Hrt And Surgical Menopause
So what is surgical menopause? Its menopause that develops suddenly after the ovaries the main producers of the hormone estrogen are surgically removed.
The removal of the ovaries is called an oophorectomy. The procedure is often combined with a hysterectomy removal of the uterus but not always. 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. It affects the brain, the bones, the skin, the heart, the blood vessels, and more. While estrogen levels lower gradually during natural menopause, they plummet with surgical menopause. That sudden drop in estrogen can lead to menopausal symptoms that can be quite severe.
Hormone therapy after surgery either with estrogen and progestin or with estrogen alone is a way to counteract the supply of estrogen youve lost. Women who have both the uterus and ovaries removed usually just get estrogen replacement therapy alone. But women who have only the ovaries removed need both estrogen and progestin. Thats because estrogen alone can increase the risk of cancer in the uterus. Adding progestin removes this risk.
Rarely, if ever, will both ovaries be removed without the uterus. Often, only one ovary may be removed, which will negate the need for HRT at the time of surgery,
It Can Take A Long Time Before The Body Adjusts To The New Changes
With so many changes that occur in the body after a person has their ovaries removed, is there a timeline as to how long it can take the body to adjust?
“That is a difficult question to answer,” Dr. Jones says. “All women experience menopausal symptoms differently. Without hormone replacement the adjustment can take years.”
Dr. Leung echoes a similar sentiment: it’s really hard to pinpoint recovery time. “As with any surgery, the body will need time to recover from the trauma of surgery,” Dr. Leung says. “Recovery time from ovarian surgery can take anywhere from two to six weeks, physically, depending on whether or not the procedure was done laparoscopically or if it is more invasive.”
But if both ovaries are removed, the patient may go through a larger change and the adjustment period will, of course, be longer.
“Removal of both ovaries requires the body to go through more of a change because the reproductive system where a woman stores her eggs has been removed,” Dr. Leung says. “This can be a huge adjustment for a woman psychologically speaking.”
What To Know About The Ovaries After Menopause
- Better Females Editors
what you need to know about ovaries after menopause
Located on either side of the pelvis in women, the ovaries are tiny organs that pack a punch. As small as they are, ovaries are essential to a womans health and well-being. Ovaries regulate a womans reproductive system, store and grow eggs, and affect how the brain communicates with the body. As a woman ages, her ovaries cease to ovulate, and she eventually undergoes menopause. Because the ovaries significantly affect the body, its vital for a woman to know about the ovaries after menopause.
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Are Ovarian Cysts After Menopause Cancerous
Unfortunately, women who experience ovarian cysts after menopause have a higher risk for ovarian cancer. Most ovarian cysts develop due to hormonal changes, and most women who are postmenopausal no longer have erratic hormonal fluctuations. Therefore, when an ovarian cyst is found in a woman after menopause, the likelihood of the cyst is due to hormonal fluctuations decreases, and the probability of the cyst developing due to other conditions increases slightly this includes a higher cancer risk.
Confirming That The Menopause Has Taken Place
Its not always easy to confirm that the menopause has actually happened. Of course, irregular periods and the occasional hot flush are a sign that changes are taking place, but identifying the time of the actual menopause is not so simple, especially if you are taking the Pill or have started Hormone Replacement Therapy for the relief of peri-menopausal symptoms.
The question may seem irrelevant, but it is helpful to know the date of your last period, not only so that you can respond to symptoms in the most appropriate way, but also for contraceptive purposes. A truly menopausal woman will be infertile and will have no need of contraception. However, most doctors advise menopausal women under 50 to continue with their contraception for two years after their last period and for one year if they are over 50.
Most doctors will evaluate a womans menopausal status according to her symptoms , pattern of periods, and medical record. It is possible to take a blood test to measure levels of a reproductive hormone known as FSH. However, while elevated FSH levels may be a sign of the menopause, the test is not always accurate and results cant be guaranteed. Measurement of FSH is not required to diagnose perimenopause or menopause in women aged over 45 years.
This is also the case in those rare instances of premature ovarian Insufficiency, when the hormonal system fails at an early age and the ovaries lose their normal function.
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Symptoms Of Ovarian Cyst After Menopause
At the initial phase of the evolution of the formation on the sex gland in the post-climacteric, it is rarely accompanied by any ovarian cyst symptoms after menopause. Signs of its presence appear in time, meanwhile, the cyst of the ovary enlarges in size.
