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To most women, a hysterectomy can feel like a frightening procedure to schedule. Sure, it’s one of the most common surgeries for women every year, but that doesn’t make the lead-up time any less anxiety-provoking, the procedure any less serious or the recovery period any less taxing.
Recovering from surgery is serious business, full stop. You’ll deal with fatigue, discomfort and a number of other side effects. And you may also see some hair loss.
While hair loss may be very upsetting in and of itself, the good news is that in many cases it may be temporary, reversible and treatable.
Below, we’ve explained what hysterectomies are, how your hair gets involved in the post-op period and how to treat that side effect if it’s happening to you.
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A hysterectomy is a fairly common surgery that women have to remove their uterus for a variety of reasons.
Some women are surprised to find out that there are several types of hysterectomy. In a partial hysterectomy only the upper uterus is removed, but the cervix isn’t. In a total hysterectomy, the entire uterus (including the cervix) is removed — the ovaries may or may not be removed in both partial and total hysterectomies. When the entire uterus, cervix and part of the vagina are removed, it’s referred to as a radical hysterectomy.
Reasons women may need a hysterectomy include:
Chronic pelvic pain
Vaginal bleeding that won’t stop despite treatment
Endometriosis that doesn’t respond to other treatments
Fibroids
Uterine prolapse or uterus drop
Cancer of the uterus, ovaries or cervix
A hysterectomy can be performed a few different ways:
A vaginal hysterectomy, in which the uterus is removed through an incision made at the top of your vagina
A laparoscopic hysterectomy, in which a small camera is inserted into your lower abdomen. Then the surgeon makes several small incisions and removes your uterus through them in small pieces.
An abdominal hysterectomy, in which your uterus is removed through a roughly six- to eight-inch long incision in your abdomen
It may seem obvious, but it’s worth mentioning that women who get hysterectomies are no longer able to become pregnant and will no longer have a period.
But depending on the type of hysterectomy performed, the effects will look a little different for each woman. For instance, if your ovaries are also removed, you will begin to go through menopause right after your hysterectomy is performed.
For the most part, immediate hair loss or hair thinning after a hysterectomy is caused by a condition called telogen effluvium.
This type of hair loss is caused by stress, and surgery can be stressful in many different ways, both mentally and physically.
However, women who have their ovaries removed may also lose hair due to the hormonal changes caused by menopause.
During menopause, your body will stop producing two hormones integral to menstruation: estrogen and progesterone. This leads to the symptoms of menopause, which include mood swings, weight gain or weight loss, hot flashes, vaginal dryness and more.
These hormonal changes can also trigger female pattern hair loss — because those hormones are also connected to hair health, you may lose some of your hair when hormonal levels dipduring menopause.
Likewise, you may become more sensitive to the effects of testosterone.
Your body may turn testosterone into a hormone called dihydrotestosterone (DHT). DHT attaches to the androgen receptors in your follicles that regulate hair growth, causing the follicles to shrink. This leads to a condition called androgenetic alopecia (commonly called female pattern hair loss).
FYI: Some women also undergo hormone replacement therapy (commonly called HRT) when they enter menopause, and it can also affect hair health and growth.
Thankfully for many women, hair loss induced by a hysterectomy is often reversible — and there are many ways to treat it.
The best way to start is having a conversation with a healthcare professional to determine the best plan for your specific needs, but they’ll almost certainly suggest one or more of the below options.
Because hair loss can have more than one post-hysterectomy cause, there are several ways to approach hair growth treatment. While plenty of non-medical “experts” will champion things like vitamin D and other common supplements, medical advice typically leans on two treatments:
Spironolactone. This prescription medication is technically only FDA-approved for heart failure and high blood pressure, but is often used off-label for post-hysterectomy hair loss and thinning. Spironolactone prevents or slows down menopause-based hair loss by stopping the formation of DHT and impeding the creation of androgens.
Minoxidil. Another medication option is topical minoxidil, also known as Rogaine®. While there are some unanswered questions about how exactly minoxidil works, we know that it’s a vasodilator that ensures nutrients and oxygen get to your hair follicles, which results in better growth. It doesn’t require a prescription and is FDA-approved.
Medications can work wonders, but protecting your hair from breakage can also do wonders for your hair health, because damaged hair can make things up top even worse.
To keep damage at bay and get your locks in good shape, we suggest the following:
Use good products. You should use a conditioner every time you shampoo to keep hair hydrated. Some research has shown that the hair care ingredient saw palmetto (which is in Hers shampoo) can neutralize the effects of DHT. Check out our volumizing shampoo and conditioner if you’re looking for new products.
Be careful with hot tools. Blow dryers, straighteners, curling irons and other hot tools can damage your hair. If you are going to use one, keep it on the lowest setting possible.
Avoid hairstyles that put strain on your hair. Tight ponytails or buns can lead to breakage. Loose hair looks are better for hair health.
Address nutritional deficiencies. While we’re not big on supplements, things like biotin can improve your hair health if you’re deficient. Want to know more? Check out our biotin gummies.
Some women feel a perfectly understandable sense of loss when they have a hysterectomy, while others feel freedom.
On the other hand, just about every woman may find the recovery symptoms unwelcome — especially the hair loss ones.
We can’t tell you how to stop hair loss after a hysterectomy — that’s a job for a dermatologist or other healthcare professional. All we’ve done is give you the lay of the land.
Whether you’re pre- or post-surgery, remember the following as you navigate this process:
Major surgeries often cause telogen effluvium — a stress-based type of hair loss that typically goes away on its own. The recovery can sometimes be sped up by medications like minoxidil.
Many women go through menopause after a hysterectomy, particularly if the ovaries are removed. Hormonal changes from menopause can also lead to hair loss, which will require different treatments.
It’s also wise to embrace healthy hair habits (like keeping it hydrated and protecting it from damage) to keep what you have safe.
If you’ve undergone a hysterectomy and are noticing thinning hair, you may want to talk to a healthcare professional. They can give you some customized advice on how you can get your hair back on track with hair loss treatments. We can help with that — reach out today.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
She received her undergraduate degree in nursing from the University of Delaware and her master's degree from Thomas Jefferson University. You can find Katelyn on Doximity for more information.