Most women go through menopause as part of a normal aging process but if you have an operation that removes your ovaries or you take medication that stops your ovaries working, it can cause you to go through menopause earlier.
If you’re not aware of what menopause symptoms are, it can be a very confusing and concerning time. You may feel your recovery is not going as expected or worry there’s additional health problems occurring.
Symptoms occurring from a surgical menopause are often more sudden and severe than symptoms from a naturally occurring menopause. For this reason, it’s especially important to be aware of how you might feel after your operation or medical treatment, and with the support of your healthcare team, you can be proactive with addressing any menopause symptoms alongside your recovery and any ongoing health concerns.
If you are under 45 years, it is even more essential that hormone replacement therapy is considered so you can benefit from the protective effects of estrogen for your future health.
If you’re experiencing an early menopause or have premature ovarian insufficiency, you may want to read our guide our early menopause and POI guide.
Causes of surgical menopause
Oophorectomy
This is surgery to remove one or both ovaries. If you only have one ovary removed, it is still likely that you will experience menopause earlier than you may have done naturally, but symptoms are more likely to appear gradually.
If you have had both ovaries removed, you would be considered menopausal immediately from this point.
Hysterectomy
The most common type of surgery that may precipitate an early menopause is a hysterectomy (removal of your womb/uterus). Your ovaries may be removed along with your uterus and when this happens, your body has lost its main supply of estrogen so it’s very common for women to experience a range of symptoms caused by a lack of estrogen (and also testosterone).
You may require a hysterectomy because of cancer in the womb, ovaries or cervix. Or you may be troubled by heavy periods, pelvic pain, endometriosis or pelvic inflammatory disease and have this surgery to treat your condition.
There are different types of hysterectomy:
- Total hysterectomy removing the uterus and cervix (abbreviated to TAH if the uterus is removed via the abdomen, and TVH if the uterus is removed via the vagina)
- Subtotal hysterectomy removing the body of the uterus only, the cervix remains in place
- Total hysterectomy with salpingo-oophorectomy: removal of uterus, cervix, fallopian tubes, and both ovaries (abbreviated to TAH and BSO)
- Radical hysterectomy is removal of all of the above as well as the surrounding tissue, part of the vagina, lymph glands and fatty tissue.
Types 3 and 4 usually cause menopause symptoms to come on suddenly as they involve removal of the ovaries. If you have type 1 or 2 hysterectomy, you are likely to still produce some estrogen afterwards, but your hormone levels may fall at an earlier age than average.
With any hysterectomy, you will not have periods afterwards.
It may not always be clear whether you’re experiencing menopause or not, but knowing the potential symptoms, listening to your body and seeking help promptly is key.
Treatments for cancer
Some treatments for cancer can affect the ovaries and how they function. As well as surgical removal of the womb or ovaries as already mentioned, examples of other cancer treatments that can bring on menopause are:
- Radiotherapy to the pelvic area
- Some chemotherapy drugs
- Hormone blocking medications such as Aromatase Inhibitors for treating hormone sensitive breast cancers
Some of these treatments can trigger menopause permanently, or in some cases, they cause a temporary menopause with the ovaries returning to producing hormones sometime after the treatment is completed. The type of treatment and the age of the woman can affect whether the ovaries stop working permanently or recover with time if your periods return.
Other hormone blockers
Some treatments for certain gynaecological conditions, like endometriosis or severe premenstrual disorders, may block or ‘switch off’ the ovaries and result in lowered hormone levels. Menopausal symptoms may occur as a result of this and they may be long-lasting or only temporary.
Symptoms
Symptoms of surgical menopause are the same as a naturally occurring menopause. As mentioned, they may come on more suddenly and/or be more severe.
The most common menopause symptoms are brain fog, changes to mood and anxiety, hot flushes and night sweats, trouble sleeping, aches in your joints and muscles, and tiredness.
If you want to know more about menopause and what symptoms can occur, take a look at our booklet on menopause.
Symptoms that are often not discussed are the changes that can occur to your genitals and urinary function. These include vaginal dryness and vulval soreness, incontinence, urinary tract infections and more. You can read about these symptoms our GSM guide . There are effective treatments for these symptoms, so you don’t need to suffer in silence.
Treatments
If you have experienced menopause due to surgery or medical treatments, there is plenty that can be done to relieve symptoms and help you feel more like your usual self. The most important thing to do is be proactive and seek help for your menopause as soon as possible.
HRT
Hormone replacement therapy (HRT) is the most effective treatment for menopausal symptoms and for looking after your future health. You can read more information on HRT here.
If your menopause has been due to breast cancer treatment, you may feel wary of taking HRT. You can always discuss this with your cancer care team and/or menopause specialist, who can talk you through the pros and cons of decisions around taking HRT. We also have a useful resource titled Menopause after Breast Cancer that helps explain some of these issues.