Symptoms of ovarian cyst:
- the multiplied necessity to urinate
- visual asymmetry of the stomach
- pronounced pain in the lower abdomen during the sexual act
- spotting from the vagina
These ovarian cyst symptoms happen when the pathology is of large dimensions. Many of them are connected with the immense pressure of the tumor on the ovary after the climaxon neighboring organs. It can be expressed by the appearance of varicose veins, disruption of the intestines, etc.
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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What Are The Symptoms Of Ovarian Cyst After Menopause
Its important to understand that most ovarian cysts dont cause symptoms. Most cysts develop and resolve without any issues whatsoever. Women are often unaware that a cyst is present until their healthcare provider discovers one during a routine pelvic exam. Not all women will experience the same symptoms. The most common symptoms of an ovarian cyst after menopause are:
- Pressure or pain in the abdomen or pelvic area.
- Swelling in the abdomen or pelvic area.
- Pain in the thighs.
- Nausea or vomiting.
- Weight gain.
If a woman feels the symptoms below, she should seek assistance from her healthcare provider right away:
- Severe pain in the abdomen or pelvis which occurs suddenly.
- Rapid breathing or shortness of breath.
- Faintness, dizziness, or weakness accompanied by pain.
- Pain with fever.
- Pain with vomiting.
What You Can Do
If you are planning to have both ovaries removed during a hysterectomy, you may want to discuss hormone therapy with your medical professional. This treatment can help your body slowly adjust to the loss of estrogen so the signs and symptoms of menopause arent so sudden and severe.
In turn, hormone therapy can help reduce your risk of age-related health issues common in people with a hysterectomy and ovary removal, including bone loss and osteoporosis.
Some people may be able to take hormone therapy short term. Others may need to remain on it until they reach the age of natural menopause, or 45 to 55. The average age of menopause is 51.
Likewise, your healthcare professional may recommend lifestyle adjustments that can help prevent health issues related to early menopause and estrogen loss. Exercise and an improved diet may be helpful.
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You Dont Necessarily Have To Get Rid Of Both Ovaries
If cancer prevention is your main objective, youll need to have both ovaries removed. But if your concern is with one single ovary, like a cyst, its perfectly safe and even advised to leave the healthy ovary be. One ovary is enough to avoid changes in fertility potential and hormonal function, Siedhoff says, which means youll keep menstruating, avoid the health risks of early menopause, and may even still be able to get pregnant.
Polycystic Ovary Syndrome And Menopause
Polycystic ovary syndrome is a hormonal disorder in which a womans ovaries produce more androgens, commonly known as male hormones, than she needs. As a result, a woman can have irregular menstrual cycles , body-hair growth in unwanted places, thinning scalp hair, weight gain, and insulin resistance, according to the Department of Health and Human Services .
Some of these symptoms, such as excessive body-hair growth and thinning scalp hair, may get worse after menopause.
On the other hand, after menopause you no longer need treatments to bring on your period, says , an assistant professor of obstetrics and gynecology at University of Chicago Medicine.
However, PCOS puts women at greater risk for cardiovascular disease, diabetes, high blood pressure, and sleep apnea, notes HHS. Aging also increases your risk for these conditions. Thats why as women with PCOS grow older and go through menopause, they need to be even more vigilant about managing risk factors for these other serious health issues, Dr. Siddiqui says.
If you have PCOS, ask your doctor about screening for high cholesterol and diabetes. Also, keep tabs on your blood pressure and weight.
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Do Ovaries Function After Menopause
The ovary releases three hormones throughout a womans reproductive life, including estrogen, progesterone, and testosterone. By the time menopause occurs, the ovaries cease to perform the major functions that theyd performed for decades the release of estrogen and progesterone to regulate the menstrual cycle. Despite this cessation, the ovaries still impact the body in specific ways.
You Don’t Necessarily Have To Get Rid Of Both Ovaries
If cancer prevention is your main objective, you’ll need to have both ovaries removed. But if your concern is with one single ovary, like a cyst, it’s perfectly safe and even advised to leave the healthy ovary be. “One ovary is enough to avoid changes in fertility potential and hormonal function,” Siedhoff says, which means you’ll keep menstruating, avoid the health risks of early menopause, and may even still be able to get pregnant.
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Menopause: Changes And Challenges
Alta Bates Summit Medical CenterBerkeley, California
US Pharm. 2018 43:13-16.
Menopause is the cessation of menstruation in a woman, typically occurring between the ages of 45 and 55 years. Smokers and women with chronic diseases may experience earlier menopause.1 This is a natural biological process, not a disease.
