Surgical Menopause: Everything You Need to Know

What is surgical menopause?

Surgical menopause involves the removal of your ovaries (oophorectomy), either on its own or in conjunction with a hysterectomy. Since the ovaries are your body’s main source of estrogen production, this could immediately trigger menopause, regardless of your age.

Why an oophorectomy might be necessary

An oophorectomy is often recommended by doctors to inhibit the development of chronic diseases. Patients at greater risk for breast or ovarian cancer based on family history may be advised to have one or both ovaries removed. In many cases, an oophorectomy is performed alongside a hysterectomy, which would similarly induce surgical menopause.

The relief of chronic and persistent pelvic pain or symptoms of endometriosis have also been cited as reasons for undergoing an oophorectomy. Others include:

• Ovarian torsion (or twisting, which hampers blood flow)
• Recurrent ovarian cysts
• Fibroids
• Ovarian cancer
• Benign ovarian tumors

What is hormone replacement therapy (HRT)?

Progesterone and estrogen are the primary hormones safeguarding your reproductive health. After surgical menopause, the shortage of these hormones produces a wide array of symptoms, such as:

• Hot flashes and night sweats
• Vaginal dryness
• Depression and mood swings
• Insomnia 
• Fatigue
• Dry skin
• Hair thinning
• Weight gain
• Decreased sex drive

To control the adverse effects of surgical menopause, your doctor might suggest hormone replacement therapy. HRT addresses the sometimes severe hormonal imbalances in your body brought on by surgical menopause. 

Menopause symptoms can be painful and disrupt your daily activities. HRT helps alleviate those symptoms while simultaneously curbing bone loss and aiding in the prevention of osteoporosis and cardiovascular disease. 

This is particularly critical for women under 45 years of age who have an oophorectomy prior to experiencing natural menopause. They possess a greater chance of developing heart disease, neurological issues, and cancer without HRT. 

Surgical menopause symptoms aside, don’t start HRT if you have:

• A personal or family history of ovarian, uterine, or breast cancer 
• A personal history of thrombosis, or blood clots
• Untreated high blood pressure 
• Liver disease

Several different types of HRT are available to manage surgical menopause symptoms. Note that estrogen-only therapy is administered to hysterectomy patients, whereas women who still have their uterus use a combination of estrogen and progesterone. 

Pros of surgical menopause

In some cases, an oophorectomy and the resulting surgical menopause could prove to be a life-saving measure. The growth of certain cancers is dependent upon estrogen, and individuals with a family history of breast or ovarian cancer are especially prone to developing the disease.  

Surgical menopause is also beneficial for women suffering from endometriosis. This condition causes uterine tissue to grow outside of your uterus. It can impact your fallopian tubes, lymph nodes, or ovaries and lead to severe pelvic pain. An oophorectomy might slow or even stop the production of estrogen and help relieve related symptoms.

Cons of surgical menopause

Potentially negative effects of surgical menopause include the following:

• More severe and sudden menopause symptoms, especially hot flashes, vaginal dryness, and night sweats
• Increased risk of osteoporosis, bone loss, and fractures
• Increased risk of heart disease
• Diminished libido due to a lack of testosterone 
• Impaired sexual function (associated with discomfort from vaginal dryness) 
• Inability to conceive

Additionally, surgical menopause might alter your mood, thinking, and cognition — thereby increasing your chances for depression and dementia. 

How to manage surgical menopause

If appropriate, your doctor will prescribe HRT to not only control surgical menopause symptoms, but to replenish the hormones your body is now lacking. The following lifestyle changes should further ease the effects of surgical menopause:

• Drop any bad habits which might trigger hot flashes. Avoid consuming spicy foods, caffeine, and alcohol. Limit your exposure to very high temperatures and reduce stress as much as possible.
• Keep cooling items close at hand. Carry a bottle of ice cold water or a portable fan to provide instant relief. Stay hydrated at all times. Dress in layers so it’s easy to remove clothing whenever needed. 
• Maintain a cool, comfortable, and quiet sleeping area in order to get a good night’s rest every night. 
• Start exercising regularly, practicing meditation or yoga, and writing in a journal. Consider joining a local support group for women who have undergone surgical menopause or natural menopause. Reach out to family, friends, and colleagues or see a counselor to share experiences and relieve stress. 
• Begin using a water-based lubricant before sexual intercourse to eliminate the discomfort caused by vaginal dryness.

Surgical menopause is a side effect of an oophorectomy and/or hysterectomy. But with the proper use of hormone replacement therapy and lifestyle changes, it’s definitely possible to lessen the impact of surgical menopause symptoms. Make an appointment with your doctor to discuss various alternatives and ensure you continue living a healthy and active life.