Menopause is the stage when all women stop menstruating permanently. Natural menopause has three stages: perimenopause, followed by menopause and then post menopause. However, there are cases where women do not undergo natural menopause always. Menopause can be induced due to surgery or some medical treatments like chemotherapy and radiation therapy.
Surgical menopause refers to the menopause caused by the removal of both ovaries before the natural menopause. If the ovaries are removed after natural menopause, the woman will not have surgical menopause and will feel no difference. Surgical menopause is caused when both the ovaries are removed surgically by bilateral oophorectomy or when the ovaries are damaged by radiation or chemotherapy. Due to surgical menopause, women lose their fertility and it is one of the causes of premature menopause.
Surgical menopause is a type of induced menopause which causes an abrupt end to the production of natural ovarian hormones. As a result, the symptoms of menopause set in like hot flashes, dryness of vagina and reduced sex drive. Due to surgical or induced menopause, there is increased risk of heart disease and osteoporosis.
Surgical menopause or bilateral oophorectomy is carried out on women due to cervical, endometrial and ovarian cancer. Surgical menopause may also be carried out as treatment for uterine fibroids, infections or endometriosis. Hysterectomy with bilateral oophorectomy will cause surgical menopause but hysterectomy which does not involve removal of ovaries does not cause premature menopause.
The different surgeries involving removal of both the ovaries are:
Abdominal Resection: Though this surgical operation involves removal of lower portion of colon and rectum, it can also extend to the removal of ovaries, uterus and rear vaginal wall, partially or totally. This surgical process is done to treat cancer of the colon and rectum.
Total Pelvic Exenteration: In case of cervical cancer, the surgery is done where most of the pelvic organs like uterus, ovaries, vagina, bladder, urethra, fallopian tubes and some part of the rectum are located.
Surgical menopause is abrupt and sudden. A woman having a period today will suddenly undergo menopause after a surgical operation the next day, unlike the natural menopause where the process is gradual. The symptoms in case of surgical menopause are more intense than in case of natural menopause. The different symptoms observed in surgical menopause are similar to those of natural menopause. This includes hot flashes, night sweats, insomnia, dryness of vagina, and tiredness.
Incase of surgical menopause, the patients are given estrogen to prevent hot flashes soon after the surgery. However, women with high risk of cardiovascular disease are not advised to take estrogen. Sometimes herbal therapy with Black Cohosh is recommended as an alternative to estrogen. Surgical menopause patients should not take progestin.
Estrogen replacement therapy (ERT) is a method to check the effects of surgical menopause like hot flashes, insomnia or dryness of vagina. It also prevents osteoporosis and helps in reducing the risk of heart diseases. However the use of ERT on regular basis increases the risk of endometrial cancer. Hence it is recommended to take estrogen along with progesterone to reduce this risk.
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