let Mr Chattopadhyay know about any such conditions that you’ve had.

If you’re able to have HRT and both of your ovaries have been removed, it’s important to continue with the treatment until you reach the normal age for the menopause (51 is the average age).

Types of hysterectomy

There are various types of hysterectomy. The type you have depends on why you need the operation and how much of your womb and surrounding reproductive system can safely be left in place.

The main types of hysterectomy are:

  • total hysterectomy – the womb and cervix (neck of the womb) are removed; this is the most commonly performed operation
  • subtotal hysterectomy – the main body of the womb is removed, leaving the cervix in place
  • total hysterectomy with bilateral salpingo-oophorectomy – the womb, cervix, fallopian tubes (salpingectomy) and the ovaries (oophorectomy) are removed
  • radical hysterectomy – the womb and surrounding tissues are removed, including the fallopian tubes, part of the vagina, ovaries, lymph glands and fatty tissue

There are three ways to carry out a hysterectomy:

  • abdominal hysterectomy – where the womb is removed through a cut in the lower abdomen
  • laparoscopic hysterectomy (keyhole surgery) – where the womb is removed through several small cuts in the abdomen
  • vaginal hysterectomy – where the womb is removed through a cut in the top of the vagina

How is a hysterectomy performed?

There are different types of hysterectomy. The operation you have will depend on the reason for surgery and how much of your womb and reproductive system can safely be left in place.

The main types of hysterectomy are described below.

Total hysterectomy

During a total hysterectomy, your womb and cervix (neck of the womb) is removed.

A total hysterectomy is usually the preferred option over a subtotal hysterectomy, because removing the cervix means there’s no risk of you developing cervical cancer at a later date.

Subtotal hysterectomy

A subtotal hysterectomy involves removing the main body of the womb and leaving the cervix in place. This procedure isn’t performed very often. If the cervix is left in place, there’s still a risk of cervical cancer developing and regular cervical screening will still be needed.

Some women want to keep as much of their reproductive system as possible, including their cervix. If you feel this way, talk to Mr Chattopadhyay about any risks associated with keeping your cervix.

Total hysterectomy with bilateral salpingo-oophorectomy

A total hysterectomy with bilateral salpingo-oophorectomy is a hysterectomy that also involves removing:

  • the fallopian tubes (salpingectomy)
  • the ovaries (oophorectomy)

The National Institute for Health and Care Excellence (NICE) recommends that the ovaries should only be removed if there’s a significant risk of further problems – for example, if there’s a family history of ovarian cancer.

Mr Chattopadhyay can discuss the pros and cons of removing your ovaries with you.

Radical hysterectomy

A radical hysterectomy is usually carried out to remove and treat cancer of the cervix and sometimes for cancer of the womb.

During the procedure, the body of your womb and cervix is removed, along with:

  • your fallopian tubes
  • part of your vagina
  • ovaries
  • lymph glands
  • tissue around your cervix and womb

Performing a hysterectomy

There are three ways a hysterectomy can be performed. These are:

Laparoscopic hysterectomy

Abdominal hysterectomy

Vaginal hysterectomy

Laparoscopic hysterectomy

Laparoscopy is also known as keyhole surgery. Nowadays, a laparoscopic hysterectomy is the preferred treatment method for removing the organs and surrounding tissues of the reproductive system. During the procedure, a small tube containing a telescope (laparoscope) and a tiny video camera will be inserted through a small incision in your abdomen. This allows the surgeon to see your internal organs. Instruments are then inserted through other small incisions in your abdomen or vagina to remove your womb, cervix and any other parts of your reproductive system. The womb is usually removed through the vagina. Laparoscopic hysterectomies are usually carried out under general anaesthetic.

Abdominal hysterectomy

During an abdominal hysterectomy, an incision will be made in your abdomen (tummy). It will either be made horizontally along your bikini line, or vertically from your belly button to your bikini line.

A vertical incision will usually be used if there are large fibroids (non-cancerous growths) in your womb, or for some types of cancer.

After your womb has been removed, the incision is stitched up. The operation takes about an hour to perform and a general anaesthetic is used.

An abdominal hysterectomy may be recommended if your womb is enlarged by fibroids or pelvic tumours


Vaginal hysterectomy (http://bsug.org.uk/userfiles/file/patient-info/Vaginal%20Hysterectomy%20for%20Uterine%20Prolapse-%20VH%20BSUG%20F1.pdf)

During a vaginal hysterectomy, the womb and cervix are removed through an incision that’s made in the top of the vagina. Special surgical instruments are inserted into the vagina to detach the womb from the ligaments that hold it in place. After the womb and cervix have been removed, the incision will be sewn up. The operation usually takes about an hour to complete.

