The Basics of Surgically-Induced Menopause

Articles on Menopause | Topics: menopause, menopausal

by Henrietta Young

Most women arrive at menopause after a gradual decline in estrogen, making it a progressive and somewhat steady process. Women who arrive at menopause by surgical means, however, are suddenly thrust into a menopausal state by more abrupt means. Some women welcome the immediate change, while others are irritated by it.

Surgically induced menopause is the result of a hysterectomy, which is the removal of the uterus and sometimes-other parts of the reproductive system as well. The removal of the uterus brings with it the end to menstruation and fertility. If the ovaries remain intact they will likely continue making hormones, although sometimes at a reduced rate. The decision to retain the ovaries is dependent upon several factors, primarily the reason for the hysterectomy. The three categories of hysterectomies are subtotal, total, and radical. A subtotal hysterectomy involves the removal of the upper portion of the uterus. A total hysterectomy involves the removal of the uterus and the cervix. A radical hysterectomy is when the uterus, cervix, ovaries, fallopian tubes, and pelvic lymph nodes are removed. Hysterectomies can be accomplished either by an incision in the abdomen or vaginally, depending upon the particular procedure.

The majority of hysterectomies accomplished are elective; the woman along with her doctor decided this was the best course of action for whatever reason. Women with heavy bleeding or very painful periods often welcome the chance to end the monthly cycle if they are finished with having children. Other reasons for elective hysterectomies include fibroids, endometriosis, and certain cancers. Emergency hysterectomy procedures are in the minority, but still result in immediate, and sometimes unexpected, menopause. An example of an emergency hysterectomy would be for a woman hemorrhaging after giving birth to a baby. The hysterectomy may have saved her life, but if she wasn't expecting to have the procedure it can be devastating.

Bit of History

The menopause is probably the least glamorous topic imaginable; and this is interesting, because it is one of the very few topics to which cling some shreds and remnants of taboo. A serious mention of menopause is usually met with uneasy silence; a sneering reference to it is usually met with relieved sniggers. Both the silence and the sniggering are pretty sure indications of taboo.

—Ursula K. Le Guin (b. 1929)

So what is the difference between natural menopause and surgically induced menopause? Both result in the end to menstruation and fertility. Arguments can be made for either side as far as which way is preferable. Natural menopause offers a fairly measured arrival, giving the woman ample time to accept the change, whereas surgically induced menopause is a sudden change. If the surgically induced menopause is a result of a woman's wishes, however, the sudden change may be a blessing. Instead of the sometimes long and drawn-out process the woman simply ends her periods. It is important to note, however, that the medical community generally supports elective hysterectomies as a last resort. A hysterectomy is major abdominal surgery and this carries with it risks of infections and other complications.

Surgically induced menopause carries with it a greater need for hormone replacement therapy. The statistics of surgically induced menopausal women using hormone replacement therapy versus natural menopausal women are dramatic: eighty to ninety percent of surgically induced menopausal women use hormone replacement therapy, whereas only around fifty percent of natural menopausal women do. Statistics abound about how surgically induced menopausal women abruptly lose more bone density than naturally menopausal women, but this research probably doesn't take into account that the naturally menopausal women have likely been losing bone mass since the perimenopausal state, making it an unfair comparison.

Women who have surgically-induced hysterectomies are more prone to suffer from depression than their counterparts who have natural menopause. This may be a result of the sudden hormonal change, or because there wasn't ample time to adjust to the idea of menopause. Hormone replacement therapy is advised in aiding depression as it helps regulate the hormonal cycle. Sometimes anti-depressant medication is prescribed in conjunction to hormone replacement therapy if needed. Some women seek out herbal supplements to ease depression, as there are ample products available. A qualified medical professional is the best source of information about menopausal depression.

The idea of controlling the onset of menopause is quite appealing to some women, particularly those women who suffer from painful monthly periods with heavy bleeding and agonizing cramps. Careful consideration must be given, however, when deciding to induce menopause through surgical means. Some may argue it is best to allow nature to take its course, but this can be hard to accept if there exists a procedure that can end monthly suffering for some women.

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Please note: All personal opinions expressed in the "The Basics of Surgically-Induced Menopause" article belong to the contributing author and are not necessarily shared by HealthExerciseSports.com.

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