Surviving Surgical Menopause — What I Wish I Knew

Introduction to Surgical Menopause

I never thought I’d be in a position to be forced to choose an oophorectomy or the removal of my ovaries. Yet, in the prime of my “child-bearing” years, I sat wearing a paper gown at my OB/GYN’s office as my lovely doctor told me that my pelvic inflammatory disease (PID) had progressed to a point where that would be the best way to reduce my symptoms. 

Understanding Oophorectomy: The Procedure and Reasons

Now, there are multiple other reasons you might undergo an oophorectomy, like ovarian cancer endometriosis, or you may test positive for the BRCA gene mutation and want to minimize the risk of ovarian and breast cancer.

Effects of Surgical Menopause

No matter why you’re undergoing this surgery, you’re in for a significant adjustment. “Surgical menopause” hits you hard and fast, and suddenly, you’re waking up in the night drenched in sweat if you can manage to sleep, your mental health is in shambles, and you’re tired no matter how many cups of coffee you consume.

Here is what I wish I’d known before and during my surgical menopause.

What To Expect After Surgical Menopause?

Most people undergoing an oophorectomy are younger than the average age of menopause, which is 51 in the United States, according to the Mayo Clinic. 

However, for someone who’s undergoing natural menopause, the symptoms of menopause often begin several years before the actual cessation of your period, during a time called perimenopause, as hormone production gradually declines. With surgical menopause, there is no gradual adjustment of hormones.

You may experience symptoms like hot flashes, night sweats, insomnia, fatigue, depression, anxiety, and more. Surgical menopause is initiated rapidly via surgery rather than gradually via aging, so the symptoms tend to be more severe. And those are just the short-term effects. The long-term effects of surgical menopause can include a decreased sex drive, vaginal dryness, a higher risk of early cognitive decline, and loss of bone density, leading to an increased risk of osteoporosis.

“Studies have also shown that if you have surgical menopause prior to the age of 45, there is a marked increased risk of heart disease,” said Tara Scott M.D. According to the CDC, heart disease is the leading cause of death for women in the United States. 

Preventing Surgical Menopause Symptoms

Experiencing instant menopause can cause some seriously uncomfortable symptoms. Thankfully, some of these symptoms can be managed with lifestyle adjustments.

Osteoporosis

Weight-bearing exercises, such as walking, hiking, weightlifting, yoga, and aerobics, can mitigate the risk of osteoporosis. These exercises slow mineral and bone density loss. You may also benefit from adding calcium and vitamin D3 supplements to your regimen, but talk to your doctor first and follow their instructions.

Skin changes

Changes to the skin can also be managed with lifestyle changes. The decline in estrogen after an oophorectomy may cause your skin to become drier, thinner, and more prone to sagging and wrinkles. Your wounds might heal more slowly. 

A moisturizer, especially one that includes hyaluronic acid, can be useful for mitigating these symptoms. In addition, staying hydrated, eating a healthy, balanced diet, and implementing a moisturizing skincare routine can help improve the condition of your skin.

Mood conditions

The surgical menopause transition can wreak havoc on mood conditions such as depression, anxiety, and bipolar disorder, said Ann L. Steiner, M.D. Irritability and insomnia are both side effects of menopause and have serious potential to affect your mood.

While some women experience improved psychological well-being post-surgery, women already suffering from depression may experience worsened mood conditions after surgical menopause, according to an article published in the Journal of the North American Menopause Society.

Suppose you’re suffering from a mood condition after surgical menopause. In that case, it’s important to talk to your doctor, who may prescribe an antidepressant or adjust your current dosage in response to your symptoms.

Menopausal Hormone Therapy

For some patients, menopausal hormone therapy (MHT), also known as hormone replacement therapy (HRT), may be an option. MHT can ease the abrupt hormone drop when the ovaries are removed. The change in hormones from the removal of your ovaries is the source of the intense symptoms of surgical menopause. Mitigating the decrease in hormones with MHT may be an effective option for symptom relief.

Estradiol, a form of estrogen, is commonly given as a hormone replacement after a patient goes through surgical menopause. Progesterone is also recommended to help prevent endometrial cancer.

However, MHT is not a cure for everyone experiencing surgical menopause. For people who had their ovaries removed out of precaution due to carrying the BRCA gene mutation, it’s a risk. -reward situation.

Estrogen causes cell growth, and estradiol receptors exist in every cell of your body. Even with progesterone prescribed to counter estrogen-related growth, there is still a risk of developing cancer. Depending on the severity of your symptoms and risk tolerance, it’s important to talk with your doctor about the risks and potential rewards of MHT.

Regardless of your situation, I recommended finding a hormone therapist who can test your hormone levels and counsel you on the options for managing your postmenopausal symptoms. Look for someone certified by the North American Menopause Society or the American Academy of Anti-Aging Medicine.

Emotional Support Options

Going through a roller coaster of symptoms from surgical menopause can leave anyone reeling— I know I wasn’t myself for about a year after surgery. You are not alone if you need support on either side of this monumental life change. Support groups can be incredibly useful, as they combine members at all stages in this challenging process.

There is also an abundance of support to be found online. Ovacome is an ovarian cancer charity whose goal is to help people who are experiencing surgical menopause. The Surmeno Connection is an online resource and support group that assists people before, during, and after surgical menopause. It offers peer-to-peer counseling from members farther along in their surgical menopause journey. The Ovarian Cancer Research Alliance also provides peer-to-peer support and a wealth of resources, including the latest research on the disease.

If you have had surgical menopause and are struggling with the symptoms, know that you are not alone. I recommend you talk to your doctor about minimizing your symptoms and contact an online or local support group to help guide you through this time.