Complications of a hysterectomy

There’s a small risk of complications, including:

  • heavy bleeding
  • infection
  • damage to your bladder, ureters or bowel
  • serious reaction to the general anaesthetic

What are the possible complications of a hysterectomy?

As with all types of surgery, a hysterectomy can sometimes lead to complications. Some of the possible complications are described below.

General anaesthetic

It’s very rare for serious complications to occur after having a general anaesthetic (1 in 10,000 anaesthetics given). Serious complications can include nerve damage, allergic reaction and death. However, death is very rare – there’s 1 in 100,000 to 1 in 200,000 chance of dying after having a general anaesthetic. Being fit and healthy before you have an operation reduces your risk of developing complications.


As with all major operations, there’s a small risk of heavy bleeding (haemorrhage) after having a hysterectomy. If you have a haemorrhage, you may need a blood transfusion.

Ureter damage

The ureter (the tube that urine is passed through) may be damaged during surgery, which happens in around 1% of cases. This is usually repaired during the hysterectomy.

Bladder or bowel damage

In rare cases, damage to abdominal organs such as the bladder or bowel can occur. This can cause problems such as:

  • infection
  • incontinence
  • a frequent need to urinate

It may be possible to repair any damage during the hysterectomy. You may need a temporary catheter to drain your urine or a colostomy to collect your bowel movements.


There’s always a risk of an infection after an operation. This could be a wound infection or a urinary tract infection. These aren’t usually serious and can be treated with antibiotics.

Deep vein thrombosis and pulmonary embolism

Deep vein thrombosis (DVT) is the formation of blood clots within veins, usually in the calves or thighs. Pulmonary embolism (PE) is a condition in which a clot becomes free from a vein, travels through the heart and lodges in the artery of the lungs. There is risk of DVT and PE after surgery (http://www.nhs.uk/Conditions/Thrombosis/Pages/Introduction.aspx). The risk of developing blood clots increases after having operations and periods of immobility. You’ll be encouraged to start moving around as soon as possible after your operation. You are at increased risk for thrombosis if you are obese, or have cancer, or smoke or have had DVT or PE in the past. DVT and PE are serious problems, and can become life threatening. Several precautions, like injection of a blood-thinner drug (called low molecular weight heparin), compression stockings and calf-pumps, are taken to prevent thrombosis.

Vaginal problems

If you have a vaginal hysterectomy, there’s a risk of problems at the top of your vagina where the cervix was removed. This could range from slow wound healing after the operation to prolapse in later years.

Ovary failure

Even if one or both of your ovaries are left intact, they could fail within five years of having your hysterectomy. This is because your ovaries receive some of their blood supply through the womb, which is removed during the operation.

Early menopause

If you’ve had your ovaries removed, you’ll usually have menopausal symptoms soon after the operation, such as:

  • hot flushes
  • sweating
  • vaginal dryness
  • disturbed sleep

This is because the menopause is triggered once you stop producing eggs from your ovaries (ovulating).

This is an important consideration if you’re under the age of 40, because early onset of the menopause can increase your risk of developing brittle bones (osteoporosis). This is because oestrogen levels decrease during the menopause.

Depending on your age and circumstances, you may need to take additional medication to prevent osteoporosis.

Recovering from a hysterectomy

A hysterectomy is a major operation. You can be in hospital for up to five days after surgery, and it takes about six to eight weeks to fully recover. Recovery times can also vary, depending on the type of hysterectomy.

Rest as much as possible during this time and don’t lift anything heavy, such as bags of shopping. You need time for your abdominal muscles and tissues to heal.

After having a hysterectomy, you may wake up feeling tired and in some pain. This is normal after this type of surgery. You’ll be given painkillers to help reduce any pain and discomfort. If you feel sick after the anaesthetic, your nurse can give you medicine to help relieve this.

You may have:

You may also be slightly uncomfortable and feel like you need to empty your bowels. The day after your operation, you’ll be encouraged to take a short walk. This helps your blood to flow normally, reducing the risk of complications developing, such as blood clots in your legs (deep vein thrombosis). A physiotherapist may show you how to do some exercises to help your mobility. They may also show you some pelvic floor muscle exercises to help with your recovery.

After the catheter has been removed, you should be able to pass urine normally. Any stitches that need to be removed will be taken out five to seven days after your operation.

Your recovery time

The length of time it will take before you’re well enough to leave hospital depends on your age and your general level of health. If you’ve had a laparoscopic or a vaginal hysterectomy, you may be able to leave between one and four days later. If you’ve had an abdominal hysterectomy, it will usually be up to five days before you’re discharged. You should ring the hospital if you have any problems during your recovery period. The hospital will then contact Mr Chattopadhyay for further advice. If you have an urgent problem, out of hours, you may have to attend the nearest NHS hospital A&E.

