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).