There are short-term and long-term risks associated with surgical menopause.
Surgical Risks
Any surgery has risks including, for example: a reaction to the anesthetic, bleeding, infection, or pain after the procedure. Your surgeon will explain these to you before your surgery before you sign the consent form. It is important to understand that surgery will only go ahead if the benefits are believed to outweigh any risks.
Psychological Effects of Surgery
While everyone’s experience is different, some people may feel emotionally upset immediately following surgery. PMDD is a sensitivity to hormone fluctuations and after surgery your hormone levels drop significantly, thus making it a difficult time for many people. Ensuring those around you understand why you are having the surgery, and having a good support network around you, are very important.
Surgery and surgical menopause is a big physical and psychological adjustment for anyone, and this should not be underestimated.
Estrogen Deficiency-Related Menopause Symptoms
Following surgical removal of the ovaries, you become post-menopausal immediately. As your hormone levels drop you may experience a sudden onset of menopausal symptoms. These may be mild, moderate, or severe depending on your particular situation. These symptoms can be minimized by taking hormone replacement therapy (HRT), or alternative if hormones are not an option following surgery.
Symptoms include, but are not limited to:
vasomotor symptoms (for example, hot flushes and sweats)
musculoskeletal symptoms (for example, joint and muscle pain)
effects on mood or anxiety (for example, feeling abnormally sad or worried)
urogenital symptoms (for example, vaginal dryness)
sexual difficulties (for example, low sexual desire).
Menopausal symptoms, as a result of estrogen deficiency, can also be long-term - but everyone is individual. HRT can reduce these symptoms and can be taken long-term, quite safely, by the vast majority.
Long-term Health Risks
The ultra-low levels of estrogen in surgical menopause can cause bothersome menopausal symptoms, but more importantly, they can reduce the length and quality of your lifespan by increasing the risk of various serious health conditions. We will address each below.
For those under the age of 40 entering surgical menopause, using HRT (Hormone Replacement Therapy) also reduces or eliminates the serious long-term health risks associated with surgical menopause, including:
osteoporosis and broken bones
cardiovascular disease (for example: heart attack, stroke)
dementia and Parkison’s disease
psychiatric disorders (for example: mood or anxiety disorders)
vulvar and vaginal atrophy
sleep disorders (for example: persistent and impairing insomnia)
higher risk of death by any cause
To summarize, surgical menopause is known to cause all of the above symptoms and health risks-- but these problems can generally be reduced or eliminated by using estrogen therapy following surgery through to the typical age of menopause (51 years).
Most individuals in surgical menopause choose to continue some level of estrogen through at least age 60 to maintain symptom relief.
Accreditation: Dr. Tory Eisenlohr-Moul and Dr. Hannah Short
Visit www.iapmd.org/surgery for lots of evidence-based information and resources for those considering, going through, or recovering from surgery for PMDD/PME.