Surgical Menopause

Menopause is often referred to as a natural part of older life. Yet sometimes the transition into menopause can be far from natural. The average age of menopause in UK women is 51-52 years, but women who undergo certain surgical procedures can induce a premature menopause.


How Can Surgery Cause Menopause?

A Hysterectomy can often cause women to undergo an early menopause

A Hysterectomy can often cause women to undergo an early menopause. This is a surgical procedure that removes the uterus (womb). It is one of the most common gynaecological operations in the UK. However, following the procedure you will no longer be able to become pregnant. Depending on the condition the led to a hysterectomy, you may also need to have other parts of your reproductive system removed, such as the ovaries, fallopian tubes, or cervix). You may need a hysterectomy as a result of:

  • Heavy, frequent, or painful periods that do not improve with other treatments
  • Non-cancerous growths in the womb (uterine fibroids)
  • Cancer of the vagina, uterus, cervix, ovaries, or fallopian tubes
  • A prolapsed womb

Chemotherapy and radiotherapy can also be a cause of induced menopause. During chemotherapy, women may experience irregular menstrual cycles, or have no period at all. Some medications used within chemotherapy can also cause damage to the ovaries, inducing menopausal symptoms or menopause. This can be immediate or delayed, and permanent or temporary, but there is no way to accurately determine how cancer treatments can affect your menstrual cycle. The menopausal symptoms you may experience can last for years, even after the treatment has ended.

Radiotherapy to the lower abdomen can cause menopause in pre-menopausal women. This causes the ovaries to stop producing eggs and female hormones such as oestrogen. It can also affect the womb, decreasing your likelihood of fertility. However, it is possible to move the ovaries out of the treatment area before radiotherapy begins, or remove and freeze ovarian tissue that contains eggs.


What are the Symptoms Associated with Surgical Menopause?

The onset of menopausal symptoms after surgery is abrupt and often dramatic. Signs of menopause caused by surgery are extremely similar to normal menopause symptoms; these include:

  • Vaginal dryness
  • Irregular or no periods
  • Hot sweats and hot flushes
  • Decreased sexual drive
  • Mood changes
  • Energy loss

How Can You Treat Surgical Menopause?

A hysterectomy is a major operation and everyone recovers at a different rate. Expect pain and discomfort during your first few days of recovery.

Your doctor will advise you not to have sex for 4-6 weeks following a hysterectomy. This allows time for scars to heal and vaginal discharge or bleeding to stop. If you notice bleeding after sex you should contact your GP to find out why it is happening.

Most menopausal symptoms that are caused as a result of surgery can be eased by hormone replacement therapy (HRT). To learn more about treating menopause, click here.


Sources

BreastCancer.org (2017) How Menopause Can Happen With Breast Cancer Treatments [online]. Breastcancer.org [viewed 31/08/2018]. Available from https://www.breastcancer.org/tips/menopausal/types/treatment-induced

Cancer Research UK (2016) Women's Sex Life and Fertility After Radiotherapy [online]. Cancer Research UK [viewed 31/08/2018]. Available from https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/radiotherapy/side-effects/general-radiotherapy/womens-sex-life-and-fertility

NHS (2016) Sex After Hysterecotomy [online]. NHS [viewed 31/08/2018]. Available from https://www.nhs.uk/live-well/sexual-health/sex-after-hysterectomy/

Oxford University Hospitals (2011) The Menopause and Hysterectomy: Information for Patients [online]. NHS Trust [viewed 31/08/2018]. Available from https://www.ouh.nhs.uk/patient-guide/leaflets/files/120611menopausehysterectomy.pdf

RCOG (2018) Hysterectomy [online]. Royal College of Obstetricians & Gynaecologists [viewed 31/08/2018]. Available from https://www.rcog.org.uk/en/patients/menopause/hysterectomy/

Taylor, M. (2001) Psychological Consequences of Surgical Menopause. Journal of Reproductive Medicine. 46(3), pp. 317-324.