Mr Chattopadhyay would like to see you in four to six weeks, to give you the results of tissue testing from the hysterectomy, to ensure you are well and to ensure you do not have any further questions.

It takes about six to eight weeks to fully recover after having an abdominal hysterectomy. Recovery times are often shorter after a vaginal or laparoscopy hysterectomy. During this time, you should rest as much as possible and not lift anything heavy, such as bags of shopping. Your abdominal muscles and the surrounding tissues need time to heal. If you live by yourself, you may be able to get help from your local NHS authority or your GP, while you’re recovering from your operation. Hospital staff should be able to advise you further about this.

Side effects

After having a hysterectomy, you may experience some temporary side effects, as outlined below.

Bowel and bladder disturbances

After your operation, there may be some changes in your bowel and bladder functions when going to the toilet. Some women develop urinary tract infections or constipation. Both can easily be treated. It’s recommended that you drink plenty of fluids and increase the fruit and fibre in your diet to help with your bowel and bladder movements. For the first few bowel movements after a hysterectomy, you may need laxatives to help you avoid straining. Some people find it more comfortable to hold their abdomen to provide support while passing a stool.

Vaginal discharge

After a hysterectomy, you’ll experience some vaginal bleeding and discharge. This will be less discharge than during a period, but it may last up to six weeks.

Contact Mr Chattopadhyay through the hospital or through Ms Claire Rossa, his secretary, or visit your GP if you experience heavy vaginal bleeding, start passing blood clots, or have a strong-smelling discharge.

Menopausal symptoms

If your ovaries are removed, you’ll usually experience severe menopausal symptoms after your operation. These may include:

  • hot flushes
  • anxiety
  • weepiness
  • sweating

You may have hormone replacement therapy (HRT) after your operation. This can be given in the form of an implant, injections or tablets. It usually takes around a week before having an effect.

Emotional effects

You may feel a sense of loss and sadness after having a hysterectomy. These feelings are particularly common in women with advanced cancer, who have no other treatment option.

Some women who haven’t yet experienced the menopause may feel a sense of loss because they’re no longer able to have children. Others may feel less “womanly” than before.

In some cases, having a hysterectomy can be a trigger for depression. See your GP if you have feelings of depression that won’t go away, as they can advise you about the available treatment options.

Talking to other women who have had a hysterectomy may help by providing emotional support and reassurance. Your GP or the hospital staff may be able to recommend a local support group.

The Hysterectomy Association (https://www.hysterectomy-association.org.uk) also provides hysterectomy support services, including a one-to-one telephone support line, counselling, and “preparing for hysterectomy” workshops.

Getting back to normal

Returning to work

How long it will take for you to return to work depends on how you feel and what sort of work you do. If your job doesn’t involve manual work or heavy lifting, it may be possible to return after four to eight weeks. Mr Chattopadhyay will be able to provide you with a sick note at discharge from the hospital.


Don’t drive until you’re comfortable wearing a seatbelt and can safely perform an emergency stop. This can be anything from three to eight weeks after your operation. You may want to check with your GP that you are fit to drive before you start. Some car insurance companies require a certificate from a GP stating that you’re fit to drive. Check this with your car insurance company.

Exercise and lifting

After a hysterectomy, the hospital where you were treated should give you information and advice about suitable forms of exercise while you recover.

Walking is always recommended, and you can swim after your wounds have healed. Don’t try to do too much, because you’ll probably feel more tired than usual.

Don’t lift any heavy objects during your recovery period. If you have to lift light objects, make sure your knees are bent and your back is straight.


After a hysterectomy, it’s generally recommended that you don’t have sex until your scars have healed and any vaginal discharge has stopped, which usually takes at least four to six weeks. As long as you’re comfortable and relaxed, it’s safe to have sex.

You may experience some vaginal dryness, particularly if you’ve had your ovaries removed and you’re not taking HRT.

Many women also experience an initial loss of sexual desire (libido) after the operation, but this usually returns once they’ve fully recovered.

At this point, studies show that pain during sex is reduced and that strength of orgasm, libido and sexual activity all improve after a hysterectomy.


You no longer need to use contraception to prevent pregnancy after having a hysterectomy. However, you’ll still need to use condoms to protect yourself against sexually transmitted infections (STIs).

Surgical menopause

If your ovaries are removed during a hysterectomy, you’ll go through the menopause immediately after the operation, regardless of your age. This is known as a surgical menopause.

If one or both of your ovaries are left intact, there’s a chance you’ll experience the menopause within five years of having your operation.

