Yes, it's normal, and it isn't only about hormones. Tearfulness in the first weeks is common enough that the surgeons' own recovery leaflets name it, with causes that are well documented and apply whether or not you kept your ovaries. There is a line, though: sadness or numbness that sticks around most days for two weeks needs its own care.
One question on a forum:
"Is this crying thing normal even though I kept my ovaries?"
The replies were a wall of yes. Two fears sit inside that one question: the crying itself, and the sense that keeping your ovaries means you've got no reason for it.
Is it normal to cry a lot after a hysterectomy?
Common enough that the surgeons write it down. The UK's Royal College of Obstetricians and Gynaecologists tells women in its standard recovery leaflets that "many women feel tearful and emotional at first," and that "for many women this is the last symptom to improve." No source puts a number on how many women cry in week two. Nobody has counted.
And if you kept your ovaries, this is not an ovaries question in these early weeks. No study measures first-week mood by whether the ovaries stayed or came out. The early causes apply either way.
Mine went the other direction. My first two or three weeks were relief. My uterus was out, the Essure was confirmed gone after a stressful run-up, and all I could feel was happy. That's my experience; yours might be different. The range is that wide, which is why the evidence can reassure a crying reader without ever calling her unusual.
What's feeding it?
Usually several things at once. Most are ordinary parts of recovery that nobody warns you about.
Tiredness comes first, and so does being stuck resting through the weeks of recovery after a hysterectomy. The same RCOG leaflets tie low mood straight to it: "sleeping in and staying in bed can make you feel depressed," and women off work for longer "start to feel isolated and depressed."
Bad sleep drags mood down by itself. A 2024 review of more than 50 years of sleep-deprivation experiments found that when people lose sleep, their mood drops and their anxiety climbs. Those were healthy volunteers in a lab, not women recovering from surgery, and nobody has measured it in hysterectomy recovery. But it holds up across decades of studies, and early recovery is nothing but broken sleep.
Being in pain wears on your mood, and feeling miserable can make the pain harder to bear. A 2016 review of surgery in general found it runs both ways, though its numbers come from heart and intensive-care patients rather than a hysterectomy.
Pain medication gets blamed for it, and the evidence is thin. One hospital's patient sheet for codeine lists mood changes among the effects to tell your doctor about. But the NHS's own codeine page names constipation, nausea, drowsiness and sweating, and no mood effect at all. Mention it to your doctor if you notice it. Don't bank on it as the reason for the tears.
Then there's recovery not going the way you expected. A Canadian study of 294 women found a rougher emotional six months for women who had endometriosis, and for those who had open surgery instead of keyhole. Thinking you'd be back to normal by now, and not being, is hard on its own.
Post-surgical low mood is a recognised thing across surgery generally, measured and taken seriously. A large 2023 study found new depression after major operations, at rates that varied by the type of surgery. Hysterectomy wasn't one of the operations it looked at, so there's no number here to hand you, only the point that this is real and studied.
The anaesthetic myth. When I read through several forums, the same explanation kept coming up around week three: the crying is "your body still clearing the anaesthetic." It's a kind instinct, and it's mostly wrong. The NHS puts a general anaesthetic's effects at around 24 hours; one NHS surgical leaflet stretches the drugs' activity to about 48. Neither the NHS nor the anaesthetists' own college lists mood change as an after-effect at all. At three weeks out, the anaesthetic is long gone. What's still hitting you is the tiredness, the bad sleep, and everything else that comes with recovery.
Does it get better? For most women, yes
Almost no one tells you this. In the studies that measured women before their hysterectomy and again after, for benign (non-cancer) reasons, mood mostly gets better.
The Maryland Women's Health Study followed about 1,300 women for two years. Depression, anxiety and symptom severity all fell after surgery, and quality of life rose. The Canadian study above found 47% reporting less depression at six months. A 2014 review pooling these before-and-after studies landed in the same place: hysterectomy for benign conditions was not tied to more anxiety, and if anything went with an improvement in depression.
The reason isn't a mystery. These are women whose baseline was dragged down for years by pain and heavy bleeding, the exact things the surgery ends. Relief from that is real relief.
Both of these are true, and they cut in different directions. A group average showing improvement does not tell you your crying isn't real or doesn't count. And the higher long-term figures don't tell you you're headed for depression. Averages describe many. You are one.
Can a hysterectomy cause depression years later?
Over the years, the risk of a new depression diagnosis does go up. By how much, and whether the surgery is the cause, is where it gets complicated.
The anchor is a 2020 study that followed women for about 22 years after a hysterectomy that kept the ovaries. It found new depression a little more common: an adjusted increase of about 6.6% in absolute terms over 30 years, and about 4.7% for anxiety. Put another way, over three decades roughly one extra woman in 15 was diagnosed with depression who otherwise wouldn't have been. That is not "you are likely to get depressed." It's a small shift across a very long time.
