Difference Between Natural Menopause And Surgical Menopause Symptoms
Menopause is a natural part of a womans aging process. It usually occurs between the ages of 35 and 51. Menopause happens when the ovaries stop producing eggs, resulting in the ending of menstruation.
This transition of phase from the reproductive stage to peri-menopause or menopause is often associated with several uncomfortable symptoms, such as hot flushes, night sweats, weight gain, irritability, mood swings, anxiety, and depression.
For some women, these symptoms are mild and easily managed by diet, exercise, and stress management techniques.
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What Causes Hot Flashes After A Hysterectomy
Declines and fluctuations in the level of the hormone estrogen after a hysterectomy affects the function of the body, especially the hypothalamus the part of the brain that regulates body temperature.
Falling estrogen levels caused by a hysterectomy can cause the hypothalamus to falsely detect an increased body temperature and release chemicals that make skin blood vessels dilate so that heat can be released and the body cooled down. This results in a hot flash.
Hot flashes and other menopausal symptoms usually subside when a woman is postmenopausal. Experiencing menopause that is induced by a hysterectomy can be a little different than natural menopause.
This is because when a woman naturally goes through menopause her body has more time to adjust as the levels of hormones in her body decrease. With a hysterectomy, the ovaries are removed, which is where estrogen is produced. This means there is a rapid cutoff of estrogen production which can result in more severe menopausal symptoms.
What Are The Different Kinds Of Hysterectomy
Your heathcare provider will discuss which type of hysterectomy is needed depending on your condition. This will determine if your fallopian tubes and/or ovaries need to be removed.
- Total hysterectomy: Removing the uterus and cervix, but leaving the ovaries.
- Supracervical hysterectomy: Removing just the upper part of the uterus while leaving the cervix.
- Total hysterectomy with bilateral salpingo-oophorectomy: Removing the uterus, cervix, fallopian tubes and ovaries . If you haven’t experienced menopause, removing the ovaries will start menopausal symptoms.
- Radical hysterectomy with bilateral salpingo-oophorectomy: The removal of the uterus, cervix, fallopian tubes, ovaries, the upper portion of the vagina and some surrounding tissue and lymph nodes. This type of hysterectomy is performed when cancer is involved.
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How Will I Feel After A Hysterectomy
After a hysterectomy, your periods will stop. Occasionally, you may feel bloated and have symptoms similar to when you were menstruating. It is normal to have light vaginal bleeding or a dark brown discharge for about four to six weeks after surgery.
You may feel discomfort at the incision site for about four weeks, and any redness, bruising or swelling will disappear in four to six weeks. Feeling burning or itching around the incision is normal. You may also experience a numb feeling around the incision and down your leg. This is normal and, if present, usually lasts about two months. It’s normal to have scarring, both internally and externally. Laparoscopic surgeries will cause smaller, less visible scars as opposed to abdominal hysterectomy.
If the ovaries remain, you should not experience hormone-related effects. If the ovaries were removed with the uterus before menopause, you may experience the symptoms that often occur with menopause, such as hot flashes. Your healthcare provider may prescribe hormone replacement therapy to relieve menopausal symptoms.
People who undergo a subtotal hysterectomy may continue to have a light period for a year after the procedure. This happens because small amounts of the endometrial lining can remain in the cervix, causing light periods.
Emotional reactions to a hysterectomy vary and can depend on how well you were prepared for the surgery, the reason for having it and whether the problem has been treated.
How Long Do They Last
There is a chance that hot flashes and other menopause symptoms can evolve within five years of having the procedure, even if one or both ovaries are left intact. Once women start suffering from hot flashes after hysterectomy, it is hard to determine when they will permanently end, although they are known to last for an extended period of time.
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Why Are My Menopause Symptoms Getting Worse
Symptoms of perimenopause leading up to menopause may increase in frequency and intensity as hormonal shifts become more severe. Around the age of 35, estrogen and progesterone production enters a phase of gradual decline. You may notice any symptoms from these gradual shifts.
In your 40s, the ratios between estrogen and progesterone will be in flux. Ovulation may not happen with every period or your periods may become irregular. These shifts in your hormones can cause more noticeable symptoms.
Management Of Surgical Menopause
Ideally, a menopause specialist should review younger women prior to surgical menopause to explain the potential consequences of surgery and to make a plan for symptom management and long-term health.
Current international guidelines advise use of MHT for all women who undergo menopause under the age of 45 years provided that they do not have other contraindications to MHT . Treatment should continue until the average age of menopause and then be reviewed. Those with a personal history of breast cancer should avoid both MHT and tibolone, as they have been associated with an increased risk of breast cancer recurrence . For high risk women without a personal history of breast cancer, observational data suggest that MHT appears to be safe . Women should be aware that discontinuation of MHT will be associated with a recurrence of hot flushes and night sweats in around 50% of cases.
