What is Surgical Menopause
Definition of Surgical Menopause
Surgical menopause simply means the artificial onset of menopause due to surgical removal of the ovaries.
The end result is the same, cessation of menstruation along with significant hormonal changes
Menopause, in the past referred to as "the change of life", is a naturally occurring event. The physiologic changes that signal the onset of menopause become evident usually when a woman is in her forties. Near age fifty, most females stop having menstrual periods.
Menopause refers to the whole period of a woman's life when she doesn't menstruate. However, when we commonly speak of menopause, we usually talk about the phase of change when menopause starts. This is more correctly called perimenopause, but again, most women refer to these changes as menopause. At this time, a woman stops ovulating and is no longer fertile. Because of the drop in estrogen levels, many changes occur that are noticed by most women and quite distressing to others.
The normal perimenopausal time can last months to years with gradual changes for the woman. Changes in the levels of estrogen and other hormones occur. About 3/4 of women report symptoms, but for some, the changes are gradual and mild and either go largely unnoticed, or are not bothersome.
The most common symptoms, when reported, in the perimenopausal phase are:
- Hot flashes or heat intolerance
- Night sweats
- Reduced sex drive
- Mood swings and irritability
- Vaginal dryness
Features of Menopause
In contrast, surgical menopause is NOT a gradual process. The ovaries are gone upon awakening from the anesthesia and the changes associated with perimenopause/menopause become evident quite quickly.
All of the changes that would happen slowly over time leading to natural menopause, occur abruptly and rapidly when the ovaries are removed.
Because of the suddenness of the changes, the symptoms of menopause can be quite severe following surgical procedures that induce menopause.
Reasons for Ovarian Surgery
Most of time, if both ovaries are removed resulting in surgical menopause, it is usually due to cancer or the threat of cancer.
A hysterectomy may or may not include the removal of the ovaries, depending on the reason for the surgery. The ovaries will be left behind whenever possible to prevent surgical menopause and decrease the risks that accompany the hormonal changes that occur when ovaries are removed.
Surgical excision of a ovary is called an oophorectomy. If both are taken it's called a bilateral oophorectomy. Because the fallopian tubes are usually removed at the same time, the surgery often is called a salpingo-oophorectomy. BSO stands for bilateral salpingo-oophorectomy and means that both Fallopian tubes and ovaries are removed.
Aside from that, the ovaries may be removed during other abdominal surgeries.
Hormone replacement therapy can ease the sudden, brutal symptoms of surgical menopause.
Treatment for Surgical Menopause
Because the symptoms and effects of surgical menopause are so much more sudden and potentially severe than 'natural' menopause, hormone replacement therapy is often recommended, at least for a while after surgery.
Estrogen, progesterone and testosterone are all important hormones produced by the ovaries. They can be prescribed in appropriate amounts to ease the transition to the menopausal state. The decision of whether or not to continue the hormones is up to the patient, hopefully after informed discussion with her doctor.
Long Term Implications of Surgical Menopause
The long term issues with surgical menopause are the same as natural menopause. Over time, women become more susceptible to problems like heart disease and osteoporosis. Other physical changes occur and can be bothersome.
There is a great deal of controversy about hormone replacement therapy and its risks and benefits. Many individual factors weigh into this decision and should be discussed with your doctor.