--- title: Surgical menopause: definition, PMS and PMDD links description: Surgical menopause means both ovaries are removed, causing a sudden hormone drop. Here's what that means for PMS, PMDD, and treatment options. url: https://niyora.com/glossary/surgical-menopause/ --- - [Niyora](https://niyora.com/) - [Glossary](https://niyora.com/glossary/) - Surgical menopause: what it means Term # Surgical menopause: what it means Surgical menopause means both ovaries have been removed, usually in an operation called a bilateral oophorectomy, so estrogen and progesterone drop suddenly instead of gradually. If you had PMS or PMDD before surgery, that hormone sensitivity doesn't just disappear, even though the menstrual cycle does. Updated 14 October 2026 Niyora editorial ## At a glance - Surgical menopause follows removal of both ovaries (bilateral oophorectomy), with or without a hysterectomy. - The hormone drop is sudden, not the gradual decline of a natural menopause transition. - A history of PMS or PMDD can make mood changes after surgery feel more intense. - Hysterectomy alone, without removing the ovaries, does not cause surgical menopause. - Tracking mood and hot flashes daily in the months after surgery helps your doctor see the real pattern. ## What is surgical menopause? Surgical menopause happens when both ovaries are removed, usually in an operation called a bilateral oophorectomy. The ovaries stop making estrogen and progesterone right away, instead of the slow decline of a natural menopause transition. This can happen on its own or alongside a hysterectomy (removal of the uterus). Removing the uterus without removing the ovaries doesn't cause surgical menopause: the ovaries keep cycling and making hormones. What usually leads to this surgery: - Ovarian or uterine cancer - Severe endometriosis - BRCA gene mutations, as a preventive step - Large or symptomatic ovarian cysts Because the hormone drop is sudden rather than gradual, hot flashes and mood changes can start within days of surgery. [Menstrual cycle hormones, phase by phase](https://niyora.com/cycle/menstrual-cycle-hormones/) explains what estrogen and progesterone normally do across a cycle, so you can see what's suddenly missing. ## How does it relate to PMS and PMDD? If you lived with PMS or **PMDD** before surgery, the hormone-sensitive mood pattern doesn't disappear just because the cycle does. PMDD is a different reaction to normal hormone changes, not a problem with the hormone levels themselves (see [what causes PMDD](https://niyora.com/questions/what-causes-pmdd/)), so a sudden hormone withdrawal can still affect mood in someone whose brain already reacted strongly to hormone shifts. Technically, PMDD as a diagnosis needs a menstrual cycle: five symptoms tied to the week before a period, easing once it starts. Once periods stop after surgery, that cyclical pattern can't be tracked the same way. A 2021 review in Current Psychiatry Reports notes that women with a history of premenstrual mood disorders may be more sensitive to the hormone changes of a menopause transition, and that providers should stay alert for a worsening of mood symptoms during this time [1]. The review focuses on the natural perimenopausal transition; whether the same holds after sudden surgical removal of the ovaries hasn't been directly studied here. See [PMDD, explained](https://niyora.com/pmdd/) for how the diagnosis works month to month. ## What does the research say? Research on hormone transitions and mood points to a few consistent patterns. | | Natural menopause | Surgical menopause | | --- | --- | --- | | Hormone drop | Gradual, over years | Sudden, within days | | Hot flash and mood symptoms | Can build slowly | Can start almost immediately | A review in Obstetrics and Gynecology Clinics of North America lists several factors linked to more frequent hot flashes during the menopause transition [4]: - Higher body weight - Smoking - Anxiety and depression - Greater symptom sensitivity - Premenstrual syndrome - Lower education - Treatments such as hysterectomy, oophorectomy, or breast cancer therapy A broader review in Physiology & Behavior ties drops in estradiol and progesterone, whatever the cause, to changes in mood and brain activity across PMS, PMDD, and menopause transitions [2]. A 1993 trial comparing endometrial resection with hysterectomy for heavy periods found fewer premenstrual symptoms like bloating after hysterectomy, but the trial didn't look at ovary removal or sudden hormone loss, so it doesn't speak directly to surgical menopause [3]. ## Why it matters for