Managing Early Menopause

23 Aug 2021
Many women at high risk of breast and/or ovarian cancer experience early menopause (due to cancer prevention surgery or in some cases some cancer therapies). Not everyone is troubled by menopausal symptoms, but if they happen, it is important to know that there are ways to help manage them.

What is ‘natural menopause’?

A woman going through natural menopause is said to be ‘postmenopausal’ when she has not had a period (menstrual cycle) for 1 year. The average age of natural menopause is around 51 years. It is usual for women to notice a change in their periods from their late 40s. Some women notice a gradual onset of menopausal symptoms before their periods stop completely. Some women do not experience any changes other than their periods stopping. It is not possible to predict who will have symptoms or changes (such as hot flushes or changes in mood, energy, sleep or sexual function) and who will not.

What is ‘surgical’ menopause?

Surgical removal of both ovaries and usually the Fallopian tubes which join to the uterus (womb) is called risk reducing salpingo-oophorectomy (RR-SO). When this surgery is done before the natural menopause it causes the menstrual cycle to stop and this is called “surgical menopause”. This type of surgery minimises ovarian cancer risk (and can reduce breast risk in some women as well). On the other hand, it can produce menopausal symptoms in some women. It is not possible to know who will be troubled by these symptoms and who will not.

There have been remarkably few studies which have followed women before and after surgery to try to understand how surgery affects their menopausal symptoms and short and long term health.

Effects of Surgically Induced Menopause

Menopause is considered early if it occurs before the age of 45 years, below are some possible effects;

Common side effects

Sudden onset of menopausal symptoms: in particular;
    • Hot flushes
    • Night sweats
    • Vaginal dryness
Some women may experience:
    • Impaired sexual function due to discomfort from vaginal dryness
    • Reduced desire or libido
    • Mood changes, particularly depressed mood
    • Sleep disturbance
    • Possible changes in memory, thinking and/or problem-solving
There is still little information about the long-term effects of early menopause and whether this differs if menopause is due to chemotherapy or surgery. Because there may be increased risks of fracture and possibly heart disease, it is important to minimise these risks with healthy lifestyle choices. More information can be found here