Your Diagnosis
If you are feeling daunted, you aren’t alone. We’ve been there too, and here’s what we wish we’d known.
Whether you are feeling relief, or need some reassurance, we’ve got
the lowdown to help you understand what’s ahead.
What does ‘surgical menopause’ mean?
Surgical menopause occurs when your ovaries are removed, or their function is lost as a result of surgery. Unlike natural menopause, where hormones decline gradually over time, surgical menopause causes a sudden drop in oestrogen, progesterone and testosterone. This change happens overnight, so symptoms can feel more abrupt and intense.
For some of us, the decision to remove our ovaries is part of a planned treatment and you’ve had time to work through the decision in advance. For others, it happens unexpectedly – during surgery to treat another condition, or because it’s a lifesaving procedure that happens so quickly you’ve not had time to process it. However you’ve arrived here, it’s completely valid to feel shocked, emotional or uncertain about what comes next.
What are the common reasons for surgery?
The decision for surgery to remove your ovaries and surgical menopause can happen for a number of reasons. Commonly, these include:
Endometriosis or adenomyosis – when tissue similar to the womb lining grows elsewhere, causing pain, bleeding and inflammation.
Persistent ovarian cysts – if they are large, complex or symptomatic.
Risk-reducing surgery – to lower the chance of developing ovarian or breast cancer in those with BRCA or Lynch gene variants.
Severe premenstrual disorders (PMDD) or hormone sensitivity not controlled by other treatments.
Fibroids, pelvic pain or complications leading to hysterectomy with removal of one or both ovaries.
Emergency surgery – where ovarian removal happens unexpectedly due to bleeding, infection or surgical damage.
In some cases, you may have an ovary is retained, or you may keep both ovaries after a subtotal hysterctomy and find that your hormone levels fall more quickly than expected, or that your ovaries go into ‘surgical shock’ or death after surgery. If this happens, you will experience similar symptoms as women who have had both ovaries removed. If you think this has happened to you then you should speak to your clinician asap.
How will surgical menopause affect me?
When the ovaries stop producing hormones, your body experiences an immediate change that can feel like you’ve fallen off a hormonal cliff edge. Within the next few days and weeks (and sometimes just hours after), you may start to notice hot flushes and mood changes, poorer sleep, and loss of focus or memory. There are many, many symptoms that women in surgical menopause experience, much like those who go through natural menopause. However, for women in surgical menopause, the onset of symptoms can be rapid and severe.
These are physical signs of low oestrogen, but they can also affect your emotions – especially if you weren’t fully prepared for them. Everyone experiences surgical menopause slightly differently. For some of us, we’ll find the physical symptoms harder, but for others the emotional and mental impact of surgical menopause can be more challenging.
It’s important in the early days of recovery to keep an eye on the symptoms you are experiencing and you can use our toolkit to help, especially those that are affecting your mental wellbeing, such as anxiety, panic, depression and sadness. It’s common to experience ‘the blues’ after anaesthesia, but this should lift after a couple of days resting. If it doesn’t, then it’s important to talk to someone you trust, and seek support from your GP or consultant.
It’s important to know that there is help. If you can take hormone replacement therapy (HRT), it can help stabilise your symptoms, protect your bones and heart, and restore quality of life. If you are unable to take HRT, there are other things that can help with your symptoms, but it’s important to discuss your long term health with your GP and/or consultant.
What else should I know?
If you’re facing surgery or have already had it, it’s never too late to ask questions. Speak to your surgeon or GP specifically about what your diagnosis means for your hormones, and make sure you have a plan for recovery and follow-up care.
You can read more about what to ask before surgery [here → Before Surgery], or explore your hormone treatment options [here → HRT & Hormones].