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Removing both ovaries causes immediate menopause at any age. Learn what symptoms to expect, how hormone therapy works after surgery and questions to ask first.
Surgical menopause happens when both ovaries are removed before natural menopause. Estrogen, progesterone and much of your testosterone drop suddenly, so symptoms can begin within days and may be more intense than a natural transition. A hysterectomy that keeps the ovaries does not cause surgical menopause, although menopause may come earlier. Hormone therapy is often recommended afterward.
The NHS explains that if both ovaries are removed during a total or radical hysterectomy, you experience menopause immediately after the operation, regardless of your age. This is known as surgical menopause, sometimes called induced menopause.
It can happen with or without removal of the womb:
If you have already been through natural menopause, removing the ovaries does not cause a sudden change in symptoms. However, the NHS notes that the ovaries continue producing testosterone for up to 20 years after menopause, and small amounts of estrogen.
Not by itself. If your ovaries are kept, they continue making hormones and you go through menopause naturally later. You won’t have periods, though, so it can be harder to tell when it happens. See how to know when menopause has started.
The NHS notes there is a chance of reaching menopause sooner than you otherwise would, even with one or both ovaries kept. This may be because surgery affects the blood supply to the ovaries.
Common reasons include:
Sometimes surgeons recommend removing healthy ovaries during a hysterectomy after menopause, to protect against ovarian cancer. The NHS notes that some surgeons prefer to leave healthy ovaries in place when cancer risk is low, because they help protect against problems such as osteoporosis and play a part in sexual desire. If you would prefer to keep your ovaries, make this clear to your surgeon before the operation.
Because hormones drop suddenly rather than gradually, symptoms can start within days and may feel more intense than natural menopause. Common symptoms include:
These come on top of normal recovery from surgery, which can make the first weeks especially tiring. Emotional reactions are common too, particularly if surgery was for cancer or ended plans for pregnancy.
When ovaries are removed before natural menopause, you spend more years without ovarian hormones. Research links this with:
The 2024 international guideline on premature ovarian insufficiency recommends that these risks be discussed when planning removal of both ovaries under 45, especially for people at average risk of ovarian cancer. Research on hysterectomy in Sweden notes that ovaries should only be removed before menopause if strictly necessary, followed by estrogen until the age of natural menopause.
For many people, hormone therapy relieves symptoms and helps protect long-term health.
For people with BRCA1 or BRCA2 variants who have not had breast cancer, the 2024 international POI guideline states that hormone therapy is an option after risk-reducing removal of the ovaries and tubes. The Menopause Society notes that short-term hormone therapy appears safe in this group when surgery happens before the average age of menopause.
Hormone therapy is generally not recommended after breast cancer. Non-hormonal options are available, and a newer medicine, elinzanetant, has been studied in women with a history of breast cancer. Your oncology team can advise on what is suitable.
Loss of ovarian testosterone can affect sex drive. The 2024 guideline recommends that testosterone be considered for low sexual desire in women whose POI was caused by medical treatment, including removal of the ovaries before 40, once other causes have been addressed. Testosterone for women is not licensed in every country, so availability varies.
Vaginal estrogen treats dryness and urinary symptoms and can be used alongside other treatment. Non-hormonal medicines and cognitive behavioral therapy (CBT) can help hot flashes and sleep. See what menopause is for an overview of treatments.
If surgery is planned, a conversation beforehand can make a big difference:
The NHS notes you may be asked to consent in advance to removal of your ovaries if an abnormality is found during surgery. Think about this carefully and discuss any concerns with your surgeon.
Seek urgent medical help after surgery if you have:
- Heavy bleeding, fever, severe or worsening pain, or wound problems
- Leg swelling or pain, chest pain or sudden breathlessness, which can signal a blood clot
If low mood includes thoughts of harming yourself, contact emergency services or a crisis line in your country straight away.
For questions to ask at later appointments, see your first menopause appointment.
Only if both ovaries are removed. If they are kept, you’ll go through menopause naturally later, although possibly a little earlier than otherwise.
Often within days of surgery, because hormone levels drop suddenly.
Usually not, because a progestogen is mainly needed to protect the womb lining. One exception is a history of endometriosis, where combined therapy may still be recommended.
Symptoms are often more sudden and may be more intense, but experiences vary. Treatment can be planned in advance to help.
For people with BRCA variants who have not had breast cancer, international guidance describes hormone therapy as an option after risk-reducing surgery. Discuss your own situation with your specialist team.
Editorial status: evidence-based educational article; not individually medically reviewed. Last evidence check: September 10, 2026.
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