This is the start of my menopause journey, a surgical menopause.
I’m going to use this first post to set the scene. Trust me, there is hope at the end of it all, but it’s a bit of a grim beginning. Here we go, the facts.
What is a surgical menopause?
Surgical menopause occurs when the ovaries are removed, usually as part of a total hysterectomy. Natural menopause occurs gradually around the age of 51 years. Surgical menopause happens immediately upon removal of the ovaries if a woman has not yet experienced natural menopause.
That’s the clinical definition. And it is – a very ‘clinical’ definition of something that has a deep emotional and psychological impact on the woman experiencing it.
But let’s just deal with the clinical science bit for now. What does having your ovaries removed do to you? Maybe a better question is what do your ovaries actually do?
The ovaries have three functions. First, they shelter and protect the eggs a female is born with until they are ready for use. It is thought that women are born with their lifetime supply of eggs.
Second, ovaries produce female reproductive hormones called oestrogen and progesterone, and some lesser hormones called relaxin and inhibin. There are three different types of oestrogen: oestrone, oestradiol and oestriol. They are used by the body to help develop adult female characteristics, such as breasts and larger hips, and to aid in the reproduction cycle. Progesterone is also key to reproduction. Relaxin loosens the pelvic ligaments so they can stretch during labor. Inhibin prevents the pituitary gland from producing hormones.
Third, ovaries release one egg, or sometimes more, each menstrual cycle.
When they are removed, it’s a lack of oestrogen that causes menopausal symptoms such as:
- hot flushes
- vaginal dryness
- sleep problems (insomnia)
- night sweats
Ovary removal has been linked to a seriously higher risk of heart disease, osteoporosis, dementia, and death by any cause, likely due to that drastic drop in oestrogen. Research suggests that premenopausal women who have their ovaries removed at age 35 or younger have nearly twice the risk of developing cognitive impairment or dementia, a seven times higher risk of heart disease, and an eight times higher risk of a heart attack.
That doesn’t even begin to explore some of the emotional impacts. I was lucky, my gynaecological problems only had a major impact after I had my children. But even for me, the finality of ‘no more babies’ and ‘losing my biological function’ was a challenge. Three children and a stepson we agreed was enough of a family for us when we got together, but there was always the potential and I had to face that it was gone.
But that is for a different post, I just want to start by outlining the medical facts. I was 33, the operation was ‘a great success’ to quote my surgeon (including an unexpected appendectomy – apparently that was a special extra for free); 12 weeks recovery awaited me. This was before the more ‘convenient’ approach to hysterectomy, so I had the full scar and internal damage to mend.
At that time I already had a relationship with depression and anxiety. My mother died of cancer when she was 48 and I was 13; despite my excellent family and friends support, aged 16, I was diagnosed with depression. That began a lifelong journey with depression and anxiety, but at this point in my life in a new relationship, working in a job I enjoyed, my mind was at peace.
And so it begins … my adaptation to ‘a new normal’