Living well in surgical menopause

Life after surgical menopause

Once the immediate recovery has passed, our next chapter is about rebuilding confidence, energy, and trust in our body again. Surgical menopause is not simply a medical event – it’s a profound physical and emotional transition. We’ve lost your natural source of oestrogen, progesterone and testosterone, but with the right treatment and care, we can protect our long-term health and feel well again.

Living well after ovary removal means working with our body. Hormones, nutrition, movement, and emotional support all play an important role. You deserve ongoing care, not just short-term recovery.

Protecting your heart, bones, and brain

Do we really need to think of our long term health, now?

The sudden loss of ovarian hormones affects the cardiovascular system, skeletal strength, and brain health. Without oestrogen, arteries can stiffen, cholesterol may rise, bone density declines, and cognitive function can be affected. These are not abstract risks — they are measurable, well-documented outcomes of untreated surgical menopause.

How to protect them

1. Hormones:

If you are able to take HRT, then it’s important to do so for your long term health. Oestrogen keeps blood vessels flexible, supports bone density, and protects brain cells from inflammation. Women who start HRT soon after ovary removal have better long-term cardiovascular, cognitive and bone health outcomes.

2. Movement:

Exercise is medicine. Weight-bearing activity such as walking, yoga, dancing, or resistance training helps maintain bone density and heart health. Even ten minutes a day adds up — consistency matters more than intensity.

3. Nutrition:

• Calcium and vitamin D are essential for bone strength.

• Protein supports muscle and tissue repair.

• Omega-3 fats help regulate inflammation and support brain health.

• A varied diet rich in fruit, vegetables and whole grains supports hormone metabolism and cardiovascular resilience.

4. Lifestyle:

• Quit smoking if you can — it accelerates bone loss and arterial damage.

• Limit alcohol to no more than 1–2 units a few times per week.

• Get regular check-ups – monitor blood pressure, cholesterol, blood sugar, and bone density every few years.

Together, these small, steady habits help your body stay strong, even without natural hormones.

Your cognitive and emotional health

Our hormones influence the brain more than most people realise. Oestrogen supports blood flow and protects neurons; progesterone and testosterone affect mood, memory, and motivation. When they suddenly disappear, it’s normal to feel “foggy”, tearful, or less like yourself.

For those of us who are able to take HRT, we will find that cognitive symptoms often ease over time as we reach optimum hormone health. But it’s not the only thing we need to do to support our long term brain health, and for those unable to take HRT in surgical menopause, the following are proven to support cognitive health and our mental wellbeing.

• Prioritising sleep, even if that means daytime rest.

• Managing stress through breathing exercises, journalling, or gentle mindfulness.

• Staying socially connected – isolation increases cognitive decline risk.

• Keeping your mind active by reading, playing music, doing puzzles, or learning something new. These activities all help maintain neural health.

If your brain fog or memory issues persist even after starting HRT, ask your clinician about checking testosterone, thyroid, B12, and iron levels. Sometimes it’s a combination of factors that mean we continue to feel this particular symptom of surgical menopause.

Sexual wellbeing

It’s common to notice physical changes in libido, sensation, or comfort after ovary removal. These changes are hormonal, not psychological – and often they’re treatable.

• Oestrogen therapy restores elasticity and moisture to the vaginal tissue.

• Localised oestrogen (cream, pessary, or ring) directly targets dryness and irritation.

• Testosterone replacement can reignite libido, pleasure, and sexual confidence.

If pain or fear have made intimacy difficult, take things slowly, change positions and use plenty, plenty of lubricant like SUTIL Luxe (Jo Divine is our go-to for safe, non-irritating lubes and moisturisers). Focus on rebuilding connection and comfort, phyiscally and mentally, and with both your partner and yourself. It can take a while to get used to your new normal, especially when you might feel a bit out of control of some of the changes happening, too. Using a gentle moisturiser or lubricant regularly (such as those with hyaluronic acid) helps maintain vaginal health even outside of sex.

You may find that there are changes to your orgasm if you have your uterus removed alongside your ovaries. Some women report a change in intensity of orgasm, or a different ‘feeling’ and it can take a while to reconnect with our sexual self as a result. Masturbation and self pleasure can help you to centre yourself in your own body again – it’s also great for relaxation and healing blood flow to your vagina and vulva to keep tissues healthy. So a little DIY is actually an act of self care during your healing journey!

Lastly, it’s important to communicate with your partner, if you have one. Talk to them about how you are feeling, and if you need to take things slowly and gently. Ask them to think about new positions to try that are focussed on your relaxation and pleasure, rather than their own. And finally, don’t forget that intimacy isn’t always about sex - it’s about mentally connecting with your loved one, cuddling, touching and kissing - and sometimes, that’s more than enough.

Pelvic floor and urinary health

Your pelvic floor is a powerful network of muscles that supports your bladder, bowel and vagina. After ovary removal, the sudden loss of oestrogen can cause these muscles and tissues to become thinner and less elastic, which can make leaks, urgency, or prolapse symptoms more noticeable. The good news is that these changes are common, reversible, and respond well to the right support.

Start with awareness. Try to consciously relax and engage your pelvic floor each day. Most women are told to “squeeze,” but the release is just as important. Think of it as a lift that goes both up and down – you want it to move freely, not stay tense.

Daily exercises work. Short, regular pelvic floor sessions are more effective than occasional long ones. Focus on a few slow, strong lifts and a few quick pulses, breathing normally throughout. Apps or guided audio programmes can help you build consistency.

Women’s health physiotherapy makes a huge difference. A specialist pelvic health physio can assess your strength, teach correct technique, and check for signs of prolapse. Many offer virtual consultations if travel or waiting lists are difficult.

Oestrogen supports the structure. Local vaginal oestrogen keeps the pelvic tissues plump, flexible and better able to support the bladder and urethra. It’s safe to use long term, even if you can’t use systemic HRT. If you can, it can be combined with HRT.

Stay hydrated – but smartly. It’s tempting to drink less when you’re leaking, but dehydration irritates the bladder and makes urgency worse. Aim for light-yellow urine and limit caffeine, fizzy drinks, and alcohol if you’re struggling with frequency.

If you notice new or worsening leaks, heaviness, or pressure, ask your GP for a referral to pelvic health physiotherapy. Early assessment and a tailored plan can prevent issues from progressing and restore confidence in your body.

Emotional resilience

Surgical menopause can reshape how you see yourself. Many women describe feeling older overnight, or grieving the version of themselves they used to be. This emotional impact is as real as the physical one and sometimes can take longer to recover from.

The goal isn’t to “bounce back”, but to rebuild gently.

• Talk openly — whether to a partner, friend, or counsellor.

• Join a community — connecting with others who understand makes a huge difference. We love the Surgical Menopause Support UK facebook group.

• Practise self-compassion — some days will still feel wobbly. That’s okay - and in fact, it’s an important part of your recovery.

• Address ongoing symptoms including low mood or anxiety. These might signal you need an HRT review, not antidepressants.

If you find yourself struggling emotionally, don’t wait — it’s important to reach out and ask for support. A menopause specialist, therapist, or GP can help you find your balance again and feel more like you.