Surgical Menopause Is Different,
But It's Something You Can Cope With

Millions of women will never experience natural menopause, but instead will begin this part of their life's journey as a result of hysterectomy surgery to remove their uterus and both of their ovaries.

Deciding to have this surgery is never an easy decision for any of us. And while it's necessary for health reasons, it's an emotionally draining time as well.

Unlike natural menopause, surgical menopause is not gradual — it's immediate, and the symptoms can be very severe.

When both of your ovaries are removed, your body will no longer produce hormones. The sudden lack of estrogen may cause fairly intense symptoms of menopause.

Hot flashes and night sweats are the most common symptoms, and they can really disrupt your life, as they can last from 30 seconds to several minutes, often even longer. And they can occur anytime of the day or night, at work or at play. Hot flashes that occur at night are called night sweats. And when you have night sweats, you may awaken from a sound sleep to find that you are soaking wet and feeling chilled.

Unfortunately, unlike natural menopause, surgical menopause symptoms are often more severe because estrogen production has stopped abruptly.

A hysterectomy is performed for health reasons — to treat fibroids or endometriosis. Sometimes when these conditions are very severe, a hysterectomy with bilateral oophorectomy is necessary. This surgery, in which the uterus and both ovaries are removed, is also sometimes necessary to treat ovarian cancer or serious recurrent infections.

Every year, 36,000 women under the age of 45 have hysterectomies with bilateral oophorectomy.

Major health reasons to have a hysterectomy or similar surgery:

• Eliminate problems associated with fibroids — growths on the wall of the uterus that can be very painful or cause heavy bleeding
• Eliminate problems associated with endometriosis — tissue that usually grows in the lining of the uterus begins to grow outside the uterus and on other nearby organs, which can cause pain and bleeding
• Treat uterine prolapse — which occurs when the uterus moves from its usual place down into the vagina

According to the North American Menopause Society, there are many different therapies available to help you cope with the symptoms of surgical menopause. These range from FDA-approved prescription hormone therapies to over-the-counter treatments, which can include vitamin and mineral supplements and vaginal lubricants and moisturizers. Positive lifestyle changes can help a great deal as well. These include the continuation of regular exercise, adequate nutrition, weight management and stress reduction.

After a hysterectomy (the removal of the uterus), a therapy of estrogen/progestin, intended to protect against the risk of uterine cancer, is unnecessary because the risk has been completely eliminated.

With surgical menopause, some women choose estrogen-only therapy. This is because once both your ovaries are removed, your body no longer produces estrogen.

In a recent study among women currently on hormone therapy,* 19% believe that herbal supplements are very effective at either relieving or treating menopausal symptoms; 12% believe that non-prescription supplements are effective; and 65% believe that estrogen/hormone therapies are effective.

Because every woman's experience is unique, it's important to talk with your doctor about what type of treatment option is best for you. For tips on talking with your healthcare professional, please click here.

*Gallup: 2005 Study of Women's Experience With Hormone Replacement Therapy.

It's not just your body that will feel different on a daily basis. While you may physically experience hot flashes, night sweats, vaginal dryness, and fatigue, your emotions may suddenly be turned upside down as well.

Having a hysterectomy and both ovaries removed is not easy to cope with:

• It's major surgery and you need time to recover
• Unlike the gradual progression of natural menopause, you have just about instant menopause
• You've lost your ability to bear children

When faced with all this at the same time, some women feel a sense of loss of their femininity and self-identity.

It's no small wonder that mood changes are common, and that the comparison made between emotions and a roller-coaster ride is often very true. Once you enter menopause, each day may find you feeling a bit depressed, anxious, or stressed, and your sex drive may be diminished as well.

In a recent study, the 2006 Menopause at Work survey^† among members of the National Association for Female Executives, 88% of the women surveyed (aged 35 and older) have had some experience with menopause.

95% of those who have experienced menopausal symptoms have physical symptoms — most commonly hot flashes (80%) and night sweats (74%).

79% of those who have experienced menopausal symptoms experience symptoms that are emotional or affect mental functioning, such as forgetfulness or diminished concentration (57%), irritability (53%), and mood changes (53%).

74% who were currently experiencing or had experienced menopause said that symptoms, such as hot flashes, night sweats, and insomnia, were problematic in their daily lives.

31% of them said their menopausal symptoms were problematic to their romantic lives; and for 28%, symptoms were extremely problematic to their overall emotional well-being.

In fact, 52% of the women in the study professed that menopause was worse than they expected.

When this happens, perhaps it's time to find out about treatment options that can help.

^†2006 Menopause at Work survey conducted by Harris Interactive among members of the National Association for Female Executives, paid for by Duramed Pharmaceuticals.

Whether you're experiencing surgical menopause or not, it's important to stay positive. Of course, it's not easy to put on a smile when you're feeling poorly. But if you can, look for ways to find your sense of humor, as laughter is always a good way to bring a bit of light in our lives. Another way is through exercise. Be sure and talk with your doctor about how soon after your surgery you'll be able to start.

Still more ways you can try and stay positive — join a local or Internet menopause support group, take breaks throughout the day and make them moments of relaxation, and eat a healthy diet.

When you're experiencing surgical menopause and its symptoms of hot flashes and night sweats you may think you're the only woman in the world who's feeling like you. But a hysterectomy is the second most common surgery in the United States. And it's estimated that 2 million women under the age of 50 have experienced surgical menopause as the result of having a hysterectomy and both ovaries removed.

That means you're not alone — there are a lot of women who know what you're trying to cope with. Because of that, there are a wide variety of support groups available. And they can be found through your healthcare professional, your local hospitals and clinics, as well as through a search of the Internet.

Your doctor can help — with prescription or nonprescription therapies, or even a combination of both.

There are many different therapies available to help you cope with the symptoms of menopause. And because every woman's experience is unique, it's important to have a deeper discussion about the benefits, risks, and side effects of any therapy you eventually choose. For instance, a woman who has had her uterus removed (hysterectomy), is not at risk for uterine cancer. Estrogen-only therapy may work to relieve her hot flashes and night sweats.

Getting good information about available therapies is the best way you can make an informed choice — so you can take charge of the changes, and live well with menopause.