The Reality of Surgical Menopause
For many women, planned surgery to remove the uterus (womb), and the ovaries, can be a relief. No longer do they have to suffer with unbearable pain, pressure effects on bladder or bowel, or bleeding that just won’t stop.
But then, for those undergoing surgery before natural menopause, something many women are never told about hits them like a wave- menopausal symptoms. Hot flushes, anxiety, night sweats, brain fog, aching joints, sleep problems, mood swings, weight changes.
That’s because when the ovaries are removed (an operation called bilateral oophorectomy), your body is plunged into surgical menopause (form of iatrogenic menopause) This isn’t a transition over years: it’s immediate. Your hormones aren’t gradually dipping - they’ve fallen off a cliff. You experience sudden and permanent hormone loss of oestrogen, progesterone and testosterone.
Women Report: ‘I Didn’t See This Coming’
Recent research from Menopause Support, behind the #MakeMenopauseMatter campaign, shows just how common this lack of preparation is. In an online survey of 521 women aged 20–59 based in the UK, an incredible 74.5% said they were not told by health care professionals that removing both ovaries would thrust them into premature menopause.
Even more worrying, 62% said hormone replacement therapy (HRT) was not discussed before their surgery, and just 36% were prescribed HRT immediately afterwards, despite NICE guidance recommending HRT as first-line treatment for menopause symptoms and that women with premature menopause are offered it until the age of around 50–51 (unless there’s a medical reason not to).
At Jaya Life, we also see this. Many women tell us how completely unprepared they’ve felt, despite six weeks off work after surgery for recovery. They’ve gone back to work only to be hit by overwhelming menopausal symptoms they didn’t know were linked to their new hormone levels. Anxiety, exhaustion, and hot flushes and without prior knowledge of this it sometimes takes time before you realise, “this isn’t just my body recovering, it’s hormones crashing.”
How Common Is Surgical Menopause?
One in five women will have a hysterectomy at some point in their life. With 55,000 operations performed each year in the UK, they are one of the most common surgeries performed on women, particularly between the ages of 40 and 50.
Typical reasons for these surgeries include:
Uterine fibroids - non-cancerous growths causing heavy bleeding and pain
Endometriosis or adenomyosis - painful tissue growth affecting reproductive organs
Other chronic bleeding disorders or pelvic pain issues including cancer.
Not all of these involve removing ovaries, but when they do, surgical menopause follows.
What Happens After Surgery? The ‘Black Hole’ of Hormone Care
At Jaya Life, what we see time and again is this pattern:
Surgery for fibroids, adenomyosis, endometriosis, or heavy bleeding, often after months or years of pain and disrupted life.
Women are told “the problem” is fixed.
They recover physically from the operation and go back to daily life… but struggle significantly as they find themselves with menopausal symptoms such as hot flushes, insomnia, anxiety, low mood, brain fog.
They struggle to access care and support or feel they should “get on with it” as they are back at work or into life and feel they cannot express how they really feel.
Even if offered some hormone replacement post operatively it is not adequate to control their significant symptoms.
Dr Lucy Mather explains:
“Often patients have been through a major operation, then discharged without systematic hormone review. Some women are given a standard low-dose patch and that’s it. But someone who was premenopausal going into that is abruptly hormone deficient, and a one-size-fits-all patch isn’t enough.”
“Many women assume symptoms are just part of surgery recovery, or fatigue from life, until things become unbearable - which is why proactive hormone planning before and after surgery makes such a difference. I recommend considering a planning appointment with a GP or menopause specialist before surgery, and definitely a full hormone review consultation afterwards.”
The Long-Term Impact of Plunging Hormones
Beyond the immediate symptoms, the sudden drop in hormones after surgical menopause can have long-term health consequences. Oestrogen plays a vital role in protecting your heart, maintaining bone density, and supporting metabolic health. Women who experience premature menopause are at higher risk of osteoporosis, cardiovascular disease, and changes in cholesterol and blood pressure in the years that follow.
This is why HRT is particularly important for those who have undergone surgical menopause - it helps replace the hormones lost abruptly, reducing the risk of these long-term health issues and supporting overall well-being until the age when natural menopause would normally occur. NICE and British Menopause Society guidance emphasise that timely, tailored hormone management can make a profound difference to both quality of life and long-term health.
Menopause Support Voices #MakeMenopauseMatter
The #MakeMenopauseMatter movement has long highlighted this gap in care. They are pushing for better information, support structures, and education so women aren’t left grappling with abrupt hormone loss on their own.
The message from advocates is clear: surgical menopause isn’t just another operation - it’s an enduring hormonal transition that deserves as much informed discussion and shared decision-making as other major surgeries that affect lifelong physiology.
What Women Deserve and How to Navigate It
If you’re facing surgery that might involve your ovaries, or you’ve already had it, here’s what’s important:
Ask about surgical menopause specifically. Understand what hormone loss might look like and what your options are.
Discuss HRT early. NICE and specialist guidance support hormone therapy for menopause symptom management, especially in premature menopause.
Seek specialist review. A GP may start HRT, but a menopause specialist can tailor doses and hormones based on your age, symptoms, and needs.
Watch for symptoms. Hot flushes, disrupted sleep, anxiety, brain fog, weight changes, muscle joint aches and pains and urinary symptoms to name a few- don’t dismiss them as “just recovery.”
Surgical menopause doesn’t have to be a hidden crisis. With knowledge, proactive, and personalised care, hormone transitions after surgery can be managed, ensuring you recover to your best health, now and in the long term.
