For many people, menopause is a totally natural transition - a phase of life where you no longer ovulate and your periods stop. However, for some people, they are plunged into early menopause by having a hysterectomy. This is known as surgical menopause.
Here we’ll explain more about surgical menopause and share the story of Carla Cressy, founder of The Endometriosis Foundation - who went into surgical menopause 3 years ago after decades of living with extreme endometriosis.
- Natural menopause usually occurs in our early 50s and can come with symptoms including low mood, hot flushes and sleep issues
- Surgical menopause is when you enter menopause early due to a partial or full hysterectomy
- Surgical menopause impacts the endometriosis community as around 12% of people with endo will have a hysterectomy to help improve their quality of life.
Perimenopause and Menopause
To understand surgical menopause, it’s first important to understand menopause and the symptoms that come with it.
Menopause is the time in life when a woman - or person with female reproductive organs - no longer has periods. Technically menopause is a one-day event - the day when you have not had a period for a year. This usually happens around the age of 50. The time leading up to this is known as perimenopause. Perimenopause can last up to 8 years and can come with a lot of hormonal fluctuations as the production of oestrogen slows down.
These hormonal changes can bring with them a lot of symptoms including:
- Low mood
- Low libido
- Hot flushes
- Vaginal Dryness
- Heart Palpitations
- Skin and Hair Issues
- Weight Gain
What is surgical menopause?
Whilst perimenopause usually begins in our 40s, it is possible to go into menopause earlier than that. If your periods stop before the age of 40 this is known as ‘early menopause’. For some people, this may be due to a medical condition like Primary Ovarian Insufficiency but for others, it could be known as ‘surgical menopause’.
Surgical menopause is when someone goes through menopausal symptoms as a result of an operation that impacts the function of their ovaries. Most commonly this is connected to some kind of hysterectomy - where the uterus, and sometimes ovaries, are completely removed. If you have had your uterus removed but retained some or all of your ovaries, you may still go into early menopause - but the process may be slower.
There is also a process known as ‘medical menopause’ where you are prescribed hormonal medicines such as GnRH Analogues to suppress the menstrual cycle for medical reasons. Unlike surgical menopause, medical menopause can be temporary and reversible.
Surgical menopause and endometriosis
So what is the connection between surgical menopause and endometriosis? Well, around 12% of people with endo will eventually require a hysterectomy to help improve their quality of life.
This is obviously a very extreme treatment route and is usually only recommended for people struggling with Stage 4 endometriosis. A hysterectomy and the early surgical menopause that follows is a huge decision for anyone to make and there are many factors to consider before embarking on this journey.
Surgical Menopause - Carla’s Story
Carla Cressy is the Founder of The Endometriosis Foundation. For years she suffered from an extreme case of endometriosis - and was constantly disbelieved and misdiagnosed. By the time she was finally diagnosed with endometriosis, it had totally taken over her uterus and ovaries, as well as spreading to her bowel and bladder. A hysterectomy was her only option and she went into surgical menopause three years ago. Here is her story.
A big decision
Surgical menopause was a long-feared decision for me, I had to take time to think about it and to really understand why I needed a hysterectomy and if this was right for me.
I made every effort to explore alternative options, but unfortunately, I was dealing with an aggressive form of endometriosis that deeply infiltrated my pelvic organs and kept coming back despite having extensive and invasive surgeries to remove it.
At the time of my hysterectomy, I also underwent bladder reconstruction surgery and had a portion of my bowel removed, all because of endometriosis. After exhausting other avenues and seeking out endless opinions from other specialists, it sadly became the best step for me.
Living with symptoms
3 years before having my hysterectomy I experienced medically induced menopause. I thought that, because I had such an awful experience with the GnRH Analogues I had to take during this time, I would be able to handle the symptoms that surgical menopause came with. But surgical menopause is so different.
From the moment I woke up in the hospital after my surgery I remember feeling really low and so incredibly overwhelmed. I couldn’t stop crying. I’d experience such awful heart palpitations, I couldn’t sleep, I was having breathing difficulties, dizzy spells, I was hot, breaking out in sweats, I couldn’t think. It was really tough and it still is to some extent.
Not a cure
It's crucial for me to emphasise that choosing a hysterectomy as a treatment for endometriosis doesn't provide a cure. I'm currently three years post-hysterectomy, and my endometriosis has grown back. Unfortunately I do still suffer with pain - with endometriosis, when the damage is done, it’s done. The impact is irreversible, and I have had to find a way to live and manage with the lasting pain.
I have a lot of neurological pain, sciatic pain, pain with my bowels and sometimes my bladder. I don’t experience the period pain or the cramps that I felt before my hysterectomy which I’m grateful for, but I tend to hold on to a lot of the pain in my lower back which is where I’ve found the Myoovi kit is really helpful.
To someone facing medical or surgical menopause due to endometriosis, my advice would be to seek support and information. Connect with healthcare professionals who specialise in endometriosis and menopause, and discuss the best treatment options even before you embark on the journey.
Additionally, reaching out to support groups or organisations dedicated to endometriosis to find a community of individuals who have gone through similar experiences can be life-changing, at least it has been for me to see and hear of other’s experiences. Embrace self-care listen to your body's needs during this transition, and remember that you're not alone in this journey.
For more support on living with endometriosis head to The Endometriosis Foundation’s website.