What Fills the Space and Other Questions About a Hysterectomy, Answered

young woman sitting on the bed and looking outside window in hospital worry about her hysterectomy procedure
Medically Reviewed
May 13, 2024

As an integrative medicine practitioner specializing in bioidentical hormone replacement therapy (BHRT), I often encounter women facing the prospect of a hysterectomy. This surgery, while sometimes necessary, can raise many questions and anxieties. One common concern? What fills the space left behind after the uterus and ovaries are removed? 

Let’s explore this and other frequently asked questions about hysterectomy, exploring both traditional and integrative approaches to supporting a healthy recovery and a fulfilling life beyond surgery. 

What Happens After a Hysterectomy? 

A hysterectomy involves the surgical removal of the uterus, and sometimes the cervix and ovaries. This can be a life-altering decision, often undertaken to address conditions like fibroids, endometriosis, or heavy bleeding.  

While it stops periods and eliminates the possibility of pregnancy, it also impacts hormone production, particularly if the ovaries are removed. 

Filling the Gap: Adapting Organs and Hormone Shifts 

Surrounding organs, primarily the intestines, gradually fill the space vacated by the uterus. This shift can feel strange initially, but the body usually adapts.  

However, the bigger concern lies with hormonal changes. The ovaries produce estrogen, progesterone, and small amounts of testosterone, all crucial for various bodily functions. With their removal, hormone levels plummet, leading to symptoms like: 

  • Hot flashes and night sweats 
  • Vaginal dryness and discomfort 
  • Decreased libido 
  • Difficulty concentrating and mood swings 
  • Sleep disturbances 
  • Bone loss (if estrogen production ceases)  Testosterone also affects bone health. E2 prevents loss, T1 builds bone back 

Traditional vs. Integrative Approaches to Managing Post-Hysterectomy Symptoms 

Conventional medicine typically addresses post-hysterectomy symptoms with synthetic hormone replacement therapy (HRT). While effective for some women, synthetic hormones can sometimes come with side effects like weight gain, blood clots, and an increased risk of certain cancers. 

Integrative medicine offers a different approach to BHRT. BHRT uses bioidentical hormones, structurally identical to those your body naturally produces. These hormones are derived from plant sources and compounded into personalized dosages based on your needs and lab results. 

Benefits of BHRT After a Hysterectomy 

Studies suggest BHRT can effectively manage post-hysterectomy symptoms like hot flashes, vaginal dryness, and mood swings. Additionally, BHRT may offer: 

  • Improved sleep quality 
  • Enhanced cognitive function 
  • Increased libido 
  • Reduced risk of bone loss (with appropriate estrogen dosing)  T1 as well

Common Questions Answered: A Patient’s Guide 

Here are some of the most common questions I receive from clients considering a hysterectomy: 

  • Will I still be a woman after a hysterectomy? Absolutely. A hysterectomy removes your reproductive organs but doesn’t alter your femininity or identity. 
  • Can I still have a sex life? Yes! While vaginal dryness can be a temporary concern, BHRT can help, and post-surgical rehabilitation can address any lingering discomfort. Learn more. 
  • Will I gain weight after a hysterectomy?  Whether a partial or full hysterectomy is performed, weight gain is likely. This is because hormone levels, specifically estradiol and testosterone, can directly influence weight. A hormone deficiency is likely to occur even if the ovaries are left intact (with a partial hysterectomy). This is because the surgery disrupts the blood flow that supplies the uterus and forms the ovaries, which are crucial for hormone production. 
  • Will I need hormone replacement therapy?  This depends on your individual situation and the extent of the surgery. If your ovaries are removed, BHRT can be a valuable tool to manage symptoms and support long-term health.

Beyond the Physical: The Emotional Journey 

A hysterectomy can be an emotionally charged experience. Some women feel relief from a long battle with health issues, while others may experience feelings of loss or grief. It’s important to acknowledge these emotions and seek support from loved ones or a therapist if needed. 

Remember, You’re Not Alone 

Hysterectomy is a common surgery, and millions of women live fulfilling lives after it. You can confidently navigate this journey by understanding the potential changes and exploring all available options for managing symptoms. 

Taking Charge of Your Health: The Road to Recovery 

Recovering from a hysterectomy involves a commitment to your well-being. Here are some tips to support your journey: 

  • Re-establish your hormonal balance with BHRT 
  • Prioritize Rest: Your body needs time to heal. Listen to its needs and get adequate sleep. 
  • Nourish Your Body: Eat a balanced diet rich in fruits, vegetables, clean protein, and healthy fats to provide essential nutrients for healing. 
  • Stay Hydrated: Drinking plenty of water helps your body function optimally and can alleviate post-surgical constipation. 
  • Move Your Body: Gentle exercise promotes healing and improves mood 


The information contained in this blog post is for informational purposes only and is not a substitute for professional medical advice. This blog post does not establish a doctor-patient relationship and should not be used to diagnose or treat any medical condition. If you have or suspect you may have a medical issue, always consult with a qualified healthcare professional. Please discuss any questions or concerns you may have regarding hysterectomy, bioidentical hormone replacement therapy (BHRT), or any other treatment options with your doctor. 

Dr. Angela DeRosa
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As our Associate Medical Director, Dr. Angela De Rosa is integral to the continued education and innovation here at Nava Health. Dr. Angela DeRosa, DO, MBA, CPE, is a dynamic professional on a mission to change the face of women’s health and wellness. As a respected, internationally recognized authority on women’s hormonal health, Dr. DeRosa understands the range of health issues women face leading up to and during menopause, as she was in full-blown menopause by age 35. Dr. DeRosa has more than 25 years of experience in the medical field, both on the pharmaceutical side and in clinical practice.

Dr. DeRosa’s enthusiasm for educating patients on the realities of menopause and the risk factors of hormonal health imbalances has never waned. It was the driving force behind her first bestselling book, A Woman’s Health Survival Guide: How to Prevent Your Doctor From Slowly Killing You. Her book and its controversial title caught the attention of the public, media, and the medical community.

Dr. DeRosa is on the advisory board for the European Menopause and Andropause Society, a member of the International Menopause Society International Society of the Study of Women’s Sexual Health, and a researcher on women’s health issues. Dr. DeRosa is a Midwestern University Clinical Assistant Professor and a Past Arizona Osteopathic Medical Association President.