Surgical menopause is one of the topics I am most asked about. Surgical menopause occurs when both ovaries are removed (bilateral salpingo-oophorectomy, otherwise known as a BSO). It is fundamentally different from natural menopause in a number of ways, including:
- It is an abrupt cessation of ovarian estrogen, progesterone, and testosterone production, rather than the gradual hormonal decline like in natural menopause
-The clinical consequences are more pronounced and affect multiple organ systems, with the magnitude of risk strongly dependent on the age at surgery relative to the expected age of natural menopause.
-Risk including cardiovascular disease, osteoporosis, cognitive decline, mental health concerns, and genitourinary and sexual dysfunction are all more pronounced after surgical menopause.
-Surgical menopause eliminates not just estrogen but also approximately 50% of testosterone production.
-Hormone therapy up until at least the age of natural menopause is the standard of car…
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