Surgical, Early, or Premature Menopause
Recently on Instagram, I asked what questions you wanted to know from my interview with brain researcher, Dr. Lisa Mosconi. I received SEVERAL questions around surgical, early or premature menopause and if #allthethings still applied here too. The answer is a resounding YES!
Let’s define them for a second.
Surgical menopause is the immediate induction of menopause due to the removal of both ovaries. The surgery is called an oophorectomy. This can occur at any age. If you had this surgery at 25 years old, you are officially postmenopausal at 25 years old. Same if you had it at 40 years old.
Premature menopause is defined when you go into menopause (stop all periods) before 40 years old not due to an oophorectomy.
Early menopause is when you go into menopause between 40-45 years old not due to an oophorectomy.
Please don’t confuse perimenopause with early or premature menopause. Perimenopause can and does tend to start in the late thirties into the early fifties. This is that transition time where you still tend to get your period (albeit it starts to become irregular at some point) along with symptoms like insomnia, hot flashes, moodiness, and brain fog.
In early and premature menopause, her periods are DONE! They have STOPPED completely at a younger than expected age. There are several potential reasons for this including:
Unknown (up to 50% of cases)
Chemotherapy or radiation history especially to pelvic/abdomen area
Partial hysterectomy (leaves ovaries but ovarian health declines as a result) or removal of one ovary (other ovary can’t maintain)
Pelvic or abdominal surgery that may affect ovaries (eg. Endometriosis)
Family history of early or premature menopause
Chromosomal such as Fragile X or Turner’s Syndrome
Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS)
Smoking and/or chronic heavy drinking
Some autoimmune are associated such as rheumatoid arthritis and scleroderma
No matter what, there are concerns about health in all three scenarios!
With surgical menopause, there is an increased rates of pulmonary and colorectal cancer, coronary disease, stroke, cognitive impairment, Parkinson’s disease, psychiatric disorders, osteoporosis and sexual dysfunction. This is due to the immediate drop in estrogens due to the removal of the ovaries. It’s very similar with early or premature menopause, especially the risks involving bone health, heart health, and cognition.
Most general guideline organizations agree that early, premature or surgically induced menopause require estradiol therapy (along with progesterone, in my opinion). This is to help reduce her risks and improve health outcomes.
Of course, I would be remiss if I didn’t mention all the foundational work that is STILL important here! Nutrition, movement, stress reduction, hydration, gratitude/joy, and sleep are examples of the cornerstones to your health and areas you can be VERY proactive about!
If someone isn’t sleeping well, routinely dehydrated, relying on alcohol for stress reduction, and hedging into the pre-diabetic glucose numbers…estradiol (and progesterone) will not single-handedly save the day.
Surgical, early, and premature menopause are NOT the end of the world! You are much more than your reproductive abilities. You’re in the next stage of your life, albeit a little earlier than you had probably hoped!
If you haven’t, I strongly recommend Dr. Mosconi’s book, The Menopause Brain!
References:
NAMS. Instant Help for Induced Menopause. https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/instant-help-for-induced-menopause
Secoșan C, Balint O, Pirtea L, Grigoraș D, Bălulescu L, Ilina R. Surgically Induced Menopause—A Practical Review of Literature. Medicina. 2019;55(8). doi:https://doi.org/10.3390/medicina55080482