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Menopause

Surgical menopause: abrupt by nature, manageable by design.

Removing the ovaries ends hormone production overnight. Symptoms tend to be more intense and the long-term stakes higher — which is why planning should start before the operation.

Why surgical menopause is different

In natural menopause, hormone production winds down over years. When both ovaries are removed — most often during hysterectomy, or for cancer-risk reduction — estrogen, progesterone, and roughly half of the body's testosterone production end overnight. Symptoms are typically more abrupt and more intense, and because surgical menopause often happens before the natural age of menopause, the long-term stakes for bone, heart, and brain are higher.

Plan before the operation, not after

If oophorectomy is scheduled or being considered, a pre-surgical hormone consultation is one of the most useful appointments you can make. We review what to expect, whether hormone replacement will be appropriate afterward (for most women without a contraindication, it is — often until at least the natural age of menopause), which formulation and route make sense for your history, and how quickly treatment can begin after surgery. We coordinate directly with your gynecologic surgeon.

After surgery

Management follows the same sequence as all care here: listen, understand, treat. Symptom control is usually the immediate priority; bone density, cardiovascular risk, and metabolic health are built into the long-term plan from the start. Women whose surgery was related to cancer require individualized decisions made jointly with oncology — including when hormone therapy is not an option and non-hormonal strategies carry the plan.

Ready for menopause care that looks at the whole picture?

The first step is a comprehensive consultation. We see patients across San Diego and welcome referrals from other physicians.

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