Nobody prepares you for what comes after surgical menopause.
Your surgeon explains the procedure, mentions “some menopausal symptoms,” and sends you home with a leaflet.
But what actually happens when your body loses 95% of its oestrogen overnight?
I’ve spent years helping women navigate surgical menopause, and here’s the truth nobody tells you upfront.
The symptoms hit harder and faster than natural menopause.
Recovery takes longer than anyone admits.
But with the right information and support, you can get through this and feel like yourself again.
Whether you’re facing this surgery or already recovering, this guide covers everything I wish every woman knew before going under the knife.
Table of Contents
What Is Surgical Menopause?
Surgical menopause hits when your ovaries get removed through a procedure called oophorectomy.
Unlike natural menopause that creeps up slowly over years, surgical menopause drops you straight into it – overnight.
Your body goes from producing oestrogen to basically zero in a matter of hours. That’s why the symptoms can feel like getting hit by a lorry. Women undergoing surgical menopause are strongly encouraged to consider hormone replacement therapy (HRT) to help manage symptoms and reduce long-term health risks. For reliable guidance, see the Cleveland Clinic’s overview on menopause.
When Doctors Recommend Ovary Removal
Most women don’t wake up one day deciding to remove their ovaries.
This surgery usually happens for serious reasons:
- High cancer risk – If you carry BRCA1 or BRCA2 gene mutations
- Existing ovarian cancer – To stop cancer from spreading
- Severe endometriosis – When other treatments haven’t worked
- Ovarian cysts – That keep coming back or look suspicious
- Family history – Multiple relatives with ovarian or breast cancer
I’ve seen women struggle with this decision for months.
The fear of cancer versus the fear of sudden menopause.
Both are valid concerns.
The Brutal Truth About Surgical Menopause Symptoms
When your ovaries disappear, so does 95% of your oestrogen production.
Your adrenal glands try to pick up the slack, but they’re not equipped for the job.
Here’s what actually happens:
Immediate Symptoms (First Few Weeks)
- Hot flushes that feel like someone cranked up the thermostat to 40°C
- Night sweats that soak through your pyjamas and sheets
- Brain fog where you forget basic words mid-sentence
- Mood swings that make PMT look like a gentle breeze
- Sleep disruption – you’re exhausted but can’t stay asleep
Long-Term Effects (Months to Years)
- Bone density loss – Starts immediately, not in 10 years
- Heart disease risk increases without oestrogen’s protection
- Vaginal dryness that makes intimacy uncomfortable or painful
- Low libido – your sex drive basically vanishes
- Weight gain around your middle, no matter what you eat
- Joint pain that makes you feel 20 years older
Recovery Timeline: What to Actually Expect
Week 1-2: The Initial Adjustment
Your body experiences significant hormonal disruption.
Expect to feel unwell during this period.
Frequent hot flushes, emotional volatility, and complete exhaustion are normal responses, not personal failings.
Month 1-3: The Adaptation Period
If you commence hormone replacement therapy (HRT), you may begin feeling more stable.
Without HRT, symptoms often intensify before any improvement occurs.
Sleep patterns gradually improve, though hot flushes typically persist.
Month 3-6: Establishing Your New Baseline
With appropriate treatment, many symptoms become more manageable.
You develop awareness of triggers to avoid and strategies that provide relief.
Energy levels begin returning, though they may not match pre-surgical levels.
Year 1+: Long-Term Adaptation
This becomes your established new normal.
Some symptoms may continue, but you’ve developed effective coping mechanisms.
Regular monitoring for bone health and cardiovascular disease becomes essential.
Recovery after surgical menopause varies, but symptoms like hot flashes and mood changes often begin immediately and can last for months. More information is available from the British Menopause Society’s surgical menopause guidance.
Hormone Replacement Therapy: Your Best Friend
Unless you had hormone-sensitive cancer, HRT is usually your lifeline.
MHT should be commenced as soon as possible post-operatively, reviewed within 6-12 weeks for symptom response, and continued at least until the average age of menopause.
Types of HRT After Surgery
- Oestrogen-only – If you had a hysterectomy too
- Combined HRT – Oestrogen plus progesterone if you kept your womb
- Testosterone – Sometimes added for energy and libido
HRT Delivery Methods
- Patches – Steady hormone levels, changed twice weekly
- Gels – Applied daily, easy to adjust dose
- Tablets – Convenient but higher blood clot risk
- Implants – Last 6 months, good for busy lifestyles
Managing Symptoms Without (Or Alongside) HRT
Sometimes HRT isn’t an option or doesn’t solve everything.
Here’s what actually works:
For Hot Flushes
- Keep your bedroom under 18°C
- Layer clothing you can remove quickly
- Carry a small battery fan
- Avoid spicy food, caffeine, and alcohol
- Try sage supplements (some women swear by them)
For Sleep Problems
- No screens 2 hours before bed
- Blackout curtains and white noise
- Cool shower before sleep
- Magnesium supplements (check with your doctor first)
For Mood Changes
- Regular exercise (even 20 minutes walking helps)
- Vitamin D supplements
- Consider counselling – this is a massive life change
- Connect with other women who’ve been through it
For Vaginal Dryness
- Vaginal oestrogen (even if you can’t have systemic HRT)
- Regular intimate moisturisers
- Don’t suffer in silence – speak to your GP
The Mental Health Side Nobody Talks About
Losing your ovaries isn’t just physical.
You might grieve the loss of fertility, even if you didn’t want more children.
You might feel less feminine or worry about ageing faster.
These feelings are completely normal.
Many women find counselling helpful during the first year.
Some join online support groups with women who understand.
Long-Term Health: What You Need to Monitor
Bone Health
Get a DEXA scan within the first year.
Take calcium and vitamin D supplements.
Do weight-bearing exercise regularly.
Heart Health
Your GP should monitor your blood pressure and cholesterol more closely.
The protective effects of oestrogen are gone.
Cancer Screening
Keep up with regular mammograms and cervical screening.
Just because you reduced one risk doesn’t mean you can ignore others.
Questions I Get Asked All the Time
“Will I feel like myself again?”
You’ll feel different, not broken.
Most women adapt within the first year, especially with proper support and treatment.
“Can I still have a sex life?”
Absolutely, but it might take work.
Vaginal oestrogen, lubricants, and patience with your partner make a huge difference.
“Will I gain weight?”
Many women do, but it’s not inevitable.
Focus on protein, strength training, and managing stress rather than restricting calories.
“How long should I take HRT?”
The guidelines and evidence state that you can continue to take HRT as long as the benefits outweigh the risks.
For surgical menopause, this often means longer than natural menopause.
“What if HRT doesn’t help?”
Sometimes doses need adjusting or delivery methods changing.
It can take 3-6 months to find what works for you.
Red Flags: When to Call Your Doctor
Some symptoms need immediate attention:
- Severe depression or thoughts of self-harm
- Chest pain or difficulty breathing
- Severe headaches with vision changes
- Heavy bleeding if you still have your womb
- Signs of blood clots (swollen, painful leg)
The Bottom Line
Surgical menopause is tough, but it’s not a life sentence of misery.
With the right treatment and support, most women find their new normal within a year.
Don’t try to tough it out alone.
Your GP, a menopause specialist, or even a good online community can make all the difference.
Remember, you chose this surgery for a reason – probably a very good one.
Focus on that when the going gets rough.
The key is working with healthcare professionals who understand surgical menopause and won’t dismiss your symptoms as “just menopause.”
This guide provides general information and shouldn’t replace medical advice. Always consult your healthcare provider about your specific situation and treatment options.
