Physical symptoms of surgical menopause

Blurb about how these can manifest

Hot flushes and night sweats

Sudden waves of heat that can leave you drenched, dizzy and disoriented. They often come day and night, disrupting sleep and confidence in public and have a pesky habit of arriving at the most inconvenient moments.

  • Flushing across the face, chest and neck

  • Dripping sweats, often occuring during the night as you sleep

  • Dizziness or nausea during an episode

  • Cold flushes and chills

Insomnia and disrupted sleep

Falling asleep becomes difficult; staying asleep feels impossible. Hormonal withdrawal alters your sleep rhythm, while night sweats wake you repeatedly.

  • Frequent waking in the early hours

  • Getting up to pee during the night and unable to get back to sleep easily

  • Racing thoughts and restlessness

  • Daytime exhaustion or “wired-but-tired” feeling

  • Vivid dreams, nightmares and night terrors

Changes to smell and taste

Hormonal shifts can alter our sensory perception including changes to our sense of smell and taste. Some women also experience phantom smells that can be disconcerting. This can also be caused by dry mouth, or dental issues caused by loss of oestrogen.

  • Foods tasting metallic, bitter or “off”

  • Stronger or reduced sense of smell and taste

  • Smelling unusual or ‘phantom’ smells - cigarettes, mouldy food, rubbish

  • Change in the way you perceive your partner’s natural scent, perhaps negatively

  • Change to your body odour, and the way it smells to you

Changes in weight and body shape

Fat tends to shift towards the abdomen, even without changes in diet or exercise, as metabolism and insulin sensitivity change after ovary removal. Insulin resistance is common for women in surgical menopause and should be monitored.

  • Bloated or puffy midsection

  • Muscle loss from thighs and arms

  • Difficulty maintaining previous weight

Changes to digestion and your gut health

Loss of oestrogen affects our gut motility and the microbiome, so its loss can alter digestion. This can result in discomfort, bloating, and issues going to the loo. It’s worth speaking to a doctor if any of these symptoms persist.

  • Bloating, cramping or trapped wind

  • Increased flatulence and pungent gas

  • Constipation, diarrhoea or swinging between the two

  • Discomfort and slow gut motility

  • New food sensitivities or IBS-like symptoms

  • Feeling of incomplete emptying when passing stools

Breast changes

Oestrogen loss can leads to a reduction in breast tissue density and elasticity, changing the size and shape of your breasts.

  • Soreness or tenderness around the time of patch changes

  • Noticeable sagging or loss of fullness in the breast and breast tissue

  • Skin thinning or puckering (always get this checked out)

  • Changes to colour or size of nipple

  • Lumpy breasts – often harmless cysts or fibrocystic changes, but always seek medical advice for any new lump, unusual pain, or discharge from the nipple.

Tinnitus (ringing in the ears)

Falling oestrogen levels can affect circulation and auditory nerve function, causing persistent ringing or humming that can drive you bonkers, especially when you are trying to sleep.

  • Constant or intermittent noise in one or both ears

  • Humming, buzzing, ringing or hissing sounds

  • Sensitivity to sound

  • Dizziness or balance issue

New or worsening allergies

Oestrogen supports our immune balance; its loss can trigger hypersensitivity in our body and increased histamine reactions, even to food, drink or products that we’ve previously tolerated well.

  • Heightened response to dust, pollen, food or alcohol

  • Skin rashes, itchy skin and hives

  • Itchy ears, tongue or mouth

  • Increased histamine reactions or “menopause allergies”

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Let’s take a closer look:

Bladder and pelvic changes

Oestrogen supports the bladder and pelvic floor. Without it, you may notice increased urgency, frequency, leaks, or recurrent urinary tract infections.

  • Sudden urge to pee, often with little warning and causing you to dash for the loo

  • Leaking wee when coughing, sneezing, running or jumping

  • Burning, stinging or pressure after urination

  • Waking up to pee in the night

  • Recurrent urinary tract infections (UTIs) or bouts of cystitis that don’t seem to respond to medications.

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Fatigue and low energy

We’re not talking about needing an early night or two - this is deep “in-your-bones” exhaustion that doesn’t lift with rest. Oestrogen helps regulate energy metabolism, so its loss can make every task feel harder and like you are wading through mud.

  • Feeling heavy-limbed or sluggish

  • Needing naps through the day, but still feeling drained

  • Loss of energy and stamina for work or exercise

  • A feeling of ‘meh’ about things you usually find enjoyable.

Joint and muscle pain

Many of us feel a bit creaky as we get older, but for women in surgical menopause the aching, stiffness and inflammation are common and often more difficult to manage. Affecting the hips, back and knees in particular. Many women describe feeling as if they’ve aged overnight and find that they feel the joint and muscle pain mostly in the morning.

  • Chronic bone ache

  • Localised joint inflammation – often affecting knees, toes, fingers and wrists.

  • “Shattered shins” sensation, or deep muscular soreness

  • Jaw pain and tension in the face and neck

  • Clicking or locking in joints - shoulder, jaw, elbow, knees etc.

Vaginal dryness and pain

As oestrogen levels drop, the delicate membranes in our vagina and vulva can thin and become drier. This can cause itching, soreness and pain during sex. This is part of genitourinary syndrome of menopause (GSM).

  • Burning or stinging sensations

  • Tearing or bleeding when wiping or clothes (pants) brush against your vulva

  • Clitoral or labial atrophy or shrinkage

  • Recurrent irritation or discharge – particularly watery, clear discharge that can indicate the vagina is working overtime to lubricate.

  • Pain, discomfort and/or bleeding during or after sex

Headaches and migraines

Sudden hormonal changes can trigger or worsen migraines and tension headaches.

  • Sharp one-sided pain or visual aura

  • Pressure behind the eyes

  • “Hormone headaches” that flare before patch change or at night

Heart palpitations

A racing, fluttering heartbeat (sometimes mistaken for panic or anxiety) can be one of the first symptoms women notice after surgery.

  • Skipping or pounding heartbeat

  • Chest tightness or fluttering in the throat

  • Sudden surges of adrenaline or panic

Skin, hair and dental changes

Dryness, thinning hair, brittle nails and a sudden loss of elasticity in the skin are all linked to low oestrogen and collagen decline. If you feel like you’ve aged in a matter of weeks, you aren’t alone.

  • Flaky or dry skin

  • Increased hair shedding

  • Fine lines appearing rapidly

  • Appearance of grey hairs (and pubes!)

  • Chin hairs and moustache

  • Adult acne and ‘backne’

  • Brittle nails that break or tear easily

  • Hives or itchy skin including in your ears

  • ‘Creepy crawly skin’ like bugs are under your skin

  • Gum problems, loose or broken teeth

  • Burning mouth and tongue

  • Electric shock sensations or buzzing or ‘zinging’ sensations under the skin