As women enter their forties, they begin to notice changes in hormones causing irregular periods, skipped periods, heavier periods, mood changes, memory loss, fuzzy brain, hot flashes, nightsweats, and/orvaginal dryness. Eventually the ovaries start to shut down and there are longer gaps in between periods until one day it’s all over and they never return. And then we can say, "congratulations--you are post-menopausal."
What happens if you are forced into menopause before your body is ready? I had a woman in my office last week in her late thirties preparing to have a complete hysterectomy because of severe endometriosis. To her, the pain she deals with everyday is a bigger factor than the sequelae of going through menopause before her time.
I explained to her that surgical menopause will occur because her ovaries are going to be removed. In my never-ending quest for easy analogies, it’s like one day the body is going about its business with all the pieces and parts communicating with each other, and the next day Betty and Lorraine are gone (her ovaries). The other glands, like the adrenals, thyroid, liver, and gall bladder don’t get the text message that Betty and Lorraine have left the building so they go about their day sending messages down to the ovaries and awaiting feedback…except nothing happens. Then there is a back up and miscommunication, tasks aren’t being completed and suddenly it’s mad chaos. Where are Betty and Lorraine?
Now the adrenals and thyroid have to make a mad scramble with the hypothalamus and the pituitary up in the brain to help pick up the pieces and fix the symptoms. Unfortunately, the body wasn’t prepared. It didn’t have the entire decade of the forties to gear up and get used to the idea that the ovaries are slowing down.
One day there is estrogen and progesterone and the next day it’s gone.
Therefore, many women come out of surgery recovering from the procedure and dealing with menopause. All the symptoms listed above (and more) start to occur. Additionally, women who have their cervix removed in the process might lose sexual response.
Thankfully the surgeon for this patient was very honest in explaining the ins and outs of what to expect. I have had many patients come into my office in tears because they are in their twenties, thirties, or early forties and not ready for menopause…or the 20-pound weight gain that came on suddenly.
I reminded this particular patient about the importance of her diet and exercise, and that we will be thorough in our testing to address all the other glands and aspects of the body that are responsible for taking over once the ovaries (Betty and Lorraine) are gone. We will focus on her adrenals to handle the new stress, thyroid for energy and weight, and brain hormone balance for memory and mood. Even with all this she may still be symptomatic but she understands and is now more ready for surgery.