Use of MHT will resolve hot flushes and sweats in 80-90% of women, although there is evidence that hot flushes and night sweats as well as vaginal dryness may persist despite MHT use in younger women . There are no specific guidelines on the type of MHT to use but oestrogen only MHT is generally prescribed for those women who have had a hysterectomy . Women who retain their uterus should use an oestrogen and progestogen combination preparation
In those without contraindications to MHT, suggest starting treatment within a week following oophorectomy.
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Treating Side Effects Of Hysterectomy
If your ovaries were removed with the uterus, you may want to consider hormone replacement therapy to ease some symptoms. Your age and medical history are factors to consider when deciding on HRT. Talk it over with your doctor.
Some women experience pain during intercourse after a hysterectomy. It helps to try different positions and lubricants and moisturizers . A low-dose vaginal estrogen cream, suppository or ring can also help relieve vaginal dryness.
Pelvic weakness sometimes develops after a hysterectomy. If you had some pelvic weakness before surgery, it may get worse afterward — leading to bladder or bowel problems. Kegel exercises can help strengthen pelvic muscles to help control urinary incontinence problems. For some women, corrective surgery is necessary.
Mayo Clinic Q And A: Estrogen Replacement Therapy After Ovary Removal
DEAR MAYO CLINIC: I have been using an estrogen hormone patch for two years since having a hysterectomy at 38. I had my ovaries removed as part of the procedure. How often should I have my estrogen levels tested, and how long will I need to continue hormone replacement?
ANSWER: For a woman in your situation, estrogen replacement therapy typically is recommended until the average age of natural menopause usually around 51. This is done mainly to reduce the risk of long-term health problems associated with removal of the ovaries. To ensure youre receiving the right dose, its a good idea to have your estrogen level checked at least once a year, and eight to 12 weeks after any dose changes.
A hysterectomy is surgical removal of the uterus. As in your case, the procedure often is combined with removal of the ovaries a surgery known as an oophorectomy. If the surgery involves removing both ovaries, its called a bilateral oophorectomy. When only one ovary is removed, its a unilateral oophorectomy. Because the ovaries make the main hormones responsible for a womans menstrual cycle, removing your ovaries results in menopause.
When both ovaries are removed before a woman goes through menopause naturally, there is an increase in the risk of a number of serious long-term health problems. They include heart disease, cognitive dysfunction and dementia, mood disorders, bone thinning, and early death. The younger a woman is when she has bilateral oophorectomy, the higher the risk.
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How Will I Feel After The Operation
After the operation you may have an intravenous drip for uids or occasionally blood. You may also have a catheter to drain urine.
If your operation is performed through an abdominal incision, the wound will be held together with clips or stitches. There will still be some stitches with laparoscopic surgery. The internal stitches used in vaginal hysterectomy will dissolve naturally. The wound will heal in a week or so but internal surgery will take longer. This is why the recovery period can take up to twelve weeks.
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How Long Does Menopause Last
Perimenopause and menopause symptoms can last anywhere from a few months to more than 10 years. Menopause officially begins and ends when you havent had your period for 12 consecutive months. We say officially because theres a lot more involved in the transition than just that specific time without a menstrual cycle.
For many women, its hard to pin down exactly when menopause starts and even more difficult to know exactly when it will be finished which can make it seem so much longer.
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Why Does Menopause Happen
Natural menopause menopause that happens in your early 50s and is not caused by surgery or another medical condition is a normal part of aging. Menopause is defined as a complete year without menstrual bleeding, in the absence of any surgery or medical condition that may cause bleeding to artificially stop As you age, the reproductive cycle begins to slow down and prepares to stop. This cycle has been continuously functioning since puberty. As menopause nears, the ovaries make less of a hormone called estrogen. When this decrease occurs, your menstrual cycle starts to change. It can become irregular and then stop. Physical changes can also happen as your body adapts to different levels of hormones. The symptoms you experience during each stage of menopause are all part of your bodys adjustment to these changes.
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What Is Surgical Menopause
The ovaries are the main source of estrogen production in the female body. Their removal triggers immediate menopause, despite the age of the person having surgery.
While surgery to remove the ovaries can operate as a stand-alone procedure, its sometimes performed in addition to hysterectomy to reduce the risk of developing chronic diseases. A hysterectomy is surgical removal of the uterus.
Periods stop after a hysterectomy. But having a hysterectomy doesnt lead to menopause unless the ovaries are removed too.
- vaginal dryness
Surgical menopause also causes hormonal imbalances. The ovaries and adrenal glands produce progesterone and estrogen, the female sex hormones. When both ovaries are removed, the adrenal glands cant produce enough hormones to maintain balance.
