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Surgical menopause

What is surgical menopause? Menopause is a naturally occurring stage in women life – it is a time of the end of women’s reproductive function and reproductive years. Medically menopause is defined as the absence of menstrual periods for 12 consecutive months. Usually menopause happens between the ages of 45 and 55. But sometimes women could experience menopause much earlier because of surgical procedures such as bilateral oophorectomy (surgically removed ovaries). It almost always occurs with hysterectomy (removal of the uterus).

These surgical procedures cause the abrupt menopause (called “surgical menopause”). Surgical menopause occurs in women who have not yet had natural menopause. Usually women with surgical menopause experience more severe menopausal symptoms than women with natural aging menopause.

Surgical menopause – peculiarities

  • Surgical menopause occurs very suddenly. Since there is abrupt disruption of hormones after hysterectomy, the menopausal symptoms are more severe, more frequent and last longer when compared to natural menopause. The symptoms are triggered by the body’s sudden inability to make certain hormones due to the removal of ovaries.
    Before operation woman is having menstrual cycles (regular or irregular) and the next day (after surgery) she is becoming hormonally postmenopausal. Healthy women with natural menopause have a gradual transition period – premenopause, menopause and postmenopause which could take many years.
  • Women with surgical menopause usually experience more severe and intense menopause symptoms than women with natural menopause.
  • Age of women with surgical menopause is usually younger than women with natural menopause.
  • Women with surgical menopause are usually facing severe emotional, mental and physical problems after surgery. Besides recovering after operation, they should dial with unusual unpleasant menopause symptoms.

Surgical menopause – symptoms

Women ovaries are the main source of female hormones (estrogens and progesterone) and small portion of androgens in the body. When they are gone (after above mentioned surgical procedures), the hormone levels fall and changes associated with menopause occur – woman body reacts promptly with severe menopause symptoms such as:

Woman in surgical menopause

  • hot flashes,
  • night sweats,
  • vaginal dryness and/or itching,
  • sleep disorders,
  • palpitations,
  • mood swings,
  • irritability
  • depression,
  • weight gain,
  • anxiety,
  • fatigue,
  • concentration problems,
  • migraine,
  • reduced libido.

Surgical menopause – solutions

Estrogen is immediately given after surgery to try to prevent the intense changes especially the hot flashes that can occur in woman undergoing hysterectomy. Estrogen replacement therapies have found to relieve many women experiencing surgical menopause.
However the use of estrogen is itself controversial and it is not usually recommended for women with existing or high risk of cardiovascular disease. A lowest dose of estrogen for the shortest possible time is recommended. When taking estrogen, take the lowest dose for the shortest possible time and consider alternative therapies.
Some antidepressants or herbal therapy, such as black cohosh, or a diet high in soy, may help to relieve hot flashes.

Women with surgical menopause should not take progestins.

Estrogen gel could be effective during surgical menopause. This is quite easy to use and it has to be applied to the upper leg or stomach daily. The gel works by releasing a consistent dosage of estrogen into the blood stream making the Hormone Replacement Therapy HRT option effective.
Vaginal creams which can be applied directly to the vagina give relief locally on the lining of the vagina and are beneficial for vaginal atrophy conditions.

HRT implants which are small pellets inserted under the skin periodically once in six months supply hormones. These are surgically inserted into the fatty layers of the abdomen under a local anesthetic.

HRT patches come in various dosages and these are small plasters which can release hormones into the blood stream transdermally. The patch needs to be changed twice weekly and possible side effects could be skin irritation and allergy.

Tablets are the most common form of HRT and they are for long term usage which needs to be carefully considered.

Surgical menopause – risks

  • Women with surgical menopause are seven times more prone to cardiovascular disease risks.
  • Women with surgical menopause have higher risk of osteoporosis.
  • Reduced levels of testosterone in women with menopause after surgery are predictive of height loss which may occur as a result of reduced bone density.
  • In women with menopause after surgery the gum tissues are affected and regular dental checkups are strongly recommended
  • Women with menopause after surgery in young ages experience lowering of sexual desire.
  • Some scientists discovered higher mortality rate in women with menopause after bilateral oophorectomy.

 


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