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How Soon Does Surgical Menopause Start

Will My Hot Flashes Stop After Menopause

Menopause – When Does It Start, How Long Does It Last?

Some people still experience hot flashes after menopause. Postmenopausal hot flashes are caused by decreased estrogen levels. It is not uncommon to experience a random hot flash for years after menopause. If your hot flashes are bothersome or intensify, speak with your healthcare provider to rule out other causes.

What Can My Health Professional Do To Help With These Symptoms

HRT is very effective at reducing menopause symptoms so starting HRT is the first thing your medical professional will offer to do. Its not clear from research when is the best time to start HRT for women with induced menopause. There can be a concern about the hormones keeping some areas of endometriosis active so sometimes it is not started for 3 to 6 months after induced menopause. However, if started immediately it can prevent bone loss and reduce menopause symptoms. This will be discussed with you.

The best HRT for women under the age of natural menopause with endometriosis contains at least two hormones, estrogen and progesterone, and is given continuously with no breaks. This can be given as tablets, patches or gel and sometimes alongside a hormone containing coil depending on what you would like and your situation. This combined HRT should be given for at least the first few years after removal of the ovaries but may be changed to oestrogen-only HRT later as it may have a better safety profile for women over the age of natural menopause. Ideally HRT should be continued until at least the age of 51 for all women in induced menopause.

For women with vaginal symptoms, vaginal estrogen tablets or cream are very effective and are safe to use alone or in combination with standard HRT in women with endometriosis. If your health professional is struggling to manage your situation they can refer you to a menopause specialist in your area to help you.

When Does Menopause Occur

Although the average age of menopause is 51, menopause can actually happen any time from the 30s to the mid-50s or later. Women who smoke and are underweight tend to have an earlier menopause, while women who are overweight often have a later menopause. Generally, a woman tends to have menopause at about the same age as her mother did.

Menopause can also happen for reasons other than natural reasons. These include:

  • Premature menopause. Premature menopause may happen when there is ovarian failure before the age of 40. It may be associated with smoking, radiation exposure, chemotherapeutic drugs, or surgery that impairs the ovarian blood supply. Premature ovarian failure is also called primary ovarian insufficiency.

  • Surgical menopause. Surgical menopause may follow the removal of one or both ovaries, or radiation of the pelvis, including the ovaries, in premenopausal women. This results in an abrupt menopause. These women often have more severe menopausal symptoms than if they were to have menopause naturally.

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Can A Woman Who Has Her Uterus Removed Go Into Menopause

And in fact, women who only have their uterus removed will not go into surgical menopause. Their ovaries are still making estrogen. Theyll go into menopause naturally when they get older, although sometimes a bit earlier than usual. Estrogen plays a key role throughout the body.

What is surgical menopause? Surgical menopause is when surgery, rather than the natural aging process, causes a woman to go through menopause. Surgical menopause occurs after an oophorectomy, a surgery that removes the ovaries. The ovaries are the main source of estrogen production in the female body.

If you have a hysterectomy, the surgeon removes only your uterus, so you may not experience surgically induced menopause right away. Your ovaries will continue to produce estrogen and progesterone, but your periods will stop. With a partial hysterectomy, youre more likely to experience early menopause.

What About My G

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The âG-spotâ is not a medically recognized part of the female anatomy, but you may have a spot on the anterior wall of the vagina that is highly sensitive and contributes to sexual arousal and satisfaction. Whether yours is affected can depend on the type of hysterectomy, whether your need repairs, and exactly where yours is located. If you have concerns about it being changed, talk to your doctor prior to your surgery.

This content was written by staff of by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support. Reprinted with permission: 10 Concerns about Intimacy after Hysterectomy

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You Wont Necessarily Go Into Menopause

I expected to have crazy hot flashes, mood swings, and night sweats all the time, and was pleasantly surprised to find out that I barely had any of those symptoms, Cohen says about her experience after hysterectomy.

