Surgical Menopause 101
Surgical Menopause:
What Every Woman Needs to Know
When menopause is sudden rather than gradual, the risks are real — and so are the solutions.
You may have heard the term "surgical menopause" but be unsure of what it really means — or what's at stake. As a menopause specialist, this topic holds a particular place in my heart, and I want to make sure you have the information you deserve.
The Basics
What Is Surgical Menopause?
Menopause is the cessation of ovarian function. For most women, this happens gradually with natural aging. But for a growing number of women, menopause arrives suddenly — because they have chosen, or needed, to have their ovaries removed through a procedure called an oophorectomy.
Unlike natural menopause, which unfolds over months or years, surgical menopause is immediate. The day of surgery is the first day of menopause — and the body has had no time to adapt.
Why It Happens
Reasons for Oophorectomy
There are several medical situations that may lead a woman and her surgical team to decide on ovarian removal:
Women with genetic predispositions such as BRCA1 or BRCA2 mutations, Lynch syndrome, or other hereditary conditions may elect oophorectomy to reduce their risk of ovarian or hormonally-mediated breast cancer.
When endometriosis has compromised or destroyed the ovaries, removal may be necessary. Oophorectomy can also be used to induce menopause, since endometriosis often improves when ovarian function ceases.
A surgical emergency in which the ovary twists on itself, cutting off its blood supply. If the tissue cannot be saved, removal is required to prevent serious harm.
For women with premenstrual dysphoric disorder who have exhausted all other treatment options, oophorectomy may be considered as a last resort to end the hormonal cycling that drives symptoms.
Understanding the Impact
Why Surgical Menopause Is Different
Regardless of the reason for ovarian removal, one thing is consistent: women who undergo bilateral oophorectomy (removal of both ovaries) enter an immediate and profound state of estrogen deprivation.
Menopausal symptoms can begin within hours of surgery and are often severe — because the brain and body have had no gradual transition, no slow decline to adapt to. Hot flashes, sleep disruption, cognitive changes, mood shifts, and genitourinary symptoms can all arrive suddenly and intensely.
Untreated estrogen deficiency after oophorectomy significantly increases a woman's long-term risk of cardiovascular disease, dementia, and osteoporosis. This is not a quality-of-life issue alone — it is a medical one.
It is standard of care to provide hormone replacement therapy for premenopausal women undergoing ovarian removal. This means treatment with both estrogen and testosterone — not one or the other. Unfortunately, many women leave the hospital without this conversation ever happening.
Ideally, you leave the operating room with an estrogen patch already in place and a testosterone prescription waiting at the pharmacy.
A Personal Note
Women in surgical menopause hold a special place in my heart. My passion for HRT education was inspired, in part, by watching a close family member suffer unnecessarily after an oophorectomy — without the information or support she needed. No woman should navigate this alone or uninformed.
— Dr. Jacqueline Riedel, DO, MSCP
What to Do
If You're Planning an Oophorectomy
If you are preparing for ovarian removal — for any reason — please advocate for yourself before, during, and after surgery. Ask your surgical team directly:
- Will I need hormone replacement therapy after this procedure?
- What estrogen therapy will be prescribed, and when will it start?
- Will testosterone replacement be addressed?
- Who will manage my HRT after surgery — you, or a specialist?
You deserve a plan. You deserve a partner in your care who understands what surgical menopause involves and how to treat it well.
I'm Here to Help
If you're navigating surgical menopause — or preparing for an oophorectomy and want guidance before and after — I would be honored to be your advocate and partner in ongoing HRT management.
Book a Consultation