Surgical menopause occurs as the result of a hysterectomy in which a bilateral oophorectomy is also performed. In plain terms, this means that your uterus and both of your ovaries were surgically removed.
As you know, menopause is caused by the ovary running out of eggs and ceasing its production of the female hormones estrogen and progesterone. When both ovaries are removed surgically, the primary source of the female hormones is suddenly gone. This incisive change will thrust you into menopause, unless your physician prescribes estrogen replacement therapy immediately to replace your lost hormones.
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One young woman told me that she left the operating room after this procedure with a transdermal estrogen patch already stuck on her abdomen, and she never experienced a single menopausal symptom.
The practice of replacing the lost hormones immediately is becoming more common for women who can take ERT and who choose to do so. (Assessing who may be a good candidate for ERT is discussed in Chapter 6.) This is particularly important for younger women undergoing hysterectomy and oophorectomy, since some studies show that along with the other menopausal symptoms that may occur, some young women may develop depression within three years after the surgery. If a medical decision has been made that you must have a hysterectomy, feel free to ask a lot of questions. Find out if your ovaries will be involved in the procedure. It is important to try to save the ovaries, if they are healthy. Even one ovary, in most cases, will still work to produce estrogen and progesterone and hold off the sudden onset of menopause until normal menopausal age. The estrogen produced by the ovaries bathes and nourishes many different organs and processes in the body. Unless an emergency hysterectomy is indicated, try and learn as much as you can about the procedure and let your surgeon know that you are interested in preserving as much of your reproductive anatomy as possible. Read! Ask questions! Get a second opinion!
More than 590, 000 hysterectomies are performed in U.S. civilian hospitals each year, and the median age of women undergoing this procedure is forty and a half. That is more than five times the number of hysterectomies that are performed in Europe. Hysterectomy is the most frequently performed operation on women in the United States. If an oophorectomy is performed at the time of the hysterectomy, premature aging begins unless steps are taken to prevent it. Dr. Winnifred Cutler reports in Hysterectomy: Before and After that the risks of hysterectomy with oophorectomy include well-documented increased incidence of heart attack, reduction in sexual functioning, and increased urinary incontinence. Speaking as someone who underwent a hysterectomy (leaving my ovaries intact) in my early forties, I personally recommend to you her blog and Dr. Vicki Hufnagel's No More Hysterectomies before you undergo this all-too-com-mon surgical procedure.
Questions about surgical menopause are quite common at the programs and usually revolve around the following issues.