The myth about hysterectomy Streicher hears most often in her medical practice is that a woman will go into menopause afterward. You wont have periods, and cant get pregnant after your uterus is removed. But that doesnt necessarily mean menopause. Streicher explains: The only one who will have menopause is a woman who has her ovaries removed during the procedure and who was not in menopause already. If surgery is limited to the uterus, timing of natural menopause may not be affected.

Putting The Risks And Benefits Of Hrt In Perspective

If you’re just glancing at list above, some of the risks of HRT might seem to overwhelm the benefits. Could a reduction in vaginal dryness possibly be worth an increased risk of cancer?

But look at the details. The risks of HRT — while real — are quite small for an individual person. For example, the 2002 Women’s Health Initiative study found that ERT increased the risk of strokes by 39%. That sounds frighteningly high. But the actual number of people affected is very small. Out of 10,000 women who are not taking ERT, 32 have strokes each year. Out of 10,000 who are taking ERT, 44 have strokes each year. That’s an increase of just 12 people out of 10,000.

On the other hand, when it comes to controlling the symptoms of surgical menopause, a huge number of women feel the benefits. One out of four menopausal women has severe hot flashes. Treatment with hormone therapy cuts down the number of hot flashes per week by 75%. So if a woman had 24 hot flashes per week, HRT would drop that number to six. That could make a big difference in the quality of their day-to-day life.

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What Are The Different Types Of Hysterectomies

To fully envision how your body may change after a hysterectomy, you need to know the different types of surgery. Dr. Macey may recommend one of three types of hysterectomies:

  • Partial or supracervical hysterectomy: Upper part of the uterus is removed, while the cervix is left in place
  • Total hysterectomy: Entire uterus and cervix are removed
  • Radical hysterectomy: Uterus, cervix, and upper part of your vagina are removed

Although a hysterectomy doesnt include your ovaries or fallopian tubes, they may also be removed depending on the reason for your surgery. When one or both ovaries are removed, the procedure is called an oophorectomy. Removal of your fallopian tubes is called a salpingectomy.

Why Does Inducing A Menopause Help The Symptoms Of Endometriosis

Perimenopause Age Range | When Does Menopause Start?

Endometriosis can develop when deposits of endometrium exist outside the uterine cavity which can then be stimulated and bleed with every cycle. By suppressing the menstrual cycle, the symptoms may resolve. Inducing menopause will stop ovarian cyclical activity and hence cyclical stimulation of endometriotic deposits.

The methods of inducing menopause are:

  • Gonadotrophin releasing hormone agonists: These downregulate the pituitary gland and lower estrogen levels to within the menopausal range. They induce amenorrhoea and often menopausal symptoms.
  • Surgery involving bilateral oophorectomy. This may be with or without a hysterectomy but will permanently induce menopause. The loss of libido is often more marked with a surgically induced menopause.

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Patient Does Not Tolerate Progestin

If you do not tolerate progestogen-based treatments then you would need a Total Hysterectomy with Bilateral Oophorectomy . This is the removal of the uterus/womb, cervix and both ovaries. Your surgeon may also suggest to remove your fallopian tubes as well.

This means that you can use estrogen-only HRT and do not need to use progesterone add-back.

This is known as estrogen therapy – you can learn more here.

If you are unsure if you are progesterone intolerant, you can read more here.

A hysterectomy without ovary removal is not a treatment for PMDD.

Some surgeons will remove only the ovaries in special circumstances where physical risks are abnormally high due to other medical conditions however, this is not standard practice for the treatment of PMDD.

What Causes Postmenopausal Bleeding

Vaginal bleeding during postmenopause isn’t a normal side effect of decreasing hormone levels. In some cases, the dryness in your vagina could cause some light bleeding or spotting after sex. In other cases, it could indicate a condition like endometrial hyperplasia or uterine fibroids, infections like endometritis, or cancer. Contact your healthcare provider if you experience any vaginal bleeding so you can be evaluated.

