Menopause is a transitional phase, during which pregnancy is no longer possible. Typically, the process starts when a person hits their 40s, but in certain cases, it can happen sooner.
Early menopause can result from certain procedures, medical treatments, and health conditions.
For instance, undergoing surgery to remove one or both of the ovaries can cause estrogen and progesterone hormone levels to dip. Trying to remove both ovaries will stimulate surgical menopause.
Find out more about surgical menopause in this post, including what to expect and some lifestyle remedies.
Surgery and menopause
Female reproductive organs may be damaged by various forms of surgery. The removal of the uterus, fallopian tubes, cervix, and either or both ovaries requires these operations.
After undergoing bilateral oophorectomy, surgical menopause may occur. This is a procedure in which both ovaries are separated by a surgeon. Depending on the reason for the operation, they may also remove the uterus, the fallopian tubes, the cervix, or a combination of these.
This is also a hysterectomy, when a surgeon removes the uterus.
If both ovaries are removed by the surgeon, menopause will commence immediately after the procedure. If the uterus, fallopian tubes, or both are removed but one or both ovaries are left intact, menopause will likely begin within 5 years.
The symptoms of surgical menopause may be similar, but may be more acute, to those of natural menopause. This is because, rather than over many years, the hormonal shifts can occur unexpectedly. As soon as the procedure is finished, the modifications will usually start.
Causes or reasons for surgery
There are many reasons for choosing to have surgery. For example, to address endometriosis or to prevent cancer, a person may seek treatment. As a part of sex reassignment surgery, some may opt for surgery.
Certain medical reasons for getting 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 can be checked to see whether they have a genetic function that raises their cancer risk, such as variations in the genes BRCA1 and BRCA2.
The person will decide to have surgery to decrease their risk of cancer in the future if these characteristics are present.
Research shows that the risk of developing ovarian, fallopian tube, or peritoneal cancer later in life may be substantially decreased through surgery.
Anyone who is contemplating ovarian surgery for any cause should discuss with their healthcare provider the benefits and risks.
Sometimes the symptoms of menopause may cause such medical treatments. Doctors call this “medical menopause.” Depending on the intervention, the effect can be temporary or permanent.
For example, chemotherapy for breast cancer can cause a temporary menstrual pause and the symptoms of menopause. Within weeks or months of starting the procedure, this will begin.
In certain cases, within a year of the completion of the procedure, menstruation will return. This is not the case for everyone, however.
25-50 percent of 30-year-olds who undergo this form of treatment will start menstruating again, according to some data. Research also indicates that a person may undergo menopause sooner than they would have if they hadn’t had the procedure, even if menstruation returns.
What to expect
Over a period of years, normal menopause occurs, but surgical menopause happens unexpectedly. The abruptness of the transition may mean that the effect of surgical menopause is slightly different from that of natural menopause, although everyone experiences menopause differently.
Menopause occurs when estrogen and progesterone levels dip. This change can lead to different effects, including:
- hot flashes and night sweats
- vaginal dryness
- changes in libido
- difficulty sleeping
- mood changes
- problems with thinking, focusing, and memory
Depending on the nature of the operation, these effects can start to occur within hours or days of the surgery.
Similar to puberty, menopause is a natural process that the body goes through. Some of the changes that occur with natural menopause may not be due to menopause but to the aging process. Around midlife, normal menopause typically occurs. People are likely to undergo other physical changes at this age as well.
Hormonal changes occurring with either natural or surgical menopause, however can cause or increase the risk of certain complications irrespective of the age at which menopause begins.
Osteoporosis and heart disease are among these complications, as estrogen plays a central role in both.
Estrogen helps sustain healthy bones, for instance. Bone density will decline as estrogen levels dip, and the bones can become weaker and more likely to break, potentially giving rise to osteoporosis.
Estrogen also plays a part in cardiovascular health and may have a greater risk of stroke, heart attack, and other cardiovascular problems for women who have experienced menopause.
That said, there could be a lower risk of some of these complications for people who eat a varied diet and get regular exercise.
It will no longer be necessary to become pregnant after the removal of both ovaries, and menopause will follow. People who still want to have children after treatment should speak to their doctor or a specialist counselor about the choices.
If a person undergoes medical menopause and there is a risk that they may restart menstruation, they may want to consider preserving some eggs to increase their chance of having a healthy pregnancy later in life, such as by freezing them.
Discussing these risks with a healthcare provider will help a person make an informed choice.
To decrease the impact of menopause, a doctor might prescribe hormone therapy after surgery.
Hormone therapy is not suitable for everyone. For instance, people with a high risk of stroke might not be capable of using it.
Other forms of therapy can also help people control the symptoms, including low mood, anxiety, hot flashes, and issues with sleep.
Trying some lifestyle treatments may help minimize the effect of menopause surgery. Such 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 changes that define menopause can influence the mental and physical health and well-being of an individual. Surgical menopause allows these effects to occur immediately, while they can develop progressively over time during natural menopause.
Before going ahead, someone who is considering preventive surgery should explore the benefits and disadvantages with a healthcare professional.
They should seek medical attention if a person experiences serious or worsening menopause symptoms after surgery. Usually, a doctor may recommend ways to better mitigate these symptoms.