| On this page: What is Surgical Menopause? Natural Menopause vs. Surgical Menopause Hormonal Impact Causes and Triggers Symptoms Long-Term Risks Treatments Emotional Impact Financial Impact References |
What is Surgical Menopause?
Surgical menopause occurs when both ovaries are removed in a procedure called a bilateral oophorectomy, resulting in a sudden, permanent drop in key hormones – estrogen, progesterone, and testosterone.
Unlike natural menopause, which unfolds gradually over time, surgical menopause causes an abrupt hormonal crash. This can trigger more intense and immediate symptoms, particularly in younger women.
Natural Menopause vs. Surgical Menopause
Natural menopause happens gradually. As the egg supply diminishes, hormone levels begin to fluctuate and eventually decline. This often leads to symptoms such as hot flushes, mood changes, and reduced sexual desire.
Medically, menopause is defined as the point when a woman has gone 12 consecutive months without a menstrual period. It typically happens between the ages of 45 and 55, with the average age in New Zealand being 51.
This process usually unfolds in three phases:
- Perimenopause – the transition phase (can last 2–10 years)
- Menopause – the one day marking 12 months without periods
- Postmenopause – the years following menopause
While “menopause” technically refers to one day, it’s often used to describe the entire transition.
Hormonal Impact
Estrogen
Estrogen is essential for reproductive health and the proper functioning of many bodily systems, including the cardiovascular system, bones, and brain. Its sudden absence can lead to symptoms like hot flushes, night sweats, and vaginal dryness, while also increasing the risk of osteoporosis and heart disease.
Progesterone
Progesterone works in tandem with estrogen to regulate the menstrual cycle and prepare the uterus for pregnancy. The sudden loss of progesterone disrupts the body’s natural balance, contributing to mood swings, sleep disturbances, and other symptoms.
Testosterone
Testosterone, although often associated with male health, is equally important for women. It helps maintain libido, bone density, muscle mass, and energy levels. A sharp decline in testosterone after surgical menopause can lead to reduced sexual desire, fatigue, and a general sense of decreased well-being.
Without ovaries, your body’s hormone levels drop rapidly, impacting nearly every system – from bones and brain to skin and heart.
Causes & Triggers
Surgical menopause can result from various medical conditions and interventions, significantly impacting a woman’s health and well-being.
Surgical Causes
- Ovarian or uterine cancer
- Genetic risk (e.g., BRCA1/2 mutation)
- Endometriosis or adenomyosis
- Chronic pain, cysts, or fibroids
- Gender-affirming surgery
Unintentional Early Menopause
In some cases, a hysterectomy (removal of the womb) or pelvic surgery may compromise the blood supply to the ovaries, leading to ovarian failure and early menopause symptoms.
| Note on Informed Consent Many women are not told that ovary removal or hysterectomy may induce menopause – or that hormone replacement therapy (HRT) or alternatives may be needed long-term. Transparency is essential for true informed consent. For more information, visit our section on Informed Consent. |
Symptoms
Surgical menopause often results in more severe and immediate symptoms than natural menopause due to the abrupt loss of ovarian function. Common symptoms include:
- Severe hot flushes and night sweats
- Mood swings and irritability
- Anxiety or depression
- Sleep issues
- Vaginal dryness or pain
- Loss of libido
- Joint and muscle pain
- Bladder irritation
- Fatigue and reduced energy
Long-Term Risks
Even if symptoms aren’t immediately noticeable, significant internal changes are underway. The ovaries, integral to the endocrine system, play a vital role in safeguarding organs like the bones, heart, and brain. Their removal results in a swift decline in protective hormones, heightening the risk of conditions such as osteoporosis, cardiovascular disease (heart disease, stroke), and cognitive decline or dementia, sexual dysfunction and pain, and increased mortality (especially under 45 without HRT).
Surgical menopause is a permanent condition, much like thyroid disease, with symptoms potentially persisting throughout life, though their severity may fluctuate.
Pre-existing conditions, particularly mental health issues, can further influence the intensity of symptoms. Recent studies indicate that menopause triggers significant brain adaptations in response to decreased hormones, a process that is particularly pronounced in surgical menopause. Ongoing research continues to uncover the full extent of the ovaries’ functions and their profound impact on women’s health.
Treatments
Treatment options are essential not only for alleviating immediate symptoms but also for safeguarding long-term health and maintaining quality of life. Approaches may vary based on individual circumstances and preferences, but most women who undergo surgical menopause should consider a holistic intervention that addresses the interplay of biological, psychological, and social factors. Treatment options could be hormone replacement therapy (HRT) or alternatives, but there will be something to help along the way. Consulting with healthcare providers to develop an individualised treatment plan is essential for effectively navigating the challenges of surgical menopause and addressing both immediate symptoms and long-term health risks.
| Self-Advocacy Understanding the essentials of surgical menopause is crucial, but advocating for yourself is equally important in managing menopause effectively. Being proactive in your healthcare decisions ensures that your needs and preferences are heard and addressed. To learn more about how to effectively advocate for your health and navigate your menopause journey with confidence, visit the section on Self-Advocacy. |
Emotional Impact
Surgical menopause is more than a medical event – it’s a life-changing experience that can bring profound emotional and psychological changes, especially for younger women. Whether it’s the grief of lost fertility, shifts in body image and identity, or the struggle to find supportive care, the impact can be complex and deeply personal. This page explores some of the emotional challenges women may face and offers compassionate insights, strategies, and pathways to support.
Financial Impact
Surgical menopause can bring unexpected financial pressures. From medical appointments and hormone therapy to time off work and the cost of additional support services, the economic burden can add significant stress during an already challenging time. Understanding your options and knowing where to seek help can make a real difference.
References
Kingsberg SA, Larkin LC, Liu JH. Clinical Effects of Early or Surgical Menopause. Obstet Gynecol. 2020 Apr;135(4):853-868.
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.
Alblooshi S, Taylor M, Gill N. Does menopause elevate the risk for developing depression and anxiety? Results from a systematic review. Australas Psychiatry. 2023 Apr;31(2):165-173.
Yang, Y., Zhang, X., Fan, Y. et al. Correlation analysis of hysterectomy and ovarian preservation with depression. Sci Rep 13, 9744 (2023).
Goudarzi, F., Khadivzadeh, T., Ebadi, A. et al. Women’s interdependence after hysterectomy: a qualitative study based on Roy adaptation model. BMC Women’s Health 22, 40 (2022).
Panay, N., Ang, S. B., Cheshire, R., Goldstein, S. R., Maki, P., & Nappi, R. E. (2024). Menopause and MHT in 2024: addressing the key controversies – an International Menopause Society White Paper. Climacteric, 27(5), 441–457.
[Updated: 9 October 2025]
Surgical Menopause New Zealand Trust 