Question

Menopause

What are the effects of hormone treatment after surgical menopause?

A Answers (3)

  • AMehmet Oz, MD, Cardiology, answered
    Hormone treatments can have a huge effect on the quality of life following surgical menopause. When we talk about surgical menopause we are referring to menopause that occurs when the ovaries are removed. Sometimes a surgeon will remove the ovaries during a hysterectomy, and sometimes the ovaries are removed sparing the uterus. It depends on a woman's age and why she needs the surgery in the first place. There are a couple of scenarios to mention. If a women is younger than 40 when she has both ovaries removed (bilateral oophorectomy), she can have a sudden drop in estrogen and symptoms might be quite severe. This is a unique group of women because they are still relatively young and they will benefit greatly from replacing the hormone production because their bodies will be deprived for many years. And it appears that younger women are at risk for some serious health risks if they go a long time without estrogen. This is in contrast to older postmenopausal women who have their ovaries removed. Because the surgery is performed later, closer to the time she would have gone through menopause naturally, the decision is more complicated. She will need to talk to her doctor about the risks and benefits of hormone therapy (HRT) based on her symptoms and health profile.
  • Many women who take hormone treatment after surgically induced menopause report getting relief similar to that experienced by women who take hormones after natural menopause. Specifically, many women report fewer episodes of hot flashes and night sweats. Researchers have also found that younger women who report memory loss after a hysterectomy do better on some cognitive tests after beginning to take estrogen, but we don't know whether this is truly an effect of the estrogen or whether it might be explained by other factors. For older women, the research evidence is clear: the Women's Health Initiative (WHI) found that taking estrogen increased the risk for dementia in women over 65 who have had a hysterectomy.

    Little research has examined the health risks of taking hormones for those of us who have had the ovaries removed. The WHI provides some data that is relevant, since all of the women in the estrogen-only part of the study had a hysterectomy, though some of them still had their ovaries. The WHI found that hormone treatment increased the risk of stroke in women who had a hysterectomy. The WHI also indicated that in colorectal cancer or a heart attack, there was neither a risk nor a benefit for these women and the effect of hormone treatment on blood clots and breast cancer for these women was uncertain. It is important to note, however, that for women whose ovaries were removed specifically to treat cancer, the risk of either recurrent cancer or other cancers associated with hormone treatment may be greater than for other women.

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  • There isn't much research on the risks of hormone treatment after surgical menopause (removal of the ovaries). A large study conducted by the Women's Health Initiative (WHI) showed that taking estrogen increased the risk for dementia in women over 65 who had a hysterectomy, but many of the women still had their ovaries.

    It's best to talk to your doctor about the risks associated with hormone treatment after surgical menopause. 

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