“I joke that I went into the hospital age 47 and woke up 60, but it’s also kind of not funny.”
That’s an actual text message from one friend to another, sent just days after the friend who sent the message underwent an emergency hysterectomy that removed cervix, uterus, and both ovaries and fallopian tubes (called a bilateral salpingo-oophorectomy). Needless to say, the friend was both relieved and reeling.
Early natural menopause — that which occurs before the age of 45 — affects a mere 1 percent of women. However, surgically induced or chemical menopause assaults a much larger population. Some women have their ovaries removed as a proactive measure after learning they carry BRCA genes or are high risk for ovarian/breast cancers, and others already have cancer (ovarian cancer is the fifth-leading cause of death for women). No matter the reason for a hysterectomy with an oophorectomy, both groups wrestle with the aftermath of surgical menopause. It can, indeed, feel like aging 15 years overnight.
Perimenopause can last up to a decade. And though the actual length of time varies by woman, an adjustment period that averages four years (though some women say it lasts 444 years) allows for a body to gradually experience a shift as hormones fall.
With a full hysterectomy there is no adjustment period. One day you have your organs. The next they are replaced with hot flashes, night sweats, insomnia, fatigue, vaginal dryness, depression, and/or anxiety. And none of that sounds like a bit of fun.
And because surgery, rather than aging, initiates this menopause, the severity of the symptoms is often much greater.
Postmenopausal Risks
During this time, self-care takes on a greater meaning and women should be aware of a number of consequences, ranging from annoying to life-threatening. For some women, recovery can be much more difficult — and longer — than anticipated.
Zero Libido
Removal of your uterus and ovaries means loss of fertility. But where bye-bye baby is an obvious consequence, the lack of sexual desire may be harder to fathom for some women. And even if the desire is there, vaginal dryness results in the kind of discomfort that is simply disincentivizing.
Osteoporosis
The earlier the onset of lower estrogen levels, the earlier the loss of bone sets in. On average, women lose up to 10 per cent of their bone mass in the first five years after menopause. The result can be a higher fracture rate long-term. Weight-bearing exercise — walking, dancing, yoga, lifting weights — slow mineral loss.
Heart Disease
One of the most prominent issues that can arise after surgical menopause is heart disease. Studies show that smoking and being overweight are two factors that strengthen the link between menopause before age 50 and a woman’s risk of cardiovascular disease.
Dry Skin and Wrinkles
Skin changes after surgical menopause can be uncomfortable and distressing. Once the ovaries are removed, estrogen declines dramatically and you might start to notice more wrinkles, flushing, sagging, and impaired wound healing. Skin starts to get drier and thinner. It may itch. A nourishing diet, excellent hydration, and a good skin care routine are imperative. The latter applies not only to your face but also your body — including the skin around your vagina. A hyaluronic acid-based moisturizer formulated especially for intimate skin can be a lifesaver.
Make Self-Care a Priority After Surgery
Quality of life after surgical menopause is within your control. Below, our recommendations to help you feel like yourself again:
Focus on fresh food. Eat a diet with plenty of fruits, vegetables, whole grains, fish. Limiting red meat, sugar, and alcohol benefits heart and cognitive functioning. Studies show that the Mediterranean diet provides the highest life expectancy and lowest rate of heart disease, and it has been shown to help with early-menopause symptoms.
Watch your vitamin levels. Get sufficient calcium and vitamin D to help support bone density.
Prioritize sleep. Sleep allows the body to repair and heal. Refine your sleep hygiene and get at least seven hours a night. Including a sleep supplement into your routine can further assist.
Get plenty of exercise. Make a point to get at least 30 minutes of activity five times a week to strengthen your heart, improve your metabolism, preserve bone density, lower blood pressure, and enhance both your mood and your ability to get good rest.
Work with a healthcare professional. Your doctor can help you identify the supplements that might be right for you — and which ones are not. Here’s a long list of things some women say work for them.