Will a hysterectomy cure PCOS? The short answer is no – and this is why

Living with polycystic ovary syndrome (PCOS)? Chances are that you’ve stumbled across a whole host of discussions online about surgical management options, and maybe even heard that having a hysterectomy could be a potential cure. 

It sort of makes sense, right? PCOS affects your reproductive system, so removing parts of that system might seem like a logical fix. 

However, a hysterectomy isn’t a cure for PCOS. And today, we’re breaking down why that is, as well as taking a look at some of the treatments and lifestyle support tips that can help manage this one in ten condition.

What is PCOS? 

PCOS is a hormonal condition that primarily affects the ovaries. 

The exact cause of PCOS isn’t fully understood, but research suggests that insulin resistance is almost always present. When your body doesn’t respond well to insulin, your levels rise, which can trigger an increase in androgens (male hormones like testosterone). This imbalance is behind many of the symptoms people with PCOS experience.

Those symptoms can vary widely, and some of us may experience a few, or even no symptoms at all, but they can include:

• Irregular or missed periods
• Enlarged ovaries or ovaries with many small cysts
• Excess hair growth on the chest, stomach, or back (known as hirsutism)
• Weight gain, especially around the midsection
• Acne or oily skin
• Thinning hair or hair loss
• Infertility and difficulty getting pregnant

PCOS is also associated with other health problems like type 2 diabetes, high cholesterol, and increased cardiovascular risk. 

So, while it’s often seen as a reproductive condition, it can have full-body implications.

What is a hysterectomy?

A hysterectomy is a surgical procedure to remove all or part of the uterus. 

Hysterectomies are typically done to treat conditions like uterine fibroids, cancer, and even sometimes endometriosis. There are two different types:

• Partial Hysterectomy: When the upper part of the uterus is removed, but the cervix is left in place. 
• Total Hysterectomy: When the entire uterus and cervix are removed. In some cases, the ovaries and/or fallopian tubes may also be removed as part of the hysterectomy.

The decision to go for a partial or total hysterectomy will depend on a couple of factors, including your age, overall health, symptoms, and, of course, your doctor’s recommendations.

Why a hysterectomy won’t cure PCOS

From what we’ve seen, it’s a really common misconception that a hysterectomy will cure or stop PCOS altogether. 

Here’s the thing. PCOS is not just a reproductive condition. It’s an endocrine disorder, which means it’s tied to the way your body produces and regulates hormones. That doesn’t stop when your uterus is removed. 

In fact, even if your ovaries are taken out, your adrenal glands can still produce excess androgens, meaning symptoms like acne, excess hair growth, or weight gain can continue.

And remember insulin resistance? This is driven by your body’s metabolism, not just your reproductive organs. So, if you’re asking will a hysterectomy cure PCOS? – the answer is no. 

It might help manage certain related symptoms (like heavy periods or pain from frequent cysts), but it won’t tackle the core hormonal and metabolic imbalances of PCOS.

With this in mind, let’s take a quick dive into three common questions for those considering surgery or who’ve already had it:

1. Can you have PCOS after a hysterectomy?

Yes, you absolutely can still have PCOS after a hysterectomy – and in some cases, the condition may even be diagnosed after the surgery.

This is because a hysterectomy won’t stop the hormonal and metabolic processes behind the condition.

If your ovaries are left in place, they may still produce the androgens associated with PCOS. And even if your ovaries are removed, your adrenal glands continue to produce androgens, which means symptoms can persist.

2. Metformin for PCOS after hysterectomy – what’s recommended?

If you’ve had a hysterectomy and are experiencing symptoms of PCOS, your provider may suggest continuing or starting metformin. 

Why? Because PCOS after hysterectomy often still involves insulin resistance, and metformin works by improving this insulin sensitivity. 

It doesn’t directly regulate your menstrual cycle if your uterus has been removed, but it can help manage some of the metabolic symptoms.

3. What is Laparoscopic Ovarian Drilling?

Laparoscopic Ovarian Drilling (LOD) is a minor surgical procedure that involves treating your ovaries using heat or a laser to destroy the tissue that’s producing androgens (male hormones).

It is a one-time procedure done under general anaesthesia, and unlike a hysterectomy, your uterus and ovaries remain in your body.

This procedure is typically only offered when medication like metformin hasn’t been helpful. According to the American Society for Reproductive Medicine (ASRM) LOD can be especially helpful for those who are trying to conceive (TTC).

Non-surgical PCOS treatment and support options

Here at TRB, we’ve spoken to more than a few PCOS experts in our time, from fertility specialists and doctors to nutritionists. 

The key takeaway? Management is all about understanding the hormonal imbalances at play, and working with them, rather than against them. 

This usually means that instead of recommending surgery, your healthcare provider may suggest:

• Taking medication: Depending on your symptoms, your doctor may recommend options like hormonal birth control to regulate periods or reduce acne and hair growth, or metformin to help with insulin resistance.

Your provider may also recommend lifestyle changes, and these can go a very long way, whether they’re combined with medication or tried on their own. 

Here’s a little checklist (we love a good actionable one) with tips you can follow yourself:

• Eating a healthy, balanced diet: Keep the focus on weight loss and optimized cholesterol levels (Peep our keto for PCOS guide for more on what the research says here) 
• Regular physical activity: We’re not talking daily gym classes here. Just finding a from that works for you, whether that’s walking, running, or at-home yoga, and sticking to a routine, can make a difference.
• Trying supplements: Inositol, vitamin D, and other targeted supplements can play a role in managing PCOS symptoms for some of us. Want to learn more from a fertility POV? Take a look at our fave PCOS supplements here.

All of these can help reduce insulin resistance, regulate periods, and lower androgen levels.

Key takeaways

• PCOS is a hormonal and metabolic condition that affects more than just the reproductive system.
• A hysterectomy won’t cure PCOS because it doesn’t fully address the hormonal imbalances at play.
• You can still have PCOS after a hysterectomy, even if your ovaries are removed, and symptoms may continue.
• Other surgical options are usually only suggested to help treat PCOS if medications like metformin haven’t been helpful.

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