What to know (and do) before surgery
So surgery is on the cards?
Before you make the decision to proceed, what should you know – and do – to prepare yourself, and your life for surgical menopause?
How to prepare for surgical menopause
Facing surgery that will remove your ovaries can bring a mix of emotions. You might feel relief, and be so glad that there is a solution to your condition, or you might feel some anxiety or trepidation of what lies ahead. You are likely feeling a mix of both (and everything in-between!). Undergoing surgery to remove your ovaries is a big decision, and sometimes, because it’s treated as a fairly routine op by clincians, we can feel like we’re making more out of it than we should.
So we’re here to say that whatever you are feeling – that’s totally normal. But while you are still planning or waiting for surgery, it’s important to feel informed, supported, and heard before you go ahead.
We know that sometimes that’s easier said than done – especially if you are dealing with a lot of pain already. Sometimes it can feel easier to simply block it out and put your head in the sand until your surgery date arrives. But that can mean we aren’t as prepared as we wish we could have been after the surgery, and when your ovaries are removed there’s no going back.
This is the time to advocate for yourself and your health. It’s your opportunity to gather information, ask questions, and plan for the surgery and your recovery – both physically and emotionally. Knowing what to expect and putting the right care in place can make a huge difference to your confidence and recovery afterwards.
Questions to ask your surgeon or specialist
Do you get nervous when you speak to your doctor, or perhaps feel a little bit intimidated? Yep, us too. That’s why we know being prepared before your appointment to ask everything (and yes, we mean everything!) you need to know to prepare is important.
Before your operation, take time to discuss the short and long-term implications of removing your ovaries. Write these down in your notes app, or in a notepad to take with you. When you arrive at your appointment, be clear that you have a number of questions to ask so that they can anticipate you may need some more time to do so.
Some questions you might ask include:
Why are my ovaries being removed? Are there any other options?
How will the surgery be done - will it be open or laparoscopic and how will this affect my recovery?
Will I keep my womb or cervix? How might that affect my recovery or HRT?
What are the risks of surgical menopause for someone my age?
Can I take HRT afterwards, and if not, what plans are there to help me manage the short and long term impact of surgical menopause?
If I can take HRT, when will I start? If there is a delay, can you explain what the clinical need is for me to wait, and how long for?
Who will review me after surgery? Will I have a follow-up appointment to discuss hormones and symptoms?
What support is available for my recovery – physically, emotionally, and sexually?
If your ovaries are being removed unexpectedly or as part of an emergency procedure, you can still ask these questions retrospectively at your post-operative or GP appointment. It’s important that you know what has happened, and when. If you’ve had an emergency procedure, sometimes a feeling of losing control over your body can happen and a debrief with your consultant, or a member of their team, can help to understand the procedures and decisions that were made for your surgery.
Planning for your recovery phase
Preparing for your recovery period is important. Not only will you be managing the physical effects of surgery, but you’ll also start to feel the early impact of hormone deficiency in this period. Remember that recovery is not linear, and dependent on the type of surgery you have, your recovery may take anywhere between 6 weeks and 6 months. It’s important to prioritise this period of rest as it can reduce the risk of future issues.
Arrange help at home for the first week or two. Whether you have open or laparoscopic surgery, you’ll feel pretty sore and need support moving around for the first few days. It’s important to move often (very gently!) to avoid the risk of deep vein thrombosis and to keep blood flowing to aid your recovery, but someone should ideally be nearby as you get back onto your feet.
Don’t lift heavy objects or children until you’ve had the all-clear from your surgical team to do so.
Follow the instructions for your home recovery phase from your hospital, including pain relief, movement and bathing.
Expect to take things easy and don’t push your body too early.
Be careful driving post-op until the advised time.
Stock up on easy meals and loose, comfortable clothing. Make your bedroom (or sofa, if you prefer) into a recovery nest with your favourite books, hand cream, sleep mask, painkillers and water nearby. And don’t forget to line up some boxsets on Netflix!
Large, steel lined drinks tumblers can keep water cool for longer
Make sure you have painkillers to hand – missing a dose can leave you feeling very sore.
Focus on self-care bits that you love and help aid your mental wellbeing through recovery.
Batch cooking can help keep you in easy meals for a couple of weeks post-surgery. If you aren’t feeling well enough to do it, don’t be afraid to ask a friend, family member or even your neighbour. People always want to find ways they can help.
