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For some women, menopause occurs as a result of the surgical removal of the uterus and both ovaries, a procedure known as a hysterectomy with bilateral oophorectomy. Surgical menopause can happen at any age between puberty and when menopause would naturally occur. It's different from natural menopause because it occurs suddenly rather than gradually; there is no perimenopause or transition time. The sudden drop in ovarian hormones as a result of surgical menopause can usually produce more intense hormone-withdrawal symptoms such as hot flashes.
If you have what is known as a "simple hysterectomy" (removal of your uterus but not your ovaries) you will not go through surgical menopause. It is only when both of your ovaries are removed along with your uterus that surgical menopause occurs. If only one ovary is removed, a procedure known as an oophorectomy, you may still be able to produce enough estrogen and surgical menopause may not occur. In this case, it is unlikely that you will experience menopausal symptoms following surgery because you will not be menopausal.
A hysterectomy is generally performed for health reasons—for example, to treat fibroids or endometriosis.
Sometimes, when these conditions are very severe, a hysterectomy with bilateral oophorectomy is necessary. This surgery, in which the uterus and both ovaries are removed, is also sometimes necessary to treat cancer or serious recurrent infections.
Since 1997, approximately 600,000 women per year in the United States have had a hysterectomy (removal of the uterus). In fact, after cesarean section, hysterectomy is the second-most frequently performed major surgical procedure for women of reproductive age in the United States. About 55% of women who have hysterectomies also have a bilateral oophorectomy, which means they experience surgical menopause.
Surgical menopause is different from natural menopause in that it occurs suddenly rather than gradually. There is no perimenopause or transition time. The sudden drop in ovarian hormones as a result of surgical menopause can produce hormone-withdrawal symptoms such as hot flashes and a decrease in sexual desire.
One of the most common menopausal symptoms you may experience is hot flashes. It is estimated that up to 90% of women who have surgical menopause experience hot flashes. Typically, hot flash symptoms begin shortly after surgery and tend to be more intense than with natural menopause. They also tend to last longer than those in women reaching menopause naturally.
Most hot flashes subside within a few minutes, although they can last longer. They may occur every hour, day or night, or only occasionally. Hot flashes that happen when you are asleep are called night sweats. When you have night sweats, you may awaken from a sound sleep to find that you are perspired and feeling chilled.
Vaginal dryness is another common symptom of menopause. The tissues of the vagina become thin and dry when you produce less estrogen. There is also a decrease in vaginal fluid and lubrication. These changes may cause burning and itching. Sexual intercourse may become uncomfortable or even painful. If you experience these symptoms, be sure to discuss them with your doctor or other healthcare professional.
Your doctor may choose to prescribe ENJUVIA, a plant-derived oral estrogen therapy, to treat moderate-to-severe hot flashes, night sweats, vaginal dryness, and/or pain with sex associated with menopause. If ENJUVIA is appropriate for you, you may want to fill your prescription before your surgery so that you have the medication available as soon as you need it. To learn more about ENJUVIA, click here.
Important information you should know when taking estrogens like ENJUVIA™:
ENJUVIA is a medicine that contains estrogen hormones. It is prescribed for relief of moderate-to-severe hot flashes and night sweats, and moderate-to-severe vaginal dryness and pain with intercourse, symptoms associated with menopause.
Estrogens increase the risk for cancer of the uterus (womb). If you experience persistent or recurring vaginal bleeding while taking estrogens let your doctor know right away, as this could be a warning sign for cancer. Your doctor should check for the cause of any unusual vaginal bleeding after menopause. Estrogens (alone, or in combination with progestins) should not be used to prevent heart disease, heart attacks, strokes, or dementia.
Estrogens (alone or in combination with progestins) may increase the risk of heart attack, stroke, blood clots, and breast cancer. Estrogens (alone or in combination with progestins) may increase your risk of dementia, based on a study of women age 65 or older. Because of these risks, estrogens should be used at the lowest dose for the shortest period of time. You and your doctor should talk regularly to determine whether you still need treatment with ENJUVIA.
Who should not use ENJUVIA?
Do not use ENJUVIA if you:
What are the common side effects with ENJUVIA?
You may experience headache, breast pain, irregular vaginal bleeding or spotting, stomach/abdominal cramps and bloating, nausea and vomiting, or hair loss.
Please see Patient Information section of the prescribing information.
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ENJUVIA™ is a trademark, and Duramed® is a registered trademark, of Duramed Pharmaceuticals, Inc.