treatment, and related terms Knowing the drop is sudden, not gradual, changes what to ask for. Before surgery, if it's planned, ask your surgeon or gynecologist about hormone therapy options. After surgery: - Track mood and hot flashes daily for the first few months, so you and your doctor can see the pattern. - If low mood or anxiety lasts most days and affects your life, ask about the same treatments used for PMDD. A doctor decides whether SSRIs or therapy are right for you. ### Related terms A few related terms worth knowing: the [corpus luteum](https://niyora.com/glossary/corpus-luteum/), the ovarian structure that won't form once the ovaries are removed; [allopregnanolone](https://niyora.com/glossary/allopregnanolone/), a mood-linked hormone byproduct that disappears along with the ovaries; and the [luteal phase](https://niyora.com/luteal-phase/), the part of the cycle that no longer happens after surgery. **Niyora is a PMS and PMDD support app**, on iPhone, with Android coming soon. If you're processing a day that feels heavy while your mood is adjusting, Moon can still help: write down what happened, see it from another angle, and draft a reply before you send it. For more on how hormones shape mood, see [PMS and PMDD research, summarised](https://niyora.com/research/). When to see a doctor If low mood lasts most days for a month after surgery, or you have thoughts of hurting yourself, tell your surgical team or a GP, and bring a daily note of how you've been feeling. ## Questions people ask What's the difference between surgical and natural menopause? + Surgical menopause happens right after both ovaries are removed, so estrogen and progesterone drop within days. Natural menopause unfolds gradually, often over several years, as the ovaries slowly make less hormone. Because surgical menopause is abrupt, hot flashes and mood changes can start almost immediately rather than building slowly. Does a hysterectomy always cause surgical menopause? + No. A hysterectomy removes the uterus, but surgical menopause only happens if both ovaries are also removed in the same operation. If the ovaries stay in place after a hysterectomy, they keep making hormones and cycling, even though periods stop because there's no uterus left to shed. Can you still have PMDD after surgical menopause? + PMDD is defined by a pattern tied to the menstrual cycle, so the diagnosis doesn't apply once periods stop after surgical menopause. But a history of PMDD can mean your mood is more sensitive to the sudden hormone drop, so talk with your doctor about what to watch for. What helps with mood swings after surgical menopause? + Mood swings after surgical menopause can respond to the same approaches used for PMDD: hormone therapy options, SSRIs, or therapy, decided with your doctor based on your history. Keeping a daily note of your mood in the months after surgery helps your doctor see the real pattern. ## Sources - 1. [Premenstrual Mood Symptoms in the Perimenopause](https://doi.org/10.1007/s11920-021-01285-1), Current psychiatry reports, 2021 - 2. [The influence of ovarian activity and menopause on mental health: Evidence from animal models and women](https://doi.org/10.1016/j.physbeh.2025.114886), Physiology & behavior, 2025 - 3. [Randomised controlled trial comparing endometrial resection with abdominal hysterectomy for the surgical treatment of menorrhagia](https://doi.org/10.1111/j.1471-0528.1993.tb15237.x), British journal of obstetrics and gynaecology, 1993 - 4. [Vasomotor Symptoms Across the Menopause Transition: Differences Among Women](https://doi.org/10.1016/j.ogc.2018.07.005), Obstetrics and gynecology clinics of North America, 2018 Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗ On this page - [What is surgical menopause?](#what-is-surgical-menopause) - [How does it relate to PMS and PMDD?](#how-does-it-relate-to-pms-and-pmdd) - [What does the research say?](#what-does-the-research-say) - [Why it matters for treatment, and related terms](#why-it-matters-for-treatment-and-related-terms) - [Questions](#faq) Niyora PMS & PMDD support For the hard moment before your period. Private, no account. [Get it on iPhone](https://apps.apple.com/app/niyora-pms-emotions/id6764561688) ## Keep reading Condition PMDD (premenstrual dysphoric disorder), explained Condition The luteal phase: what's happening in your body and mood Question What causes PMDD? Cycle guide Menstrual cycle hormones, phase by phase Guide All 26 research findings Term Corpus luteum: what it means Term What Does PMS Mean in Text and Slang? Term Allopregnanolone: what it means for PMDD