Surgical menopause

Introduction
 Surgical menopause, also known as induced menopause or
oophorectomy.
 It is a medical procedure in which a woman's ovaries are
surgically removed, leading to the abrupt cessation of
ovarian hormone production.
 This procedure can be performed for various medical
reasons, such as the prevention or treatment of certain
conditions.
Causes of Surgical Menopause
 Ovarian Cancer
 High Genetic Risk.
 Endometriosis.
 Benign Ovarian Tumors.
 Pelvic Inflammatory Disease (PID).
 Adenomyosis.
 Ectopic Pregnancy.
 Gender-Affirming Surgery.

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Types of surgical menopause

Bilateral Unilateral
oophorectomy oophorectomy

1.Bilateral Oophorectomy
 Bilateral oophorectomy involves the complete removal of
both ovaries.
 This procedure results in a complete cessation of ovarian
hormone production, leading to an immediate and often
severe form of surgical menopause.
 Bilateral oophorectomy is commonly performed as part of
a hysterectomy (removal of the uterus), particularly when
there is a history of ovarian cancer, high genetic risk, or
other gynecological conditions.
2.Unilateral Oophorectomy
 Unilateral oophorectomy involves the removal of one ovary
while leaving the other intact.
 This type of surgery typically results in a less abrupt
hormonal change than bilateral oophorectomy since the

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remaining ovary continues to produce some levels of

hormones, particularly if it remains functional.
 However, even with one ovary intact, hormonal imbalances
and menopausal symptoms can still occur.

symptoms

1. Physical symptoms

2. Psychological symptoms

Physical symptoms
 Hormonal Changes: Surgical menopause leads to an
abrupt decrease in estrogen and progesterone levels,
resulting in symptoms such as hot flashes, night sweats,
vaginal dryness, and mood swings.
 Cardiovascular Health: Estrogen plays a role in
maintaining cardiovascular health. Surgical menopause
may increase the risk of cardiovascular diseases, including

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heart disease and stroke, due to changes in lipid profiles

and endothelial function.
 Bone Health: Estrogen is essential for maintaining bone
density. The rapid decline in estrogen levels during surgical
menopause can lead to accelerated bone loss and an
increased risk of osteoporosis.
 Sexual Function: Vaginal dryness and decreased libido are
common during surgical menopause due to reduced
estrogen levels. These changes can impact sexual function
and intimacy.
Psychological challenges
Surgical menopause can have a profound psychological
impact on individuals. The abrupt hormonal changes can
contribute to mood swings, anxiety, depression, and
cognitive disturbances. Coping with the physical symptoms
and emotional challenges can be demanding, necessitating
strong support systems, counseling, and mental health
interventions.
Mood Disorders: The hormonal fluctuations associated
with surgical menopause can contribute to mood disorders
such as depression and anxiety. Estrogen has an impact on
neurotransmitter systems that regulate mood.
Cognitive Function: Estrogen plays a role in cognitive
function and memory. Surgical menopause has been

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associated with cognitive changes, including difficulties

with memory and concentration.
Quality of Life: The combination of physical symptoms
and psychological distress can significantly affect a
woman's overall quality of life during surgical menopause

Management approach
Hormonal replacement therapy

Non hormonal intervention

Support and counselling

Hormone replacement therapy

 HRT involves the administration of estrogen and, if
needed, progesterone to replace the hormones lost due to
surgical menopause.
 This therapy aims to alleviate menopausal symptoms,
improve bone health, and mitigate some of the
cardiovascular risks associated with estrogen deficiency.

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 The decision to pursue HRT should be individualized,

considering the woman's medical history, risk factors, and
preferences.
Non hormonal intervention
 For women who cannot or choose not to undergo HRT,
non-hormonal interventions offer alternative strategies for
managing surgical menopause symptoms.
 Lifestyle modifications, such as regular exercise, a
balanced diet rich in calcium and vitamin D, and stress
reduction techniques, can contribute to overall well-being
and bone health.
Support and counselling
 Emotional and psychological challenges during surgical
menopause underscore the importance of psychological
support and counseling.
 Cognitive-behavioral therapy (CBT) and mindfulness-
based interventions helps women manage their mood
disturbances, anxiety, and cognitive changes.
 Creating a supportive environment and fostering open
communication can also play a significant role in
improving emotional well-being.

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Conclusion
 Emotional and psychological challenges during surgical
menopause underscore the importance of psychological
support and counseling.
 Cognitive-behavioral therapy (CBT) and mindfulness-
based interventions helps women manage their mood
disturbances, anxiety, and cognitive changes.
 Creating a supportive environment and fostering open
communication can also play a significant role in
improving emotional well-being.
Bibliography
 Bhaskar Nima, Textbook of midwifery and obstetrics,
EMMESS medical publisher, 2nd edition page no. 95-99.
 D.C.Dutta, Textbook for obstetrics, 6th edition 2004, page
no. 55-60.
 Http://WWW.Ncbi.nih .govt/pubmed/11028580

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