After the uterus is removed due to fibroids or other diseases, will it become low voice, grow a beard and throat knot, or even become a man? The answer is no! The main difference between men and women is the difference in the structure of the reproductive organs, which is the first sex characteristic. In addition to the difference in reproductive organs, men and women also have their own characteristics, that is, the difference between the physical appearance of men and women. The man is tall, muscular, sweaty, long beard, prominent throat knot and so on. The women are shown as the breast bulge, pelvis wide, delicate skin, rich subcutaneous fat and voice, these are the second sex characteristics. These differences between men and women are mainly due to the different roles of the gonads, that is, the female ovaries and the male testicles, and are not directly related to the uterus. For women who still have menstruation but need to have their uterus removed due to fibroids, one or both ovaries are usually preserved when the uterus is removed. As long as the ovaries are preserved, they will still produce estrogen, progesterone and androgens. While it was previously thought that hysterectomy had no effect at all on ovarian function, this view has changed somewhat and it is now believed that when the hysterectomy is performed, the function of the ovaries is temporarily or permanently affected to some extent, but to a limited extent, because one of the two blood supply systems to the ovaries is cut off. After the operation, except for the fact that menstruation does not occur anymore, the endocrine activity in the body continues, so there are no symptoms such as breast atrophy, vaginal dryness, hot flashes, sweating and irritability, and no “male change”. Some women may gain weight after hysterectomy, which may be related to the fact that they ate too much and moved too little after the operation. If both ovaries are removed at the same time as the hysterectomy due to the condition, the woman will still not become a man. One misconception that tends to lead people astray is that ancient eunuchs gradually became effeminate after having their testicles removed at an early age, so it is assumed that if a woman has her ovaries removed, she will also become a man. But in reality, even if a woman has her ovaries removed at a very young age for some reason, her body will not develop masculine signs unless she is given long-term injections of androgens. This is because developmentally speaking, “man is a woman by nature”. The sex of a person depends on the Y chromosome in the sex cells. Embryos containing the Y chromosome differentiate into testes at about 7 weeks. This step is extremely crucial! Because as soon as the testes appear, they secrete androgens; androgens both determine the differentiation of both internal and external reproduction toward the male and fail to develop into female internal and external genitalia, and induce the hypothalamus to differentiate toward the male and secrete hormones continuously, rather than cyclically to cause a fluctuating cycle of surplus and deficit in the female. At this point, estrogen is slightly inferior. Because the female internal and external genitalia do not need estrogen to develop, they automatically differentiate toward the female, with or without ovaries and estrogen, as long as there are no androgens. It is also known as: “In the beginning of man, the sex is female,” and it is completely dependent on the androgens produced by the testes that there are boys. When puberty comes, androgen stimulation makes the secondary sexual characteristics mature and the boy grows into a man. Girls, on the other hand, are stimulated by ovarian estrogen and develop into curvaceous girls. However, if both ovaries are removed along with the uterus, symptoms such as hot flashes, sweating, irritability, palpitations and other menopausal symptoms such as breast atrophy and vaginal dryness may occur due to the lack of estrogen. In this case, hormone supplementation can be given appropriately under the guidance of a gynecologic endocrinologist, i.e., by supplementing with a minimum effective dose of exogenous estrogen to effectively improve symptoms and prevent the occurrence of diseases such as osteoporosis in the future.