Surgical menopause has implications that go beyond symptoms — it affects your long-term health in ways that are important to understand and actively manage. The good news is that with the right support, many of these risks can be significantly reduced.
Understanding & managing long-term health risks
Hormones affect every part of your body. When both ovaries are removed, the sudden drop in oestrogen and testosterone can accelerate changes across multiple systems simultaneously. Knowing what to expect helps you stay proactive and protect your long-term wellbeing. Everyone’s experience is unique, influenced by overall health, risk factors, and family history — so working with your clinical team to plan ahead is key.
Hormonal deficiency & health risks
When hormone levels drop suddenly, the effects can be widespread-impacting joints, muscles, mood, memory, skin, sleep, digestion, sexual health, and more. These symptoms are often more severe and long-lasting for women who experience menopause before 45. In addition to these symptoms, hormone deficiency also poses well-documented long-term health risks, including:
- Accelerated biological ageing
- Increased risk of mortality
- Chronic conditions such as osteoporosis, heart disease, dementia, depression, diabetes, hypertension, and some cancers
While this sounds concerning, there are effective ways to manage these risks and support long-term health.
Hormone replacement therapy (HRT)
Hormone Replacement Therapy (HRT) is the gold standard treatment for supporting bone, brain, and heart health and reducing long-term disease risks after surgical menopause. HRT works by supplementing lost hormone levels. The decision to use HRT should be made in consultation with a healthcare provider, taking into account your medical history and personal health factors.
The Menopause Society (formerly NAMS) highlights that early initiation of HRT can reduce:
- Hot flushes and night sweats (vasomotor symptoms or VMS)
- Genitourinary symptoms
- The risk of osteoporosis and fractures
- Likely cardiovascular disease and overall mortality
For more details on treatment options, visit the Treatments section.
Complementary & non-hormonal treatments
For those who have been advised against HRT or prefer to explore alternative approaches, there are still effective options to manage symptoms and protect long-term health. These include:
- Non-hormonal treatments: Certain antidepressants, gabapentin, or herbal supplements, can relieve symptoms like hot flushes and mood swings.
- Complementary approaches: Herbal therapy and therapies like cognitive-behavioural therapy (CBT) or hypnotherapy may offer additional support.
For more information on treatment options, visit the Treatments section.
Holistic health approaches
Beyond medical treatments like HRT or alternatives, adopting a holistic approach to health is crucial. Regular exercise, a balanced diet, stress management, sleep hygiene, and self-care can significantly enhance long-term well-being and quality of life. Taking proactive steps in these areas can help navigate surgical menopause and support a healthy future.
| Long-term health monitoring after surgical menopause is not optional — it is part of your ongoing care. Make sure your GP knows your surgical history and that it is factored into your regular health checks and screenings. |
Key health risks after surgical menopause
Bone, muscle & joint health
Estrogen is vital for maintaining bone density, muscle strength, and joint function. When estrogen levels drop suddenly, women may experience:
- Joint pain, stiffness, and inflammation
- Muscle loss (sarcopenia) and weakness
- Decreased bone mineral density
- Increased risk of falls and fractures
These symptoms are collectively referred to as the musculoskeletal syndrome of menopause, which affects over 70% of women during the menopause transition, with around 25% experiencing disabling effects.
HRT can help reduce these effects by slowing the rate of bone and muscle loss. Other options include Selective Estrogen Receptor Modulators (SERMs) and bisphosphonates, which help preserve bone density.
Supplements for bone health
Certain supplements support bone health, particularly when used alongside HRT or other treatments:
- Vitamin D3: 1000 IU/day may improve bone density and reduce the risk of falls.
- Magnesium: 500 mg/day supports vitamin D metabolism.
- Vitamin K2: May slow bone loss in some people.
- Protein and resistance training: Crucial for maintaining muscle mass and reducing fracture risk.
Osteoporosis risk
Osteoporosis is a well-known risk associated with surgical menopause. It’s characterised by weakened bones that are more susceptible to fractures. The sudden drop in estrogen accelerates bone loss, leading to a reduction in bone mineral density. This increased bone loss can make the bones fragile and more likely to break, especially in the hips, spine, and wrists. Osteoporosis can significantly impact quality of life and fractures can lead to pain, loss of mobility, and even long-term disability.
Importance of DEXA scans
A Dual-Energy X-ray Absorptiometry scan (or DEXA scan), is a specialised imaging test used to measure bone mineral density (BMD). It is the most common and reliable method for diagnosing osteoporosis.
The DXA scan is quick and non-invasive, focusing on key areas prone to fracture like spine, hips, and sometimes the forearm. The scan uses two X-ray beams at different energy levels to assess bone density, with lower bone density indicating a higher risk of fractures.