If your womb has been removed, you would usually be recommended estrogen-only HRT which has not been associated with any increased cancer risk.
Ideally, discussions around whether to take HRT or not are well placed to happen before the medical intervention that will affect your ovaries. If you do decide to take HRT, it is generally advised to start this as soon as possible to limit the occurrence of unwanted symptoms.
It is also important to take the right dose and type of HRT for you and your health history. You may wish to see a menopause specialist who is experienced in helping menopausal women after cancer, if this applies to you.
Aside from HRT, there are other important ways of managing your menopause that don’t involve any associated risks to your health.
Vaginal hormone treatments
There are hormone treatments that are not absorbed in the same way as systemic HRT. Vaginal hormone replacement treatments are designed to help the genital and urinary symptoms you may experience.
Medication containing estrogen (and sometimes testosterone) is inserted into the vagina (and/or spread on the vulva) to relieve discomfort and restore the health of the genital tissue and urinary function. It works where it is placed and the surrounding areas, but it does not circulate round the body as systemic HRT does.
Vaginal hormone treatments are very safe, and can be used long term, including for those who have had hormone dependent cancers.
You can read more about these treatments our GSM guide
Importance of a healthy lifestyle
Whether you decide to take HRT or not for your menopause symptoms, the importance of adopting healthy lifestyle measures cannot be underestimated for managing your menopause transition and giving all aspects of your health the best chance for the future.
These are the key areas to focus on and each one is linked to further information with advice and tips on how to incorporate these healthier habits into your daily lives:
As well as ensuring you’re eating a nutrient rich diet, you may wish to further boost certain aspects of your nutrition with supplements. Some suggested ones for women going through menopause are:
- Vitamin D and calcium for your bone health
- Magnesium and vitamin B to aid sleep and relaxation
- Pre- and probiotics for your gut health
- Essential fats like Omega 3 for brain health
Look after your mood and stress levels
You can also learn more about protecting your future health with our trio of booklets on this subject:
Pelvic floor therapy
After surgery such as hysterectomy, it is very important to recover strength in the muscles around your vagina and anus. Pelvic floor exercises when done correctly, can significantly improve any incontinence you may be experiencing as a result of your surgery (and it may also improve sexual enjoyment).
There are a number of apps and videos available online to support you to regularly carry out pelvic floor exercises, as it’s essential that they’re repeated several times a day. ‘Squeezy’ is an NHS app for this purpose. There are also devices that you insert into the vagina to help you train and work the correct muscles.
If you are struggling with incontinence, prolapse, or carrying out pelvic floor exercises, you may wish to see a specialist nurse or physiotherapist who can assist with your pelvic floor therapy.
Sex after surgery
If you have had a hysterectomy (or other gynaecological surgery), your sex life may be a concern or worry for you, as well as the potential onset of menopause.
You may have been advised to wait 4-6 weeks before having sexual intercourse or any play involving the vagina. This is to allow time for tissue to heal and any discharge or bleeding to have stopped.
Don’t worry if you don’t feel like resuming your sex life after this time, it is different for everybody. As well as concern about levels of pain or causing damage to internal scarring, your libido (sex drive) may have also been affected by the lack of circulating hormones, so you may not be interested in sex at all and this is also normal.
Having a hysterectomy can shorten the length of your vagina and make it feel tighter as scar tissue is healing. This can make penetration feel more uncomfortable than usual. If you have penis-vagina sex, the Ohnut is a device that can be used on the shaft of the penis to reduce depth of penetration without negatively impacting your partner’s pleasure.
If you have a partner, talk to them about how you feel and consider other ways of being intimate together that you would both be more open to. There are plenty of ways to be sexually intimate without involving vaginal penetration for example.
If you do feel ready, here are some tips to make sex and sexual play as comfortable as possible for you, whether it’s with a partner or you’re going solo:
- Use plenty of lubricant, choosing one that is free from irritating ingredients such as glycerin, glycols and parabens. Always do a skin test first, if you’re trying a new product, and you may need to try different types to find the best one for you. Yes, Sylk and Sutil are vagina-friendly brands.
- Try different positions to prevent deep penetration, and reduce pressure in certain areas, if needed.
- If you’re aiming for penis-in-vagina sex but finding it painful, you may want to try using a slim skin-safe sex toy first.
- To help stretch the vagina, you can use silicone dilators and these will also help massage scar tissue.
- Using a vibrator promotes blood flow, which can aid healing and improve sensation in and around the vagina and clitoris. A small bullet vibrator may work well for this.
You can read more about enjoying sex and sexual pleasure in our guide our sex and pleasure guide.
Above all, take your time to get back to sex and follow your own pace. Remember it should be fun and you should never feel pressured into doing anything you’re not comfortable with.
Last updated: May 2026
