Surgical Menopause

Menopause is a biological phase in every woman’s life which usually begins after 45 to 55 years of age and is characterized by cessation of menstrual cycles for a period of 12 months or more. With advancing age, the production of female reproductive hormones by ovaries (such as progesterone & estrogen that regulates menstrual cycle) reduces to a considerably low level, thus culminating in menopause.

In some women, menopause comes banging at the door rather earlier than expected. It happens to women who had their ovaries removed for some reason. For example, surgical menopause or oophorectomy involves surgical removal of a woman’s ovaries. The procedure may either be minimally invasive or accompanied along with the gynecological surgeries like

• Salpingectomy, involves removal of fallopian tubes
• Hysterectomy, involves removal of uterus
• Salpingo-oophorectomy, involves removal of fallopian tubes as well as ovaries

Who Is At Risk Of Experiencing Surgical Menopause?

Oophorectomy is recommended by healthcare professionals for a number of reasons; such as:

• Ovarian cancer
• Non-cancerous cysts or tumor masses in the ovaries
• Endometriosis
• Ovary torsion, characterized by the twisting of the ovary which affects the blood flow
• To minimize the risk of ovarian or breast cancer

Women who have a positive family history of breast or ovarian malignancy have a potential risk of developing such cancer type. Some women prefer being tested for any genetic alterations in the BRCA genes as they are responsible for the production of

proteins that play a major role in suppressing the growth of the cancerous tumor. National Cancer Institute suggests that 15% of ovarian cancers result due to mutation in the BRCA1 and BRCA2 genes.

The hormones produced by the ovaries can speed the growth of cancerous cells; thereby putting women at higher risk of developing breast cancer. Therefore, removal of ovaries may be important for lowering the risk. If the genetic testing for the above two genes is found positive, it doesn’t mean that a woman will certainly develop ovarian or breast cancer. However, it signifies that a woman is at high risk.

Side Effects Of Surgical Menopause

With the ovaries removed, the levels of progesterone and estrogen drop drastically causing following side effects:

• Menopausal symptoms: Memory issues, marked reduction in the vaginal lubrication, hot flashes, and disturbed sleeping patterns.
• Osteoporosis: Estrogen strengthens the bones. With decline in its production, a woman is more at risk of developing osteoporosis, a disease characterized by the thinning of bones.
• Heart disease: Low levels of estrogen increase the risk of developing heart diseases like heart attack, stroke and may directly influence the function of the heart.

Treatment

To alleviate the side effects the doctor may suggest hormone therapy which at times can escalate the risk of developing breast cancer. Apart from this, various lifestyle changes can also help relieve the symptoms associated with surgical menopause:

• Avoiding coffee and alcohol consumption
• Avoiding exposure to high temperature
• Avoiding spicy foods
• Staying relaxed
• Using water-based lubricant for preventing vaginal dryness during sex
• Getting adequate sleep in a quiet relaxing bedroom space
• Exercising or practicing yoga

References

• Peng, W., Adams, J., Hickman, L., & Sibbritt, D. W. (2014). Complementary/alternative and conventional medicine use amongst menopausal women: Results from the Australian Longitudinal Study on Women's Health. Maturitas, 79(3), 340-342.