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Will I Start Menopause If I Have A Hysterectomy

During a hysterectomy, your uterus is removed. You wont have a period after this procedure. However, if you kept your ovaries removal of your ovaries is called an oophorectomy you may not have symptoms of menopause right away. If your ovaries are also removed, you will have symptoms of menopause immediately.

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When Should I Call My Doctor

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If any of your postmenopause symptoms bother you or prevent you from living your daily life, contact your healthcare provider to discuss possible treatment. They can confirm you have completed menopause and are in postmenopause.

Some questions you might ask are:

  • Are these symptoms normal for people in postmenopause?
  • Is there treatment for my symptoms?
  • Is hormone therapy still an option?
  • What can I do to feel better?

If you experience any vaginal bleeding during postmenopause, contact your healthcare provider to rule out a serious medical condition.

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Ongoing Management Of Symptoms After Surgical Menopause

With the increased risk of developing osteoporosis after surgical menopause, its smart to make a few lifestyle changes to help counteract the loss of bone density. Your doctor might recommend adding calcium and vitamin D supplements to help keep your bones strong and healthy.

As soon as you are fully recovered from your surgery, adding a regular exercise program that includes resistance training at least twice a week can help build and repair healthy bones.

Limiting your use of caffeine and quitting smoking are two other ways you can improve the health of your bones and protect yourself against osteoporosis.

With the removal of your ovaries, your doctor may recommend hormone replacement therapy to help you manage symptoms related to changes in your blood vessels , such as hot flashes, night sweats, and vaginal dryness. People younger than 45 may need a higher dose of estrogen, and doctors may also recommend adding testosterone to help with the loss of libido. In the beginning, they will likely prescribe low doses of estrogen to see how well you tolerate this kind of therapy.

Doctors also typically recommend bone density scans for people younger than 45 who are undergoing surgical menopause. You should have a bone scan every two years. Your doctor might also recommend MHT to help with bone loss after surgical menopause.

Pros Of Surgical Menopause

In some cases, an oophorectomy and the resulting surgical menopause could prove to be a life-saving measure. The growth of certain cancers is dependent upon estrogen, and individuals with a family history of breast or ovarian cancer are especially prone to developing the disease.

Surgical menopause is also beneficial for women suffering from endometriosis. This condition causes uterine tissue to grow outside of your uterus. It can impact your fallopian tubes, lymph nodes, or ovaries and lead to severe pelvic pain. An oophorectomy might slow or even stop the production of estrogen and help relieve related symptoms.

Potentially negative effects of surgical menopause include the following:

  • More severe and sudden menopause symptoms, especially hot flashes, vaginal dryness, and night sweats
  • Increased risk of osteoporosis, bone loss, and fractures
  • Increased risk of heart disease
  • Diminished libido due to a lack of testosterone
  • Impaired sexual function
  • Inability to conceive

Additionally, surgical menopause might alter your mood, thinking, and cognition thereby increasing your chances for depression and dementia.

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Menopause Induced By Surgery: Will I Still Have Symptoms

Menopause is a natural transition that occurs in the female body causing the end of the menstrual cycle. Some women may experience complications with their reproductive systems which may cause early menopause. In other instances, menopause may be induced by surgery. Read on to learn more about menopause induced by surgery, the reasons for it, and advice on how to handle it.

How Long Does Perimenopause Last

What happens to my hormones after a hysterectomy “Surgical Menopause”?

The length of each stage of the menopause transition can vary for each individual. The average length of perimenopause is about four years. Some women may only be in this stage for a few months, while others will be in this transition phase for more than four years. If you have gone more than 12 months without having a period, you are no longer perimenopausal. However, if there are medications or medical conditions that may affect periods, it can be more difficult to know the specific stage of the menopause transition.

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What Other Changes May Occur

You may encounter information saying that a hysterectomy makes you gain weight or lose your sex drive. These issues may develop, but only if both ovaries are removed. A hysterectomy alone doesnt affect your weight or desire for sex.

