Surgical Menopause: What to Expect After Oophorectomy or Hysterectomy

Estimated read time: 4-5 min

What Is “Surgical Menopause”?

Surgical menopause happens when your ovaries are removed (oophorectomy) or stop functioning after a hysterectomy. Because the ovaries make 90 % of the body’s estrogen, hormone levels plunge within 24 hours—much faster than the gradual decline of natural menopause.
Quick definitions

Oophorectomy: removal of one (unilateral) or both (bilateral) ovaries.
Hysterectomy: removal of the uterus; ovaries may or may not be removed. If they stay, you usually don’t enter menopause right away, but blood supply can be reduced, causing earlier menopause on average by 1-3 years.

Disclaimer: Information below is educational and doesn’t replace personalized medical advice. Always talk with your healthcare team.

Why the Sudden Hormone Drop Matters

Estrogen and progesterone touch nearly every system. When they vanish overnight you can expect:

Body System	Possible Changes (often within weeks)
Brain	Hot flashes, night sweats, mood swings, brain fog, insomnia
Heart & Vessels	Rising LDL (“bad”) cholesterol, palpitations, higher long-term risk of heart disease
Bones	Accelerated bone loss—up to 7 % in the first year
Genitourinary	Vaginal dryness, lower libido, painful sex, recurrent UTIs
Skin & Hair	Dryness, thinning, hair loss or new growth in unwanted places

Sources: ACOG, NIH.

Typical Timeline

Days 1-14: Surgical recovery + abrupt hot flashes, fatigue.
1-3 months: Sleep disruption, mood changes, irregular bowel/bladder habits.
6-12 months: Bone density drops fastest; cholesterol often climbs.
>1 year: Risks for osteoporosis, heart disease, cognitive change show up on long-term labs and scans.

Managing Symptoms & Protecting Long-Term Health

1. Hormone Therapy (HT)

Estrogen-only if you no longer have a uterus.
Estrogen + progesterone if your uterus remains (lowers risk of endometrial cancer).
HT is the gold-standard for hot flashes, bone protection, and mood stabilization when started before age 60 or within 10 years of surgery. See the North American Menopause Society for dosing guides.
Contraindications: history of breast cancer, clotting disorders, stroke—discuss alternatives with your doctor.

2. Non-Hormonal Options

SSRIs/SNRIs (e.g., venlafaxine) for hot flashes & mood Mayo Clinic.
Gabapentin for night sweats.
Vaginal moisturizers & DHEA for dryness.
Bisphosphonates or denosumab for osteoporosis prevention if HT is off the table.

3. Lifestyle Upgrades

Weight-bearing exercise (30 min, 5x/week) — boosts bone density CDC.
Mediterranean-style diet: more plants, fish, olive oil—heart + brain benefits.
Quit smoking & limit alcohol: lowers fracture and heart risk.
Mind-body tools: CBT, paced breathing, yoga reduce vasomotor symptoms by ~30 % in trials.

Key Questions to Ask Your Surgeon/OB-GYN

Will both ovaries be removed? If yes, why?
Am I a candidate for immediate HT in the recovery room?
How often should I have bone scans and cholesterol checks post-op?
Are there pelvic floor or sexual health specialists you recommend?
What red flags should prompt an urgent call (e.g., chest pain, calf swelling)?

When to Seek Help Fast

Fever >101 °F, heavy bleeding, or foul discharge (possible infection).
Sudden severe headache, vision changes (possible HT complication).
New leg pain/swelling or shortness of breath (possible blood clot).

Take-Home Points

Surgical menopause is abrupt but manageable with the right combo of HT, lifestyle, and monitoring.
Early intervention protects bones, heart, mood, and sex life.
Partner with a menopause-informed provider; regular follow-ups are your safety net.

For more evidence-based tips, check out our in-app library or visit Menopause.org and NCCIH.