Surgically Induced Menopause (Hysterectomy and Oophorectomy) and Premature Menopause
While it is true that perimenopause and menopause are completely natural, they can be annoying and disruptive parts of the normal life cycle. For some women, they come abnormally early (premature menopause), or as a result of surgical or medical interventions (hysterectomy or as a result of some cancer treatments like radiation and chemotherapy).
In some cases, you may be able to treat your menopause symptoms under these circumstances with HT (Hormone Therapy).
In the meantime, let’s take a look at what we’re talking about.
We women love to change things up: our hairstyle, our hemlines, our wardrobes. And if we don’t like something—that couch, that old dress—we toss it and get a new one. Well, let me stop you right there, because if your doctor tells you that you should have a hysterectomy, make sure you get a second opinion, and maybe a third. After all, a hysterectomy is forever.
How are these for some startling stats? The CDC reports that 600,000 women have their uterus removed every year. More than one-third of women will have had a hysterectomy by the time they turn 60, the National Women’s Health Network reports.
The important thing is to be sure that you understand the pros and cons of a hysterectomy. Some women have a long recovery and experience side effects that they were not aware of such as, incontinence and sexual dysfunction. If that’s not enough, a landmark study showed that removing ovaries along with the uterus ups the likelihood of heart disease and bone loss, according to study coauthor William Parker, MD, of the UCLA School of Medicine.
Only 10% of hysterectomies are performed to treat cancer. Most of them are done to treat bothersome but benign bleeding from fibroid tumors—even though there may be other ways to treat them, such as uterine fibroid embolization, a non-surgical technique that introduces microbeads via a small catheter to block the blood supply to the tumor, thereby reducing its size and alleviating symptoms. Other less invasive treatments include hysteroscopic myomectomy (removing the fibroid through the cervix rather than slicing you open) and endometrial ablation.
If you do indeed need a hysterectomy, due to cancer or prolapse, ask your doctor about laparoscopic surgery. Laparoscopic surgery is done through small incisions rather than one large incision. Be sure to talk to your doctor before surgery, so that you can have a plan in place to deal with the hormonal and other physical and emotional effects of the procedure.
After the procedure, a woman may no longer become pregnant. If she has not yet entered menopause at the time of surgery and her ovaries are left in place, they will continue to produce estrogen. However, she still may enter menopause at an earlier age.
If her ovaries are removed during the hysterectomy, she will enter menopause and encounter symptoms caused by a lack of estrogen such as hot flashes, vaginal dryness, and sleep problems. She may also be at risk of developing osteoporosis at an earlier age, according to The American College of Obstetrics and Gynecologists.
FYI, a woman still needs regular Pap tests to screen for cervical cancer if she has a partial hysterectomy and does not have her cervix removed, or if her hysterectomy was performed as a treatment for cancer. Most of the Gynecologists that I have interviewed recommend that any woman who has had a hysterectomy should still have regular pelvic exams and mammograms.
There can be emotional effects from a hysterectomy as well. Some women feel depressed because they can no longer have children, and, if they have entered menopause after the surgery, hormonal changes can cause emotionally difficult symptoms. However, many women feel relieved because the symptoms they were having are no longer present.
What does hysterectomy mean for your love life? Some women experience more sexual pleasure post-surgery because of the loss of symptoms, as they no longer are having discomfort or heavy bleeding during sexual intercourse, according to a study by Jan-Paul W. R. Roovers, MD, an obstetrics-gynecology professor at the University Medical Center in Utrecht, the Netherlands.
For others when the uterus has been removed, the uterine contractions that the woman may have felt during orgasm will no longer occur. This can decrease sexual satisfaction for some women. A minority of women report developing sexual dysfunctions following a hysterectomy. Reduced estrogen levels are the main cause of vaginal dryness, says the Mayo Clinic. I know that when my estrogen levels began plummeting, my vagina took a trip to the desert. It was dry and parched!
Perimenopause arrives unscheduled and uninvited. Most women first begin to experience perimenopause in their early to mid-forties, but some women begin to have symptoms in their thirties, or even in their twenties and achieve full menopause (no period for 12 consecutive months) before the age of 40. I wish I could tell you that you will receive a “Hold the Date” notice so that you’ll know exactly when your menopausal journey will begin—sorry, no dice.
The loss of ovarian function at an early age is often referred to as premature menopause, early menopause, premature ovarian failure, or premature ovarian insufficiency (POI). Where are the naming police?
There are many factors that contribute to menopausal timing, including autoimmune and genetic disorders, chemotherapy, radiation therapy, and surgical history. However, sometimes the cause is unknown. Women who undergo an oophorectomy or radical hysterectomy in which the ovaries are removed jump right over perimenopause into full menopause. This is not fun!
According to an article published in JAMA Internal Medicine, which looked at a group of nearly 1,500 women with frequent symptoms of the onset of menopause, women who began to experience hot flashes and night sweats at a younger age tended to have them over a greater period of time. That means women who experience early or premature menopause symptoms may experience these symptoms longer than average.
According to a study published in the Journal of the American Medical Association Cardiology,women who experience menopause earlier are at greater risk for cardiovascular issues such as heart disease and stroke and even have greater all-cause mortality rates than women who experience menopause nearer the average age of 51. Speak to your menopause specialist about being proactive about your health choices based on this new heart health info.
Speaking of being proactive, when I first met Christine Eads, she was co-host of the popular radio show “Broadminded” on Sirius XM Radio 107. Now Christine is the co-host of the digital radio show, “The Mom Squad Show.” Christine opened up and shared her powerful story about her own struggle to find hormone happiness. When she was 24, her period stopped. For the next five years, she saw doctor after doctor, looking for a solution. They told her the problem was caused by everything from depression to weight gain to weight loss to sexually transmitted disease! All the while, she was experiencing terrible mood swings and waking up in pools of sweat—both typical menopausal symptoms.
Ultimately, she went to a specialist at the National Institutes of Health, who discovered that she suffered from primary ovarian insufficiency (POI). Christine was devastated! She wasn’t ready to have kids at that point in her life, but she had always dreamed of having a huge family with tons of children. She was really angry at the doctors who didn’t diagnose her properly. After five years of suffering needlessly, Christine was put on hormone therapy. The therapy curtailed her symptoms and ultimately she was able to conceive!
What saved Christine in the end was her determination to find an answer. “You have to be your own advocate. No one cares about your health more than you. Don’t blow it off and say that it’s normal or it will go away. If you don’t feel right in any way, get to a specialist and ask a million questions until you are satisfied. Don’t be embarrassed to talk to family and friends about what is happening with you. You may not know that POI, or other disorders, run in your family, for instance, and you might find strength sharing your experience with another person who is feeling the same way. It is worth taking the time and doing the research to feel better.” she says.
I couldn’t have said it better myself!
Suffering in silence is OUT! Reaching out is IN!
Click here to download my free eBook, MENOPAUSE MONDAYS The Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.