Many women feel healthier because the symptoms they had before surgery are gone. As a result, they become more active and find sex more enjoyable.

You should plan on six to eight weeks to rest and heal, depending on the type of hysterectomy and whether Dr. Macey performs minimally invasive surgery or you need conventional open surgery.

Many women struggle with unexpected emotions following their hysterectomy, so during your recovery, you may feel a sense of loss or struggle with depression. Though theres no way to predict how youll react or feel, please know that Dr. Macey is available, and you should call if you encounter challenges during your recovery.

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Important Information About Early Menopause And Surgical Menopause

The purpose of this article is to provide the newest updates about early and surgical menopause. First, let us begin with some definitions:

Menopause: no period for 12 months. The average age is 51.

Early menopause: menopause younger than age 45.

Premature menopause: menopause younger than age 40. This can be due to premature ovarian insufficiency, removal of ovaries, chemotherapy, radiation or other medical problems.

Surgical menopause:menopause due to the removal of ovaries. Symptoms tend to be abrupt and more severe.

Perimenopause: the period of time in which your body is transitioning to menopause. This is marked by irregular cycles, fluctuating levels of estrogen and the beginning of menopause symptoms for many like hot flashes, sleep problems, vaginal dryness and mood changes.

What is not commonly discussed, but is of enormous clinical importance is early menopause has big health effects that women need to know about so that they can be proactive. Some of the significant health aspects of early menopause compared to women with menopause after age 46 include more pronounced:

  • Hot flashes
  • Sleep problems
  • Heart disease
  • Hot flashes :effects 80% of women, lasts for about 7 years on average and is commonly associated with worsening quality of life. Hormone therapy remains the gold standard treatment for hot flashes. The much misunderstood Womens Health Initiative study does not apply to women in early menopause.
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    Why Is Hormone Replacement Therapy Important In Managing Women With An Induced Menopause

    • Women with an induced or surgical menopause due to endometriosis are usually younger women, below the age of natural menopause. The loss of estrogen can predispose them to osteoporosis and cardiovascular disease. HRT has been shown to be protective for both of these factors2.
    • Distressing symptoms such as vasomotor, cognitive and vaginal can be alleviated by adequate HRT.
    • Lack of libido is caused by the low estrogen state and loss of testosterone particularly in women with a surgical menopause.

    How Do I Stay Healthy After Menopause

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    It is important to maintain a healthy lifestyle, especially as you age and your risk for certain medical conditions increases. Some ways for people in postmenopause to stay healthy include:

    • Exercising regularly. Walking, doing yoga or strength training can help lower your risk for many medical conditions.
    • Weight-bearing exercises can strengthen your bones and muscles.
    • Eating a healthy diet. Foods like fruits, vegetables, lean meats and whole grains should make up the bulk of your diet. Avoid lots of salt or sugar and limit your consumption of alcohol.

    A note from Cleveland Clinic

    Going through menopause can be uncomfortable and present new challenges and health concerns. Speak with your healthcare provider about any symptoms you feel or questions you have. They can help make sure you are supported through this time and get the care you need.

    Last reviewed by a Cleveland Clinic medical professional on 10/05/2021.


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    Managing Surgical Menopause Symptoms

    To reduce negative side effects of surgical menopause, doctors may recommend hormone replacement therapy. HRT counteracts the hormones youve lost after surgery.

    HRT also lowers the risk of developing heart disease and prevents bone density loss and osteoporosis. This is especially important for younger women who have removed their ovaries before natural menopause.

    Women younger than 45 who have their ovaries removed and who arent taking HRT are at an increased risk of developing cancer and heart and neurological diseases.

    However, HRT has also been associated with an increased risk of breast cancer for women with a strong family history of cancer.

    You can also manage your surgical menopausal symptoms through lifestyle changes that help to reduce stress and alleviate pain.

    Try the following to reduce discomfort from hot flashes:

    • Carry a portable fan.


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