Menopause and perimenopausethe period of transition beginning 2 to 8 years before and lasting up to 1 year after a womans final menstrual periodoccur because as women get older, the ovaries begin to shut down.1 Eventually, ovaries stop producing estrogen and other hormones. Since the body has depended on these hormones for years, when hormone levels decrease, the changes are noticeable and may result in emotional reactions and bodily changes.2 These may include physical symptoms, such as hot flashes, decreased energy levels, and sleep disruption, as well as mood-related symptoms, such as anxiety and depression. Over time, these symptoms gradually disappear.1 Although menopause ends fertility, women can stay healthy, vital, and sexual. This article will briefly review the physiology and types of menopause, signs and symptoms, and symptomatic treatment.
Can I Get Pregnant During Menopause
The possibility of pregnancy disappears once you are postmenopausal, you have been without your period for an entire year . However, you can actually get pregnant during the menopause transition . If you dont want to become pregnant, you should continue to use some form of birth control until you have gone fully through menopause. Ask your healthcare provider before you stop using contraception.
For some women, getting pregnant can be difficult once theyre in their late 30s and 40s because of a decline in fertility. However, if becoming pregnant is the goal, there are fertility-enhancing treatments and techniques that can help you get pregnant. Make sure to speak to your healthcare provider about these options.
Premature Thinning Of The Bones May Become A Concern
When it comes to our bones, aging takes its toll. The depletion of estrogen after having your ovaries removed can speed up the process of the thinning of the bones.
“Bones are constantly undergoing destruction of bone and replenishment of bone,” Dr. Honaker says. “This is done by osteoclasts and osteoblast, respectively. Estrogen helps the replenishment part of this balance and so when it is taken away, the destruction outpaces the replenishment, thus thin bones .”
You may think that your calcium intake throughout your life can protect your bones, but while calcium is great to keep bones strong, it can’t prevent thinning of bones or keep that necessary replenishment part of this whole process going.
Again, this is where the decision to take supplements is going to be important.
Hysterectomies That Save Ovaries Still Carry Health Risks Study Finds
Women who have had their uterus and ovaries removed need to be monitored for high blood pressure, weight changes and high cholesterol, a new study suggests. This photo is from a blood pressure check at the Centers for Disease Control and Prevention in 2005.
CLEVELAND, Ohio For years, surgeons performing hysterectomies have opted to leave the patients ovaries in place, when possible, to reduce the risk of heart disease and other health problems.
But preserving ovaries may not help as much as was previously thought, a new study suggests.
A recently published 22-year-long study found increased risks of hypertension, obesity, heart disease and coronary artery disease, even when ovaries were left intact after a hysterectomy.
That was a surprise, said Dr. JoAnn Pinkerton, executive director of the North American Menopause Society, and professor of gynecology at the University of Virginia Health System. She spoke by phone from Charlottesville, Virginia.
Women who had hysterectomies especially those women younger than 35 faced increased health risks. The study also suggested that if women take estrogen until 51, the average age of menopause, their health risks dropped to average levels.
This study could help women who are considering a hysterectomy to make important health decisions, and to look for alternatives to the surgery, Pinkerton said.
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Will My Pcos Symptoms Go Away At Menopause
Yes and no. PCOS affects many systems in the body. Many women with PCOS find that their menstrual cycles become more regular as they get closer to . However, their PCOS hormonal imbalance does not change with age, so they may continue to have symptoms of PCOS.
Also, the risks of PCOS-related health problems, such as diabetes, stroke, and heart attack, increase with age. These risks may be higher in women with PCOS than those without.
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Can You Ovulate With An Ovarian Cyst
Ovarian cysts can result in abnormal ovulation, and according to the American Society for Reproductive Medicine ovulation dysfunction accounts for 25 percent of female infertility cases. Large ovarian cysts or those resulting from endometriosis or polycystic ovary syndrome can hamper a womans fertility.
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What Can I Do To Prevent Osteoporosis
Osteoporosis isnt entirely preventable, but you can take steps to strengthen your bones. Eating foods high in calcium like cheese, yogurt, spinach or fortified cereals can help boost calcium intake. Adding a calcium supplement can also help. Some people also need a vitamin D supplement because it helps their body absorb calcium.
But Your Fallopian Tubes Are Coming Out
If you’re getting your ovaries removed, say good-bye to your fallopian tubes. That’s because there’s really no good reason to keep them, since no eggs will be traveling down the tubes from the ovaries anyway. Plus, there’s evidence, Siedhoff explains, that ovarian cancer doesn’t always start in the ovaries, but can first grow in the fallopian tubes. Women who have had their tubes tied have a lower risk of ovarian cancer, so doctors are mostly convinced that removing the fallopian tubes is required for optimal cancer risk reduction.
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