Keep a notebook or phone list of your symptoms, medications, and questions for your follow-up. This record is not only useful for you to keep an eye on your recovery, but it can also inform clinicians of what you’ve taken, when and what stage your recovery is at.
You may also find benefit in journalling during your recovery, as it’s often recommended for mindful relaxation. Don’t overthink it, or strive for perfection. It’s about simply allowing your thoughts and feelings out onto the page.
Ask your surgical/ specialist team whether you’ll receive discharge information about HRT and recovery. If you are discharged on the same day, many hospitals will provide a comprehensive recovery booklet with tips for diet, fluids, pain relief and movement in the first few days of your recovery at home. It’s important that you follow the advice given.
You should also recieve a call from the recovery ward or discharge team in the following two to three days after. It’s important to take this call and speak honestly about your recovery, and any needs or concerns you have so that they can follow up as necessary.
Line up emotional support, whether it’s a friend, family member or therapist you can talk to openly. Many women experience a rollercoaster of emotions in the first few months of recovery, both as a result of surgery and from hormonal deficiency. Even if you are able to take HRT, you may find this period of recovery unsettling and difficult as you find the right balance for you hormonally.
Ask people in advance and be specific in how they can help. Unfortunately, not everyone instinctively knows how they can support you, and this can help give them a clear expectation of your needs.
Try to ask more than one person, so that there is always someone ready to help.
If you are feeling low, depressed or anxious, it’s important to seek help. You can find emotional support on our resources page, here.
Talk about HRT early
If you’re premenopausal or under 45, most clinicians recommend starting hormone replacement therapy (HRT) as soon as possible after surgery, unless there’s a medical reason not to. Research shows that early oestrogen replacement can protect your long-term heart, bone and brain health.
If your surgeon or GP hasn’t raised this yet, it’s absolutely appropriate to ask for a clear plan. You can take a copy of NICE or British Menopause Society guidance to your appointment if you need it — they both recommend HRT for eligible women until at least the average age of natural menopause (around 51) although there is no need for you to stop at this age if you do not wish to.
You might wish to ask the following questions:
Will I be able to take HRT and when will I start it?
What type of HRT is available for me and what dose will I be started on?
Do I need combined therapy, and what do you recommend?
Will I be prescribed testosterone, and if not, why not?
How will my HRT be reviewed, and who by?
Reasons that you may not be able to take HRT include oestrogen receptive cancer, liver disease, and deep infiltrating endometriosis. However, you should always understand exactly why you cannot have hormone replacement therapy, and what your team recommends in lieu of it - both for your short and long term health.
Localised oestrogen
Localised oestrogen, also known as vaginal oestrogen is used by many women in natural, medical and surgical menopause. It’s available in different forms – vaginal cream, pessary, or ring – and can make a big difference to everyday comfort as well as protecting your vagina, vulva and urinary health. It helps ease vaginal dryness, soreness, and risk of urinary tract infections by restoring moisture and elasticity to the tissue. Because it acts locally, it’s safe to use alongside systemic HRT or on its own if full-body oestrogen isn’t suitable.
Preparing emotionally for surgical menopause
The impact of removing your ovaries shouldn’t be underestimated, but unfortunately the emotional toll is often overlooked by clinicians. Before surgery, it’s important to take a pause and focus on your mental wellbeing and how you will approach your emotional needs in recovery (and beyond).
Many women find that their surgery has had a positive impact on their mental wellbeing. If you have been in pain, managed heavy bleeding, or carried worry and fear for a long time, it’s very common to feel relief and a sense of freedom from removing your ovarian function and ceasing your menstrual cycle.
For others, it can be a challenging decision that comes with a complex set of emotions. Feelings of regret, sadness and even bereavement are common. You may feel a mix of everything, too. Preparation can help you manage these feelings, but it’s important to not place too much expectation on yourself, too early. Allow yourself to process the myriad of emotions you experience – and if you need help, reach out to your GP, a therapist or a support line for help.
Here’s some ways you can prepare emotionally for surgical menopause:
Journalling or voice notes – release anxious thoughts before bed by writing or recording how you feel.
Breathing exercises or guided meditations – focus on slow exhalations to calm your nervous system.
Creating a comfort list – note what soothes you (music, baths, a walk, certain scents) and plan to have them ready for recovery.
Connecting with community – join a trusted online space or support group for women who’ve been through surgical menopause.
Setting small goals – choose one thing a day to prepare, like packing your hospital bag or planning meals, to feel more in control.