Menopause is the end of menstrual periods and fertility. It is usually a naturally occurring process. Menopause may also be caused when both ovaries are surgically removed. This procedure is called a bilateral oophorectomy.1
If both ovaries are removed as part of your ovarian cancer surgery, you will immediately go into surgical menopause.1
While natural menopause and surgical menopause share some features, there are some differences between them. Understanding surgical menopause and its effects can help you prepare and get the care you need.
What is surgical menopause?
Surgical menopause is the sudden end of menstrual periods and fertility. This happens when both ovaries are surgically removed.1
In most cases, the effects of surgical menopause are more severe than those experienced with natural menopause.1
How to prepare for surgical menopause
If both of your ovaries need to be removed as part of your treatment, talk to your doctor about what to expect. Your doctor can help you understand surgical menopause and how to manage it.
After surgery, you may be given hormone replacement therapy with estrogen. If your uterus does not need to be removed, your doctor may recommend different hormone replacement therapy. You may need estrogen along with progestin. This protects the uterine lining from developing abnormal cells or uterine cancer. When given alone, estrogen can increase the risk of uterine cancer.2
Other things you can do to prepare for surgical menopause may include:2
- If you smoke, talk to your doctor about quitting
- Get regular physical activity, if your doctor says it is safe to do so
- Maintain a healthy weight
- Make sure you are getting enough calcium, preferably through the foods you eat rather than supplements. Talk to your doctor about how much calcium you need.
Effects of surgical menopause
In most cases, menopause is gradual as your body produces less estrogen over time. This gives your body time to adjust to different hormone levels.
During surgical menopause, this happens all at once. This forces your body to adjust right away. The most common symptoms of this change include:3
- Hot flashes
- Vaginal dryness
- Sexual issues (painful sex, loss of libido)
- Weight gain
- Sleep problems
- Memory changes
- Hair and skin changes
- Mood changes, depression, menopausal grieving
Surgical menopause has also been linked to some severe side effects. These include increased risk of:1
- Colorectal cancer
- Lung cancer
- Heart disease and stroke
- Cognitive issues
- Osteoporosis
- Sexual issues
- Overall mortality rate
Talk to your doctor about things you can do to reduce your risks or manage these issues.
These are not all the possible side effects of surgical menopause. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with surgical menopause.
Ways to manage surgical menopause
Many of the symptoms caused by surgical menopause can be managed. There are also things you can do to reduce your risk of more severe side effects.
Hormone replacement therapy
Hormone replacement therapy (HRT) is one common treatment. HRT can reduce your risk of heart disease and bone loss. It may also improve cognitive issues and sexual function. There are risks and benefits of HRT, so talk to your doctor about whether it is right for you.1
Vaginal estrogen
Vaginal estrogen can help reduce vaginal dryness and difficulties with sex. It is available in a cream, tablet, or ring. Vaginal estrogen may also help with some urinary symptoms.4
Antidepressants
Some low-dose antidepressants known as selective serotonin reuptake inhibitors (SSRIs) can help minimize hot flashes. They may also be helpful for those who cannot take HRT or those who have mood changes or depression.4
Other medicines
There are other medicines that can help manage menopause symptoms.
Research shows that gabapentin may help with hot flashes. It is usually used to treat certain types of shingles and pain. Another drug, clonidine, may also help with hot flashes. It is usually used to treat high blood pressure.4
Medicines to help treat or prevent osteoporosis may help build bone strength and reduce bone loss from lack of estrogen. Vitamin D supplements may also help strengthen bones.4
Things to consider
Before beginning treatment for surgical menopause, tell your doctor about any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.
If you have any questions about your menopause treatment or management, let your doctor know. Together, you can find something that works for you.