Womens Health

Is the Uterus Necessary After Childbearing is Completed?

Frederick R. Jelovsek MD

\\\"What are the advantages of keeping your uterus over a lifetime? Does the uterus perform any functions past child-bearing years? Some sources say the uterus continues to produce needed hormones during a woman\\\'s entire life; that it is part of the endocrine system; and that the loss of the uterus decreases sexual enjoyment.

I am 50 and still having regular periods. In the 1960\\\'s my mother had a hysterectomy. Those years seemed to be the start of an epidemic of hysterectomies similar to tonsillectomies, which now are being thought to be often unecessary. Thanks!\\\". z at aol

This is certainly a loaded question that gets to the multiple different effects that have been attributed to having a hysterectomy. The issue gets quite confused if the ovaries are removed at the same time as the hysterectomy because then you have a sudden menopause superimposed upon the surgery itself. I assume that the above question is directed at the independent effect of a hysterectomy and not that of both removal of the ovaries and the uterus before menopause. However, at age 50, it is likely that the surgery will also include removal of the ovaries and if you are not yet menopausal, this will add additional menopausal effects.

Popular Questions About The Uterus

Does the uterus secrete proteins or hormones independent of ovarian function?

The uterus secretes hormones and proteins but they are almost always in response to the cyclical hormonal changes from the ovaries or the prolonged high levels of hormones during pregnancy. Various prostaglandin hormones, cellular growth factors and other compounds are made in response to the changing hormones and the lining of the uterus (endometrium). After the ovaries are non functional such as with surgical or natural menopause, there are no hormones or proteins that are secreted into the body\\\'s blood stream that I am aware of. Certainly the muscle cells of the uterus secrete enough local substances that have to do with keeping the cells alive but those substances are pretty much confined locally and do not have any systemic effect.

With the above general comments about the lack of any general hormone secretion from the uterus after menopause already expressed, there are some notable exceptions. It is likely that the local effects of some of the uterine proteins are perceived under special circumstances after menopause. The main one I am aware of is in response to sexual stimulation and intercourse. The physiologic response of blood vessels swelling full of blood during sexual arousal is likely a systemic response of nerves going directly to the blood vessels and not from secretions of the uterus, however there are more blood vessels to become swollen if the uterus is still in place. The substances that cause uterine contractions during orgasm probably do come from the uterus even after menopause. If the uterus is removed, not only do the secreted substances fail to be produced but also their target organ, the muscles of the uterus are gone. Thus the feeling of light uterine cramps during orgasm is gone after hysterectomy.

Table of Contents
1. Is the Uterus Necessary?
2. The uterus and orgasm
3. Lack of libido
4. Is hysterectomy necessary?
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