For that reason, and depending on your medical history, some doctors may or may not recommend hormone replacement therapy after an oophorectomy to reduce the risk of disease. Doctors will avoid giving estrogen to women who have a history of breast or ovarian cancer.
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What Happens During A Hysterectomy
Your healthcare provider will determine the type of hysterectomy you need and the best surgical method to perform that procedure. You will change into a hospital gown and get hooked up to monitors that track your heart rate. An intravenous line is placed in a vein in your arm to deliver medications and fluids.
An anesthesiologist will give you either:
- General anesthesia in which you will not be awake during the procedure or
- Regional anesthesia in which medications are placed near the nerves in your lower back to “block” pain while you stay awake.
There are several different surgical approaches your healthcare provider may use to perform a hysterectomy:
- Your uterus is removed through an incision at the top of your vagina. There is no external incision.
- Dissolvable stitches are placed inside the vagina.
- Most commonly used in cases of uterine prolapse and other non-malignant conditions.
- Fewest complications and fastest recovery and is considered the preferred approach.
- Patients often go home the same day of surgery.
- A laparoscope is inserted in the lower abdomen through a small incision in the belly button.
- Surgical tools are inserted through several other small incisions.
- Your uterus can be removed in small pieces through the incisions in your abdomen or through your vagina.
- Some people go home the same day or after one night in the hospital.
- Full recovery is shorter and less painful than an abdominal hysterectomy.
What Happens After Menopause
During post-menopause the time after menopause your body is still producing hormones. As reproductive hormones, estrogen and progesterone decline once your childbearing years end. But that doesnt mean theyre not needed at all, so your body still makes them, just in lower amounts.
In the years of post-menopause, you may still experience symptoms of hormonal imbalance or maybe even have certain symptoms for the first time. For example, its not unusual to have continuing hot flashes as a result of estrogen deficiency. Some women in post-menopause experience vaginal dryness, which affects a womans interest in sex and can make sexual activity uncomfortable or even painful. The most common post-menopausal symptoms are:
- Hot flashes
- Bone loss and fracture
- Memory loss
If you experience postmenopausal bleeding no matter how slight or brief talk with your OB/GYN healthcare provider as soon as possible to rule out any serious issues.
The Female Reproductive System
The female reproductive system is made up of the:
- womb a pear-shaped organ in the middle of your pelvis where a baby develops the lining of the womb is shed during a period
- cervix the neck of the womb, where the womb meets the vagina the cervix is the lower part of the womb and not separate
- vagina a muscular tube below the cervix
- fallopian tubes tubes that connect the womb to the ovaries
- ovaries small organs by the fallopian tubes that release an egg each month
Page last reviewed: 01 February 2019 Next review due: 01 February 2022
Reactions To Surgical Menopause
A surgical menopause can be a difficult time for many women. Menopausal symptoms are often severe, and depression and anxiety are more likely.
How you react can be influenced by the reason for the surgery. If your surgery is necessary because of a diagnosis of cancer, this creates challenges to cope with at the same time as coping with menopausal symptoms. On the other hand, if your surgery is the solution to ongoing chronic pain, then a surgical menopause may offer relief.
What’s happening in your life will affect your reactions to surgical menopause. This includes your age, whether you are in a relationship, whether you have children, whether you wanted to have children or more children, and whether you have support and help.
Some women say the impact of surgical menopause is that they no longer feel like a woman other women feel a sense of freedom from pain and fear. Some women feel they might not be as sexually attractive to their partner, and others feel they can be more sexual because they are not worried about pain or heavy bleeding.
No feeling should be dismissed as silly or small. It is important to talk to someone if you are upset and distressed about a surgical menopause. You can ask your doctor for help with symptom relief and with referral to a psychologist to discuss your feelings.
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How Does Menopause Affect My Bladder Control
Unfortunately, bladder control issues are common for women going through menopause. There are several reasons why this happens, including:
- Estrogen. This hormone plays several roles in your body. It not only controls your period and promotes changes in your body during pregnancy, estrogen also keeps the lining of your bladder and urethra healthy.
- Pelvic floor muscles. Supporting the organs in your pelvis your bladder and uterus are called the pelvic floor muscles. Throughout your life, these muscles can weaken. This can happen during pregnancy, childbirth and from weight gain. When the muscles weaken, you can experience urinary incontinence .
Specific bladder control problems that you might have can include:
- Stress incontinence .
Hot Flashes After A Hysterectomy
A hysterectomy is a procedure that removes the uterus. Generally, it does not immediately cause menopause unless the ovaries are also removed. However, removal of the uterus can lead to menopause sooner than normal, causing women to experience symptoms like hot flashes.
Continue reading to learn more about hot flashes after hysterectomy as well as treatment for hot flashes after hysterectomy to take control of your reproductive well-being today.
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