By Dr Louise Newson | The Menopause Doctor
While the menopause is a natural phenomenon that occurs to most women sooner or later…
…it can begin early for women who have undergone certain operations. An oophorectomy, an operation in which your ovaries are removed, or a total hysterectomy or bilateral oophorectomy, where your womb (uterus) is also removed, will cause an immediate menopause. Likewise, if you have just had your womb removed (a hysterectomy), you may still experience an early menopause.
Unlike a natural menopause, where symptoms tend to occur more gradually, surgical menopause results in sudden and abrupt symptoms that can be difficult to handle without proper treatment. This is because your ovaries are largely responsible for producing most of your estrogen, testosterone, and progesterone, and removing them means a sudden drop in these hormones. Symptoms that tend to be worst with surgical menopause are the mental ones, such as anxiety, memory, concentration and energy levels.
If you undergo surgery before the age of 51, it’s very important to receive hormones that your body would naturally be producing…
For women going through surgical menopause, the National Institute of Health and Care Excellence (NICE) suggest in their guidelines that they be offered support and given information about the menopause, ideally before their operation. The best treatment for symptoms is Hormone Replacement Therapy (HRT). HRT comes in a variety of forms (pill, gel, patch), and can contain estrogen only, or a combination of hormones. If you undergo surgery before the age of 51, it’s very important to receive hormones that your body would naturally be producing, at least until the natural age of menopause (51). If you have your womb removed, the best HRT is one which contains progesterone as well. This is because if you only take estrogen, the lining of your womb builds, which increases your risk of womb cancer. Progesterone reverses this risk.
Not only are there different forms and types of HRT, but there are different dosages a woman can take. When you have ovaries removed at a younger age (below 51), your body requires more estrogen, and thus a higher dosage of HRT. In fact, many young women actually need 2-3 times more HRT than the average dosage. If you’re still experiencing menopausal symptoms while taking HRT, it probably means your dosage is too low.
…women produce three times more testosterone than estrogen before the menopause.
Finally, a lesser talked about – but very important – hormone is testosterone. While it’s typically considered a ‘male hormone’ it is needed by women too. In fact, women produce three times more testosterone than estrogen before the menopause. While it’s also produced in your adrenal glands (found in the kidneys), testosterone is largely produced in the ovaries, so removing your ovaries means a huge reduction in testosterone. This can result in lower mood, energy, and sex drive (libido). While estrogen can help with these symptoms, many women find that taking testosterone too is the best treatment. It is usually given as a gel and can sometimes take a few months to take full effect.
Whatever type of HRT you choose to take, it’s important to talk to your doctor about your symptoms and experience of your menopause, as it varies between women. Surgical menopause can be very difficult to deal with given the abrupt nature and severity of symptoms, but it can be managed with the right help and treatment.
For more from Dr Newson, visit her website: https://menopausedoctor.co.uk