Surgically Induced Menopause (Hysterectomy and Oophorectomy) and Premature Menopause

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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.

Hysterectomy

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!

Premature Menopause

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.

After struggling with her own severe menopause symptoms and doing years of research, Ellen resolved to share what she learned from experts and her own trial and error. Her goal was to replace the confusion, embarrassment, and symptoms millions of women go through–before, during, and after menopause–with the medically sound solutions she discovered. Her passion to become a “sister” and confidant to all women fueled Ellen’s first book, Shmirshky: the pursuit of hormone happiness. As a result of the overwhelming response from her burgeoning audiences and followers’ requests for empowering information they could trust, Ellen’s weekly blog, Menopause MondaysTM, was born.

  • Great tips Ellen. I was sent into chemical menopause followed by forced menopause because of estrogen positive breast cancer. I went from someone who was easily cold to dripping sweaty with no recourse to remedy the situation. My oncologist was very forthcoming so I was aware this would happen. Some other cancer patients either didn’t hear this or it was not stressed enough or couched with it may happen!

    • I am so happy that your oncologist prepared you! I am not sure if you are still having hot flashes, but the oncologists at Yale Cancer Center told me in my interview with them that they recommend Remifemin to their patients. They feel it is the best black cohosh on the market. Here is the blog I did with them: http://ellendolgen.com/2015/01/breast-cancer-and-menopause/

  • You’re so right about getting 2nd or 3rd opinions before going through major surgery. I’ve been lucky. 62 and still intact. No hormones either. It reminds me of how easily doctors did C sections.

  • Cheryl Nicholl

    I have a friend who had a full hysterectomy (Ovaries and Uterus) at age 20 because her family doctor recommended it for her severe cramps. HOLY TOLEDO! Her parents didn’t know any better and never questioned it in rural 1965. Needless to say everyone of us is delighted that medical science has expanded. I still can’t get over her doctor’s solution and her parents blind faith.

    • OMG!!! Thanks for sharing this. It reminds us all of the importance of being educated about our own body and the options available for treating specific symptoms. Be your own BEST health advocate!

  • Yes! Getting at least two opinions is essential before any surgery. I’m glad to see this type of information. I know so many women who weren’t so lucky and had the surgery like it was pulling a tooth.

    • I totally agree, Carolann. If you need to have the surgery, it’s def an important option.

  • Hysterectomy is forever. You said it. Great and informative post. Some docs are way too casual about this. I knew one who used to refer to it as “throwing away the baby carriage.”

    • That is horrible! I have a friend whose doctor told her to put her uterus in a jar! Thankfully, she ran out of that office -and BTW her uterus is still in tact.

  • Lois Alter Mark

    You teach me something new every day. Christine’s advice is so important. We MUST be our own advocates and not be embarrassed to ask the important questions.

  • Mary La Fornara

    Thank you for this post. I learned so much. 3 opinions, always!

    • I am so happy you found the blog informative. Thanks for sharing the info!

  • Linda

    Hi Ellen,
    This is such important information!
    Back in the 90’s there weren’t many alternatives in finding out the options we REALLY had! I was 35yrs young when I had a partial hysterectomy. My husband and I were told by the dr the tumor was too big to take out vaginally as I could have excessive bleeding since I did not give birth naturally, but had a c section. The dr felt it was better to go in through c section area which was at the time such a light scar, you could hardly see it. He also suggested to take out ovaries and be done with it. My decision: thank GOD I had the sence to keep my ovaries! There wasn’t a problem in that area, so I didn’t feel like throwing away my women parts like they had no meaning! If it wasn’t for the pain and needing the surgery immediately, I would have searched for a new dr. I’ve since learned, you do not need to have given birth vaginally to have your uterus removed in a non invasive way! Praying who ever reads this doesn’t allow any dr to cut them if it isn’t necessary.

    • Thanks for sharing your story, Linda! When we share we help so many other women with their journey.