Dr. Sarrel discusses the risks women face after surgical menopause if they do not undergo hormone replacement therapy.
What happens in the surgical menopause is it’s cut off prematurely. So we have to say, well, what if a woman were, say, 35 or younger and lost her ovaries and those hormones–estrogens and androgens, is she at an increased risk compared to natural menopause for any conditions? And the answer is yes, she is. For example, the mental health risk.
Let me wear my psychiatry hat for a moment. Women attempt suicide. It’s a real issue in women’s health. The risk that a woman will be hospitalized for a suicide attempt is doubled; it’s actually 2.4. So almost two and a half times as great in the woman who has had a surgical menopause at 35 or under versus, and no hormone replacement versus a woman who has a natural menopause. That’s the risk of trying to kill herself. That’s a big one in psychiatry.
Let’s take one in internal medicine: The risk of having a hip fracture, that’s almost tripled if that young woman doesn’t replace her hormone, the missing hormones. Then her risk that she will have a hip fracture is tripled. It’s 2.8 compared to a woman who has a natural menopause.
What about a sex problem what we were talking about? That risk is doubled, the risk that she will have a loss of desire, pain with intercourse, decreased sex response. Those women who have had no hormone replacement after early loss of their ovaries have double the risk of developing a sex problem.
But probably the most serious of all is the risk of having a heart attack because sex hormones play an important role in protecting arteries, and we do know that if a woman is 35 or under and she loses ovarian hormones and doesn’t replace them properly, her risk of having a heart attack compared to a woman having a natural menopause is increased almost 800 percent. That’s an extremely high-risk situation.
So we really need to reach out to teach women cardiovascular health is number one in your priority list and knowing what to do from an exercise point of view, a diet point of view, and potentially from a hormone point of view, can make all the difference in the world.
About Dr. Sarrel, M.D.:
Philip M. Sarrel, M.D., completed his medical education at New York University School of Medicine, his internship at the Mount Sinai Hospital, and his residency at Yale New Haven Hospital. In addition to his many years on the faculty of the Departments of Obstetrics and Gynecology and Psychiatry at Yale University School of Medicine, Dr. Sarrel has also been a Faculty Scholar in the department of psychiatry at Oxford University, Visiting Senior Lecturer at King’s College Hospital Medical School at the University of London, Visiting Professor in Cardiac Medicine at the National Heart and Lung Institute in London, and Visiting Professor in the Department of Medicine at Columbia University College of Physicians and Surgeons in New York. He is currently Emeritus Professor of obstetrics, gynecology, and psychiatry at Yale University.