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A large study suggests that women who undergo a hysterectomy face an increased risk of developing type 2 diabetes. Sorrasak Jar Tinyo/Getty Images
  • According to new research, having a hysterectomy may increase your risk of developing type 2 diabetes.
  • The study, which included over 83,000 women, found that women under 45 who had a hysterectomy had a 52% higher risk of developing the condition.
  • The findings suggest that keeping the ovaries intact could help reduce some individuals’ risk of developing diabetes after a hysterectomy.
  • Type 2 diabetes is often preventable and manageable through diet and lifestyle modifications, even among this risk group.

Hysterectomies — or surgical removal of the uterus that occasionally involves removal of the ovaries (oophorectomy), cervix, and fallopian tubes, are typically recommended as a treatment for heavy, painful periods and reproductive health conditions like endometriosis and cancer.

According to new research, women who received hysterectomies before age 45 had a 52% higher risk of developing type 2 diabetes than women who did not receive a hysterectomy.

The study was recently presented at the European Association for the Study of Diabetes (EASD) Annual Meeting in Stockholm, Sweden. The research has yet to be peer-reviewed and published.

It’s unclear how having a hysterectomy might contribute to diabetes, but the researchers suspect depression — which is prevalent in women who get hysterectomies — and metabolic changes may play a role.

Though more research is needed to understand the link between hysterectomies and diabetes, the researchers hope their findings can help doctors identify patients who may benefit from making lifestyle changes to lower their risk of diabetes.

“A better identification of these women might help to propose some prevention measures that might be implemented, in particular, in case of associated risk factors such as obesity, sedentarily, familial history of diabetes,” the study’s lead author Dr. Fabrice Bonnet, PhD, an endocrinologist at CHU de Rennes and The Centre for Research in Epidemiology and Population Health, told Healthline.

The researchers evaluated the health data of 83,582 French women who were born between 1925 and 1950.

The participants completed self-administered questionnaires every 2 years that included information about their hormonal and lifestyle factors, health conditions, and treatments. The women did not have diabetes at the start of the study, and the researchers only included hysterectomies for benign gynecologic conditions in their analysis.

During a 16-year follow-up period, 17,141 women had a hysterectomy, and 2,672 developed type 2 diabetes.

The research team found that people who received a hysterectomy had a 27% greater risk of developing diabetes. Women under the age of 45 who underwent a hysterectomy had a 52% higher risk of developing type 2 diabetes. Those who also had their ovaries removed had the greatest risk.

Additionally, the researchers found that the association between hysterectomy and type 2 diabetes didn’t change when the researchers adjusted for factors like diet, physical activity, and BMI, all important risk factors for type 2 diabetes

More research is needed to better understand the link between hysterectomies and diabetes, but the researchers did note that women whose ovaries were kept intact had a 13% reduced risk of diabetes. As such, they say the findings suggest that keeping the ovaries intact in some patients could help reduce the risk of developing diabetes after getting a hysterectomy.

The researchers suspect that depression may contribute to type 2 diabetes.

Many of the women in the study who underwent hysterectomies also experienced depression, a known risk factor for type 2 diabetes.

“We observed that women who had a hysterectomy were more likely to get a higher score of depression, in favor of the presence of severe depressive symptoms. Therefore, this suggests a potential underlying mechanism,” Bonnet said.

Hysterectomies may also have metabolic consequences.

Ovaries secrete hormones, such as estrogens and anti-Mullerian hormone (AMH), and the removal of the glands leads to a sudden drop in hormones. Prior research, such as this study from 2021, has found that lower levels of AMH were associated with a higher risk of type 2 diabetes.

Dr. Michelle Forcier, a FOLX health clinician who specializes in sexual healthcare, said there is clear evidence that estrogens offer protective effects against problems with glycemic control, cholesterol, and heart disease.

According to Forcier, the uterus does not secrete these hormones, so the removal of the uterus alone would not directly impact AMH and estrogen levels.

But Bonnet suspects that hysterectomies could potentially impact ovarian function, perhaps indirectly, even if the ovaries are kept intact.

The researchers did not evaluate the health effects of hysterectomies in transgender individuals, and Forcier said the findings from this study could not be applied to transgender people who received a hysterectomy.

“These ages, these health conditions are vastly different than many of our younger TGD persons who remove their uterus — again, with or without ovaries — for dysphoria,” Forcier said.

It’s also unlikely that depression plays the same role in transgender individuals who get a hysterectomy as the gender-affirming procedure may actually be protective against depression.

“The experience of having a uterus or wanting a uterus removed is different for cis persons than for many transgender persons desiring hysterectomy,” Forcier said.

There are many steps people can take to lower their risk of diabetes.

Bonnet said that increasing physical activity, having a healthy diet, and managing weight can help offset the risk.

Avoiding smoking and vaping, excessive alcohol, and substance use can help lower the risk of type 2 diabetes as well.

Hormone or estradiol replacement therapy could protect people’s metabolic health, especially if the ovaries were removed. According to Forcier, maintaining a healthy lifestyle is likely the most effective way for people to lower their risk of diabetes.

“That is more important than having or not having a uterus in protecting against diabetes,” Forcier said.

According to new research, having a hysterectomy may increase a person’s risk of developing type 2 diabetes.

While the link between hysterectomies and type 2 diabetes is not fully understood, factors like depression, a drop in hormones, and loss of ovarian function may play a role.

Although type 2 diabetes is a chronic condition, diet and lifestyle modifications may help some individuals manage or reverse their symptoms.

If you recently had a hysterectomy or are considering one for personal or medical reasons, be sure to speak with your doctor about your potential type 2 diabetes risk.