Menopause is the cessation of a woman’s monthly cycle, and the end to ovulation. This tends to occur about midway through life, usually in a woman’s early to mid fifties, though actual age can vary. As normally experienced, this change can happen gradually, over a number of years, as the ovaries gradually produce fewer hormones, but in surgical menopause the change is necessarily abrupt. What occurs in this form of menopause is that the ovaries are surgically removed, for many possible reasons, and the normal cycle completely ends with surgery.
Those who undergo oophorectomy (ovary removal), with or without hysterectomy (uterus removal), instantly lose capacity to ovulate, and the sudden loss of the ovaries means loss of production of certain types of hormones, such as progesterone and estrogen, that regulate menstrual cycle. In particular, estrogen loss after surgical menopause begins can cause the appearance of a number of “menopause symptoms” including things like hot flashes, changes in mood, loss of hair on head and hair growth on face, vaginal dryness, and reduced libido.
It’s been suggested by many that surgical menopause tends to be much more difficult to undergo than natural menopause. With natural menopause, there is a gradual cessation of hormones, and symptoms can still be uncomfortable. Yet, they do not all appear at once, within a few hours, and that can make the sudden descent into surgical menopause more jarring. To this end, should women need a hysterectomy and not have medical reason for oophorectomy, they will often ask doctors to leave the ovaries intact, if it is possible.
On the other hand, it is sometimes absolutely necessary for a bilateral oophorectomy to occur. If ovarian cancer is suspected or if ovarian behavior has resulted in severe side effects and symptoms for other reasons, removing the ovaries may be necessary, and in the latter case could result in a cessation of troublesome problems. Some women are happy to trade some of the potential challenges of surgical menopause with present medical conditions.
In some circumstances, doctors may attempt to control the rapid onset of surgical menopause by using hormone replacement therapy. This is not an option for all people, and usually those who had an oophorectomy to treat cancer are too high a risk to take estrogen because of its cancer causing properties. Where risk of cancer was not the reason for oophorectomy, patients and doctors can weigh risks versus benefits of hormone treatment and gradual cessation of hormones in a manner similar to traditional menopause.
Whatever path chosen, surgical menopause can be challenging, and support is useful. Some communities have support groups for those who have suddenly undergone menopause, and work with individual therapists with experience in this are can be helpful too. Close work with doctors involved is also of help in looking for ways to alleviate symptoms either hormonally or via non-hormonal means.
There are some greater risk factors for women who undergo surgical menopause. These include a higher risk for heart disease and increased likelihood of developing osteoporosis earlier. These matters should be discussed with a physician to determine ways to reduce risks, such as through good diet and exercise protocol, periodic exams to assess cardiac health, and through taking medications or supplements that may reduce bone thinning.