Two cautions come with that figure. First, the link may run partly backwards: a companion study found women who go on to have this surgery are somewhat more likely to have had anxiety or depression already, so the surgery isn't cleanly the cause. Second, the field's own review says these studies show associations rather than proof of cause. The same shows up elsewhere. Studies in Australia and Taiwan found increases of a similar size, and the Taiwan data showed the rise was bigger for younger women.
If your ovaries came out, the long-term picture is mixed. The best long study of early ovary removal found more depressive and anxiety symptoms decades later, larger the younger the woman was. Shorter studies often find no difference, or even improvement in the first year, though those improvement figures come from women who were mostly on oestrogen at the time. No one has reconciled the two, and both sets of findings stand.
Women who kept their ovaries often get told, at the first mention of feeling emotional, that they need HRT right away. But guidance points HRT at menopausal low mood, and keeping your ovaries is not the same as being in menopause. NICE, which sets treatment guidance in the UK, suggests HRT for low mood that comes from menopause, and talking therapy for low mood or anxiety from menopause, and it says there's no clear evidence that antidepressants help menopausal low mood in women who haven't been diagnosed with depression. Not sure whether you're in menopause yet? Start with how to tell if you're in menopause, and what happens to your hormones after a hysterectomy covers the rest.
For me, the mood changes came later. Not in the weeks after surgery, but about two years on, with perimenopause I didn't recognise as perimenopause. I was irritated for no reason, angry a lot, anxious about everything, foggy and unable to focus. At points it felt like being a bystander in my own body. I had kept my ovaries, so none of it lined up until I went looking. It turned out to be my hormones, and what a hysterectomy does to them is something I know from the inside.
Grief, relief, and both at once
Both are normal, and you can feel them at the same time. The US Office on Women's Health names grief over lost fertility or a changed body; the NHS names a sense of loss and sadness, and, for some women, feeling less "womanly." ACOG says sadness and relief are both common. None of it is a wrong way to feel.
The numbers say relief is the majority experience. A 2024 survey of women after hysterectomy for benign disease found 88% reported relief and 7% regret, with age and whether they'd had children making no difference either way. Grief is real and lasting for a minority, most often women with a history of infertility, and it sits right alongside having wanted the surgery. Choosing something and grieving it are not opposites.
Some women reading this chose to end their fertility. Some had it ended for them, in an emergency, after a birth that went wrong. That loss is described as especially hard where there was no other option, and reasonably so.
How long do mood swings last, and when should you get help?
Nobody has measured how long it lasts, and no credible source gives a timeline. RCOG will only say it's often "the last symptom to improve," with no number attached. So watch the pattern rather than the calendar.
When to get help is a different question, and it does have an answer. See your doctor if low mood or loss of interest is there most of the day, nearly every day, for two weeks or more. That two-week mark is what NIMH and CAMH use to separate ordinary low spells from depression. The Office on Women's Health puts it more loosely, at sadness or lost interest lasting "longer than a few weeks" after surgery. Where they disagree, go with two weeks rather than waiting longer.
Recovery makes this hard to read, because some depression symptoms are also just recovery: fatigue, poor sleep, appetite changes, trouble concentrating. Those overlap with any surgery. The ones that point past ordinary recovery are the mood ones, and the persistence:
- low or "empty" mood most of the day, nearly every day
- loss of interest or pleasure in things you used to enjoy
- feelings of hopelessness, worthlessness, or guilt
- and any of it holding steady for two weeks or more
Take those to your doctor. If a physical symptom is what's worrying you rather than mood, when to call your doctor after a hysterectomy covers the red flags.
If you are thinking about harming yourself, or you can't see a way through right now, reach a person tonight. You don't have to have the words ready first.
- Canada: 988 Suicide Crisis Helpline. Call or text 988, any time.
- United States: 988 Suicide and Crisis Lifeline. Call or text 988, or chat at 988lifeline.org.
- UK and Ireland: Samaritans. Call 116 123, any time.
If you are in immediate danger, call 911 (or your local emergency number).
Common questions
Yes. In the first weeks, the emotional side isn't an ovaries question at all. The documented causes (tiredness, broken sleep, pain, medication, and the gap between the recovery you expected and the one you got) apply whether your ovaries stayed or came out. Keeping them doesn't mean you have no reason to feel wrung out.
No credible source gives a timeline, and any page that hands you a firm one is guessing. What to watch instead is the two-week mark: low mood or loss of interest most of the day, nearly every day, for two weeks or more is the point to see your doctor.
Long-term studies find a modest increase in new depression diagnoses years later, on the order of one extra woman in 15 over 30 years for women who kept their ovaries. The link may run partly the other way (women who have this surgery are somewhat more likely to have had depression already), and the research shows association rather than proven cause. It is not a prediction that you personally will become depressed.
Because the things feeding it (sleep, pain, energy, how the day went) change day to day, especially early in recovery. Day-to-day swings are ordinary. It's steady, most-days low mood lasting two weeks or more that should prompt a call to your doctor.