For women in surgical menopause, regular DEXA scans are an important tool to:
- Monitor treatment effectiveness
- Assess current bone density
- Guide preventive treatment (e.g. calcium, vitamin D, HRT)
For more information on osteoporosis, visit: Osteoporosis New Zealand.
| Women with autism, ADHD, PMDD, or a history of anxiety or depression may be more sensitive to hormonal changes. Let your clinical team know your full history so your care can be tailored to your needs. |
Heart & metabolic health
Estrogen supports healthy cholesterol levels, blood vessel function, and metabolism. Surgical menopause increases the risk of cardiovascular disease, high blood pressure, abdominal weight gain, insulin resistance, and abnormal blood lipids.
What helps: Staying active, eating a balanced diet, avoiding smoking, limiting alcohol, and regularly monitoring blood pressure, cholesterol, and blood glucose.
In some cases, your doctor may recommend medications to manage cholesterol or blood pressure.
For more information, visit Heart Foundation New Zealand and Diabetes New Zealand.
Brain & cognitive health
Hormonal changes can affect memory, concentration, and mental clarity. Some women notice brain fog or slower thinking, particularly in the months following surgery. Estrogen has neuroprotective properties and supports memory, attention, and cognitive function. Its sudden loss may increase the risk of memory issues, brain fog, difficulty concentrating, and dementia, particularly when ovaries are removed before age 45.
What helps: Engage in mentally stimulating activities, eat a diet rich in antioxidants, stay physically active, and prioritise sleep and manage stress.
For more information, visit Dementia New Zealand, Alzheimers New Zealand, and Parkinson’s New Zealand.
Genitourinary & sexual health
After surgery, many women experience changes in sexual function due to the sudden decline in hormone levels, particularly estrogen and testosterone. These hormonal shifts can lead to symptoms such as:
- Genitourinary syndrome of the menopause (GSM), which can include vulvovaginal dryness, urogenital atrophy, recurrent urinary tract infection and incontinence.
- Pain during intercourse (vulvodynia, vaginismus).
- Lower libido as ovaries produce half of testosterone reserve.
The psychological impact of surgery and hormonal changes may contribute to feelings of anxiety, depression, or body image issues, further affecting sexual wellbeing.
What helps:
- Hormone replacement therapy (HRT)
- Local vaginal estrogen cream or DHEA treatments
- Moisturisers and/or lubricants
- Pelvic floor therapy
- Counselling or sex therapy
- Mindfulness and stress reduction techniques
Open conversations with your healthcare provider can help tailor the right approach for your needs.
Mental health & energy
Hormonal shifts and the life transition of surgical menopause can affect mood, emotional wellbeing, and energy. Common challenges include anxiety, depression, mood swings, low motivation or self-esteem, irritability, and emotional overwhelm.
What helps: Medical treatment including HRT or antidepressants where recommended, psychological therapy or counselling, regular physical activity, good sleep hygiene, relaxation practices, peer support, and staying connected to the things and people that matter to you.
For more information, visit Mental Health Foundation of New Zealand.
Gut health
Hormonal changes can affect digestion and gut microbiome balance, leading to bloating, constipation, reflux, or changes in appetite.
What helps: A balanced fibre-rich diet, staying well hydrated, regular physical activity, and tracking symptoms to discuss with your healthcare provider if they persist.
| Don’t wait for a problem to become serious before seeking help. Regular health checks, open conversations with your clinical team, and staying informed are the most powerful things you can do for your long-term health. |
References
The Menopause Society, formerly known as the North American Menopause Society (NAMS) Position Statement (2022) on Hormone Therapy.
Kingsberg SA, Larkin LC, Liu JH. Clinical Effects of Early or Surgical Menopause. Obstet Gynecol. 2020 Apr;135(4):853-868.
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Georgakis MK, Beskou-Kontou T, Theodoridis I, Skalkidou A, Petridou ET. Surgical menopause in association with cognitive function and risk of dementia: A systematic review and meta-analysis. Psychoneuroendocrinology. 2019 Aug;106:9-19.
Price MA, Alvarado BE, Rosendaal NTA, Câmara SMA, Pirkle CM, Velez MP. Early and surgical menopause associated with higher Framingham Risk Scores for cardiovascular disease in the Canadian Longitudinal Study on Aging. Menopause. 2021 Jan 4;28(5):484-490.
Rocca WA, Grossardt BR, Geda YE, Gostout BS, Bower JH, Maraganore DM, de Andrade M, Melton LJ 3rd. Long-term risk of depressive and anxiety symptoms after early bilateral oophorectomy. Menopause. 2008 Nov-Dec;15(6):1050-9.
Wright VJ, Schwartzman JD, Itinoche R, Wittstein J. The musculoskeletal syndrome of menopause. Climacteric. 2024 Jul 30:1-7.
[Updated: April 2026]
Surgical Menopause New Zealand Trust 