Menopause is a transitional time, after which it is no longer possible to become pregnant. The process usually begins when a person reaches their 40s, but it can happen earlier in some circumstances.
Some surgeries, medical treatments, and health conditions can result in early menopause.
For example, undergoing surgery to remove one or both of the ovaries will cause levels of the hormones estrogen and progesterone to dip. Removing both ovaries will trigger surgical menopause.
In this article, learn more about surgical menopause, including what to expect and some lifestyle remedies.
Various types of surgery can affect the female reproductive organs. These surgeries include the removal of the uterus, fallopian tubes, cervix, and one or both ovaries.
Surgical menopause can occur after undergoing bilateral oophorectomy. This is a procedure in which a surgeon removes both ovaries. They may also remove the uterus, the fallopian tubes, the cervix, or a combination of these, depending on the reason for the procedure.
When a surgeon removes the uterus, this is called a hysterectomy.
If the surgeon removes both ovaries, menopause will begin immediately after the operation. If they remove the uterus, fallopian tubes, or both but leave one or both ovaries intact, menopause will probably start within 5 years.
The effects of surgical menopause will be similar to those of natural menopause, but they may be more acute. This is because the hormonal changes will happen suddenly rather than over several years. The changes will generally start as soon as the procedure is over.
There are many reasons for choosing to have surgery. For example, a person may undergo treatment to resolve endometriosis or to prevent cancer. Others may opt for surgery as part of sex reassignment surgery.
Some medical reasons for undergoing an oophorectomy include:
- easing endometriosis
- treating benign or cancerous tumors or cysts
- easing ovarian torsion, in which an ovary becomes twisted
- preventing ovarian cancer in those at high risk
People with a personal family history of breast cancer, ovarian cancer, or both may undergo testing to see if they have a genetic feature that increases their risk of cancer, such as changes in the BRCA1 and BRCA2 genes.
If these features are present, the person may decide to have surgery to reduce their risk of cancer in the future.
Research suggests that undergoing surgery can significantly reduce the risk of developing ovarian, fallopian tube, or peritoneal cancer later in life.
Anyone who is considering ovarian surgery for any reason should discuss the benefits and risks with their healthcare provider.
What does oophorectomy involve? Learn more here.
Sometimes, certain medical treatments can trigger the effects of menopause. Doctors call this “medical menopause.” The impact may be temporary or permanent, depending on the intervention.
Chemotherapy for breast cancer, for example, may cause a temporary pause in menstruation and the effects of menopause. This will start within weeks or months of beginning the treatment.
In some cases, menstruation will resume within a year of the treatment finishing. However, this is not the case for everyone.
According to some data, 25–50% of 30-year-olds who undergo this kind of treatment will start menstruating again. Research also suggests that even if menstruation returns, a person may experience menopause earlier than they would have if they had not had the treatment.
Learn more about menopause here.
Natural menopause occurs over a number of years, but surgical menopause occurs suddenly. Although everyone experiences menopause differently, the abruptness of the change can mean that the impact of surgical menopause is slightly different to that of natural menopause.
Menopause happens when levels of estrogen and progesterone dip. This change can give rise to various effects, including:
- hot flashes and night sweats
- vaginal dryness
- changes in libido
- difficulty sleeping
- mood changes
- problems with thinking, focusing, and memory
These effects may start to appear within hours or days of the surgery, depending on the extent of the procedure.
Menopause is a normal transition that the body goes through, similar to puberty. Some of the changes that occur with natural menopause may not be due to menopause but to the aging process. Natural menopause usually happens around midlife. At this age, people are also likely to experience other physical changes.
However, the hormonal changes that occur with either natural or surgical menopause can trigger or increase the risk of certain complications, regardless of the age at which menopause starts.
These complications include osteoporosis and heart disease, as estrogen has a key role in both.
For example, estrogen helps support strong bones. When estrogen levels dip, bone density can decrease, and the bones can become weaker and more likely to break, possibly giving rise to osteoporosis.
Estrogen also plays a role in cardiovascular health, and people who have experienced menopause may have a higher risk of stroke, heart attack, and other cardiovascular concerns.
That said, people who eat a varied diet and get regular exercise may have a lower risk of some of these complications.
After the removal of both ovaries, it will no longer be possible to become pregnant, and menopause will follow. People who still wish to have children after treatment should discuss the options with their doctor or a specialist counselor.
If a person undergoes medical menopause and there is a chance that menstruation will resume, they may wish to consider preserving some eggs, such as by freezing them, to increase their chance of having a healthy pregnancy later in life.
Discussing these risks with a healthcare provider can help an individual make an informed decision.
What happens when a person freezes their eggs? Learn more here.
A doctor might prescribe hormone therapy after surgery to reduce the impact of menopause.
Hormone therapy is not suitable for everyone. Those with a high risk of stroke, for example, may not be able to use it.
Other types of treatment can also help people manage the effects, which may include low mood, anxiety, hot flashes, and sleep problems.
Learn more about hormone therapy here.
Trying some lifestyle remedies might help reduce the impact of surgical menopause. These remedies include:
- Avoiding the triggers of hot flashes: Alcohol, caffeine, spicy foods, stress, and warm temperatures can all trigger hot flashes.
- Keeping cooling items to hand: It may help to keep a portable fan and a bottle of ice water nearby.
- Using a lubricant during sex: This can help make sex more comfortable and enjoyable.
- Keeping the bedroom cool and quiet: This can help make sleeping easier. Other tips include avoiding large meals and fluids before bedtime, following a regular routine for going to bed and getting up, and leaving mobile devices outside of the bedroom, if possible. Also, a person may wish to keep a fan near their bed.
- Taking steps to relieve stress: Some tips to relieve stress include getting enough sleep, exercising, taking walks in nature, meditating, and practicing yoga.
- Seeking help when needed: A doctor, counselor, or other healthcare provider can offer support and treatment if a person has any physical or mental health concerns.
- Joining a support group: A person can ask their healthcare provider about local support groups for people with menopause or surgical menopause. In many cases, friends or family will also be willing to help.
The hormonal fluctuations that characterize menopause can affect a person’s mental and physical health and well-being. Surgical menopause causes these effects to develop immediately, whereas in natural menopause, they may develop slowly over time.
Anyone who is considering preventive surgery should discuss the benefits and drawbacks with a healthcare professional before going ahead.
If a person experiences severe or worsening menopause effects after surgery, they should seek medical help. A doctor can usually suggest ways to help manage these effects.