About 50 percent of a woman’s total testosterone comes through her ovaries. And testosterone, as you may know, is the hormone closely related to sexual drive, or desire.

Testosterone levels begin dropping up to ten years before menopause (known as peri-menopause), a slow, steady decline that never actually ends. If menopause happens, as a result of surgery, that decline occurs much more dramatically and could affect your libido. Although there’s good evidence that supplemental testosterone can improve desire, it may be that the dosage or form of testosterone you’re using isn’t the right one for you, or that other things are going on in addition to hormonal problems.

Estrogen, which is also produced by the ovaries, plays a role in our sexual enjoyment, given that it’s responsible for keeping tissues like those in the vagina moist and healthy. That’s why some women find sex becomes uncomfortable or even painful around and just after the menopause transition—when estrogen levels drop rapidly. That fear of pain can in turn affect desire. And if you’ve had surgical menopause, that drop in estrogen, like the drop in testosterone, is much more dramatic, and the symptoms that result can be much more intense.

If the ovaries were left in the body after the hysterectomy, there may be other reasons for sexual alterations. While removing the uterus itself doesn’t seem to contribute hormonally to low libido, it may play a role in other ways.