If you experience a surgical menopause after having a hysterectomy, you should be offered hormone replacement therapy (HRT).

Hormone replacement therapy (HRT) is a treatment used to relieve symptoms of the menopause. It replaces hormones that are at a lower level as you approach the menopause.

Benefits of HRT

How to get started

Who can take it

Types of HRT

Stopping HRT

Risks and side effects


Benefits of HRT

The main benefit of HRT is that it can help relieve most of the menopausal symptoms, such as:

  • hot flushes
  • night sweats
  • mood swings
  • vaginal dryness
  • reduced sex drive

Many of these symptoms pass in a few years, but they can be very unpleasant and taking HRT can offer relief for many women. It can also help prevent weakening of the bones (osteoporosis), which is more common after the menopause.

How to get started on HRT

Speak to Mr Chattopadhyay in your post-operative 4-6 weeks visit or your GP if you’re interested in starting HRT. You can normally begin HRT as soon as you start experiencing menopausal symptoms and won’t usually need to have any tests first. Mr Chattopadhyay and your GP can explain the different types of HRT available and help you choose one that’s suitable for you.

You’ll usually be started off on a low dose, which can be increased at a later stage. It may take a few weeks to feel the effects of treatment and there may be some side effects at first. You will be advised to try treatment for three months to see if it helps. If it doesn’t, they may suggest changing your dose or changing the type of HRT you’re taking.

Who can take HRT

Most women can have HRT if they’re experiencing symptoms associated with the menopause.

But HRT may not be suitable if you:

  • have a history of breast cancer, ovarian cancer or womb cancer
  • have a history of blood clots
  • have untreated high blood pressure – your blood pressure will need to be controlled before you can start HRT
  • have liver disease
  • are pregnant – it’s still possible to get pregnant while on HRT, so you should use contraception until two years after your last period if you’re under 50 or for one year after the age of 50

In these circumstances, alternatives to HRT may be recommended instead.

Types of HRT (http://www.nhs.uk/Conditions/Hormone-replacement-therapy/Pages/How-it-works.aspx)

There are many different types of HRT and finding the right one for you can be tricky.

There are different:

HRT hormones – most women take a combination of the hormones oestrogen and progestogen, although women who don’t have a womb can take oestrogen on its own ways of taking HRT – including tablets, skin patches, gels and vaginal creams, pessaries or rings

HRT treatment regimens – HRT medication may be taken continuously without a break, or in cycles where you take oestrogen continuously and only take progestogen every few weeks

Your GP can give you advice to help you choose which type is best for you. You may need to try more than one type before you find one that works best.

Stopping HRT

There’s no limit on how long you can take HRT, but talk to your GP about the duration of treatment they recommend. Most women stop taking it once their menopausal symptoms pass, which is usually after a few years. When you decide to stop, you can choose to do so suddenly or gradually.

Gradually decreasing your HRT dose is usually recommended because it’s less likely to cause your symptoms to come back in the short term.

Contact your GP if you have symptoms that persist for several months after you stop HRT, or if you have particularly severe symptoms. You may need to start HRT again.

Risks and side effects of HRT (http://www.nhs.uk/Conditions/Hormone-replacement-therapy/Pages/side-effects.aspx)

As with any medication, HRT can cause side effects. But these will usually pass within three months of starting treatment.

Common side effects include:

  • breast tenderness
  • headaches
  • nausea
  • indigestion
  • abdominal (tummy) pain
  • vaginal bleeding

Some types of HRT can also cause a small increase in your risk of certain serious problems, such as blood clots and breast cancer. The benefits of HRT are generally felt to outweigh the risks. But speak to your GP if you have any concerns about taking HRT.

Alternatives to HRT (http://www.nhs.uk/Conditions/Hormone-replacement-therapy/Pages/Alternatives.aspx)

If you’re unable to take HRT or decide not to, you may want to consider alternative ways of controlling your menopausal symptoms.

Alternatives to HRT include:

  • lifestyle measures – such as exercising regularly, eating a healthy diet, cutting down on coffee, alcohol and spicy foods, and stopping smoking
  • tibolone – a medication that’s similar to combined HRT (oestrogen and progestogen), but may not be as effective and is only suitable for women who had their last period more than a year ago
  • antidepressants – some antidepressants can help with hot flushes and night sweats, although they can also cause unpleasant side effects such as agitation and dizziness
  • clonidine – a non-hormonal medicine that may help reduce hot flushes and night sweats in some women, although any benefits are likely to be small
  • Several remedies (such as bioidentical hormones) are claimed to help with menopausal symptoms, but these aren’t recommended because it’s not clear how safe and effective they are.
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