Surgical Menopause: Effects, Symptoms, and Treatment

What is surgical menopause?

When menopause happens naturally, it’s a gradual process that can start anytime around age 45 until around 51. During this time, you’ll experience fluctuations in estrogen and progesterone, as your ovaries produce less and less of these hormones. 

Once you haven’t had a period for 12 consecutive months, you have officially reached menopause and are now entering post-menopause.

With surgical menopause, however, menopause symptoms can begin overnight. With the removal of the ovaries, the body stops producing estrogen and progesterone, which immediately stops the menstrual cycle. The medical term for the procedure that removes both ovaries is bilateral oophorectomy. 

If you have a hysterectomy, the surgeon removes only your uterus, so you may not experience surgically induced menopause right away. Your ovaries will continue to produce estrogen and progesterone, but your periods will stop. With a partial hysterectomy, you’re more likely to experience early menopause. Depending on why you’re having a hysterectomy, the surgeon may also remove your ovaries, particularly if they’re treating a disease or condition such as endometriosis.

Positive effects of surgically induced menopause

There are many reasons why your doctor might recommend an oophorectomy or hysterectomy, including if you have a greater risk of developing certain cancers.

If you experience heavy and painful periods, particularly in the presence of fibroids, you could benefit from surgically induced menopause. Doctors often recommend a full hysterectomy in this case, along with a bilateral oophorectomy to remove your ovaries. One of the positive effects of surgical menopause can be relief from the painful symptoms of heavy periods and fibroids. 

Another positive effect of surgical menopause is a reduced risk of developing ovarian cancer. If you have a family history of ovarian cancer or are predisposed to this disease, your doctor may recommend surgical menopause. Some people who undergo this surgery find it helps relieve the anxiety of constantly worrying about ovarian cancer. Researchers have also found that surgical menopause has helped to reduce the risk of breast cancer. 

Surgical menopause can bring relief to some people, particularly those who experience the pelvic pain of endometriosis. This condition causes the uterine lining (endometrium) to grow in places where it shouldn’t, such as in the ovaries and fallopian tubes, causing intense pain during menstruation. While surgical menopause has been shown to help some people with endometriosis, its effectiveness varies from individual to individual, and it may not be right for everyone.

Surgical menopause symptoms and side effects

The symptoms of surgical menopause are much like the symptoms of natural menopause, and you can expect the same side effects. Instead of a gradual lessening of hormones, however, surgical menopause stops hormones quite suddenly, causing the symptoms to also appear suddenly and sometimes more severely. 

• The most common symptoms of surgical menopause are hot flashes, night sweats, and vaginal dryness.
• Lack of estrogen can result in decreased bone density and increase your risk of developing osteoporosis. Fractures are also more common.
• Vaginal dryness can make intercourse uncomfortable and sometimes painful, leading to a lack of interest in sex.
• With a loss of ovarian testosterone, you may experience a drop in libido.
• The removal of your ovaries with surgical menopause will mean a loss of fertility, which may impact your emotional and mental health.
• Estrogen plays an important role in the vitality of your tissues. Low levels of this hormone can affect your cardiovascular system and make you more susceptible to heart disease.

Surgical menopause treatment

If you’re concerned about surgical menopause symptoms, you might want to talk to your doctor about menopausal hormone therapy (MHT). Though not for everyone, especially those with endometriosis, doctors often prescribe hormone replacement therapy (HRT) to help ease the symptoms of surgical menopause.

The main benefit of hormone replacement therapy is managing the risk of cardiovascular disease and osteoporosis. This kind of surgical menopause treatment is not always effective for everyone.

If you are under 45 and not a high-risk candidate for MHT, your doctor will most likely prescribe hormone replacement therapy for surgically induced menopause. Most people will follow this surgical menopause treatment plan until they’re 51, the average age of natural menopause. At this point, your doctor will talk with you about how to manage any symptoms you’re experiencing without HRT.

MHT is not for everyone, especially those with a history of breast cancer; however, studies have found it to be a safe surgical menopause treatment for women with a higher risk of developing breast cancer.

Weaning yourself off hormone replacement therapy needs to be done under the careful supervision of your doctor, as you will experience a sudden return of menopausal symptoms. About 50 percent of women report severe hot flashes and night sweats. 

The right kind of surgical menopause treatment plan for you will depend on your situation. For people recovering from a hysterectomy, doctors usually prescribe an estrogen-based replacement therapy. People with their uterus intact will receive a combination of estrogen and progesterone hormone replacement. If you’re younger than 45, your doctor might recommend a testosterone supplement to help boost your sex drive. 

If you get the all-clear from your doctor to start MHT, your best option is to start your first dose no later than a week after surgical menopause. Your doctor will give you clear instructions about when to begin your treatment.

Ongoing management of symptoms after surgical menopause

With the increased risk of developing osteoporosis after surgical menopause, it’s smart to make a few lifestyle changes to help counteract the loss of bone density. Your doctor might recommend adding calcium and vitamin D supplements to help keep your bones strong and healthy. 

As soon as you are fully recovered from your surgery, adding a regular exercise program that includes resistance training at least twice a week can help build and repair healthy bones. 

Limiting your use of caffeine and quitting smoking are two other ways you can improve the health of your bones and protect yourself against osteoporosis.

With the removal of your ovaries, your doctor may recommend hormone replacement therapy to help you manage symptoms related to changes in your blood vessels (vasomotor symptoms), such as hot flashes, night sweats, and vaginal dryness. People younger than 45 may need a higher dose of estrogen, and doctors may also recommend adding testosterone to help with the loss of libido. In the beginning, they will likely prescribe low doses of estrogen to see how well you tolerate this kind of therapy.

Doctors also typically recommend bone density scans for people younger than 45 who are undergoing surgical menopause. You should have a bone scan every two years. Your doctor might also recommend MHT to help with bone loss after surgical menopause. 

Surgical menopause stops the production of estrogen and progesterone, and this affects your body in many different ways. Pay close attention to your heart health by limiting cholesterol and high-fat, high-sugar foods. Regular check-ups will help you monitor your blood pressure and cholesterol so you can protect yourself against cardiovascular disease. While MHT will help with bone loss and vasomotor symptoms, there’s no evidence to determine if it’s an effective surgical menopause treatment for heart disease. 

With all these changes going on in your body, it’s not uncommon to feel depressed after surgical menopause. Many people seek help through counseling and support groups to help manage these symptoms. Online forums offer a great resource for support and help through this difficult time. Don’t hesitate to reach out and seek help. You’re not alone.

Takeaway

When considering surgical menopause, talk to your gynecologist and ask a lot of questions so you have all the facts before making a decision. Put your treatment plan into place before your surgery so you’ll be prepared. Talk openly with your family and friends, and don’t be afraid to ask for help. Having support through surgical menopause can help you manage your symptoms and get back to feeling like yourself.