What is Surgical Menopause?

Surgical menopause occurs when both ovaries are removed (bilateral oophorectomy) or their function stops because of pelvic surgery. This causes an immediate and total loss of oestrogen, progesterone and testosterone, leading to sudden and often severe symptoms. Unlike natural menopause, which happens gradually, surgical menopause is instant and can increase the risk of heart disease, osteoporosis, cognitive decline and mood disorders if left untreated.

How common is it?

Every year, around 30,000–40,000 hysterectomies take place in England and Wales, and many include removal of one or both ovaries. Research shows that women with endometriosis are seven times more likely to experience surgical menopause and more likely to reach menopause early, even without surgery.

What are the symptoms?

Symptoms can include hot flushes, night sweats, anxiety or low mood, fatigue, brain fog, insomnia, joint pain and loss of libido. Because hormones drop so suddenly, symptoms are often more intense than during natural menopause. Many women also describe feeling emotionally shocked or disconnected after surgery.

Is Hormone Replacement Therapy (HRT) recommended after surgical menopause?

Yes. NICE and the British Menopause Society recommend that women who experience surgical menopause before the natural age of menopause (around 51) should be offered HRT unless there is a medical reason not to take it. However, a 2024 audit of three NHS hospitals found that only 4.8% of women received HRT after surgery, despite the known health risks of hormone deprivation. This exposes a critical gap in care that Surge Menopause is working to close.

What are the risks if HRT isn’t prescribed?

Without HRT, women are at increased risk of heart disease, osteoporosis and fractures, cognitive decline and dementia, depression and anxiety, and early mortality. HRT can protect against many of these outcomes, and testosterone replacement can further improve mood, energy and sexual wellbeing.

Why are so many women left without HRT?

Many women are refused HRT because of outdated misconceptions or clinician uncertainty. This is particularly common in those with endometriosis or a history of breast cancer. In the UK, fewer than half of eligible women are offered HRT after ovary removal—a serious failure that Surge Menopause aims to address through advocacy, education and system-wide change.

Is surgical menopause the same as medical or natural menopause?

No. Surgical menopause happens suddenly after the ovaries are removed. Medical menopause is triggered by drugs or treatments (for example, chemotherapy or GnRH analogues) and may be temporary. Natural menopause develops gradually as ovarian function declines. Each requires tailored care and individualised treatment.

Who founded Surge Menopause?

Surge Menopause was founded by Kate Dyson, a writer, advocate and founder of The Motherload community. Kate entered surgical menopause at 44 following the removal of both ovaries for endometriosis. Experiencing the abrupt hormonal crash and lack of medical support that followed, she founded Surge Menopause to advocate for women facing the same journey — offering information, resources and community to help them navigate surgical menopause with evidence-based care and understanding. The advocacy campaign that accompanies the site supports policy change and awareness, but the heart of Surge Menopause is support, education and empowerment.

What does Surge Menopause advocate for?

We’re calling for mandatory pre-operative counselling about surgical menopause; immediate HRT provision at hospital discharge, in line with NICE guidance; specialist training for gynaecologists and GPs on surgical menopause; national data collection to monitor care and outcomes; and recognition of surgical menopause as a distinct medical condition, not just “early menopause.”

Where can I find support?

Visit our Support & Resources section for practical information, lived experience stories, and guidance on accessing HRT, supplements and expert care. You can also follow Surge Menopause on social media to connect with others and stay up to date with advocacy efforts and awareness events.