Joint and Muscle Pain

The anatomic, structural and hormonal changes caused by hysterectomy (the surgical removal of the uterus) are far-reaching. Some of the most frequent changes women report after hysterectomy include a loss of sexual feeling, a loss of vitality, profound fatigue, personality change and joint pain. When the female gonads, the ovaries, are also removed the effect on the muscles, bones and joints is greater. Even when the ovaries are not removed a high percentage of hysterectomized women report muscle and joint pain. 

The uterus is a hormone-responsive reproductive sex organ. The ovaries (the female gonads) are attached to one end of the fallopian tubes and the other end of the fallopian tubes attach to the uterus. The ovaries are an organ that produces and regulates hormones throughout a woman’s entire life. Oophorectomy (the surgical removal of the ovaries) is performed on about 75% of the women who undergo hysterectomy. The medically correct term for the removal of the female and male gonads is castration. When the blood supply to the ovaries is damaged during a hysterectomy, a loss of ovarian function occurs in about half of the women whose ovaries were not removed during the surgery. This often results in de facto castration–a total or partial loss of ovarian function. 

Widespread muscle, bone and joint pain known as fibromyalgia (similar to fibrositis) is common after hysterectomy. The ovaries produce estrogens, androgens (such as testosterone), DHEA and progesterone. Clinical studies confirm that fibromyalgia after hysterectomy is associated with the loss of hormones caused by removal of the ovaries or damage to the blood supply to the ovaries. Exogenous (hormones not produced in the body), synthetic (pharmaceutical) and animal hormones are commonly prescribed to hysterectomized women, but they cannot replace the functions of the natural hormones produced by the uterus and ovaries.

The uterus is attached to broad bands of ligaments, bundles of nerves and networks of arteries and veins. Regardless of whether the hysterectomy is “total” (removal of the uterus and cervix) or “partial” (amputation of the uterus from the cervix, leaving the stump of the cervix), all of the ligaments, nerves and blood supply attached to the uterus must be severed to remove it. 

The severing of the ligaments permits the pelvic bones to move and widen, which affects the hips, lower back, spine and skeletal structure. The displacement of the pelvic bones results in compression of the spine. Women report that as the spine compresses, the rib cage gradually drifts down until it sits on their hip bones. This compression causes hysterectomized women to have protruding bellies and little or no waist. 

Fibromyalgia and fibrositis (widespread muscle, bone and joint pain) after hysterectomy is reported by about three quarters of hysterectomized women.