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 Women typically go through menopause between ages 45 and 55. As the
ovaries curb production of the hormones estrogen and progesterone,
women can experience symptoms ranging from vaginal dryness to mood
swings, joint pain and insomnia.
Women who have their ovaries surgically removed, however, are thrust
into menopause virtually overnight. This kind of procedure may be
done to treat cancer or reduce the risk of tumors for women with a
genetic risk for breast and ovarian malignancies. Surgery may also
be done to remove cysts or treat endometriosis, or painful scarring
in the reproductive tract.
In the current study, women who underwent surgical menopause were
more than twice as likely to experience insomnia and reported lower
quality sleep compared with women who went through natural
menopause.
"Menopause is a difficult transition for many women, both
psychologically and physically, and is often not well-discussed in
psychiatric or medical settings," said senior study author Sooyeon
Suh of Sungshin Women's University in Seoul.
"Many women bear the burden of going through this phase feeling
isolated and frustrated, without much information or education," Suh
said by email. "The results of this study show that women who have
surgery and experience menopause may be especially more vulnerable
to sleep difficulties compared to women who transition naturally."
The study included 429 women who went through menopause naturally
and another 97 women who had menopause induced by surgery. All were
from Korea and were in their 50s and 60s. On average, those who had
surgery were about 7 years younger when they entered menopause than
the women who had natural menopause.
About 8 percent of women with surgical menopause and 4 percent of
women with natural menopause used hormone therapy to ease symptoms.
With surgical menopause, women reported more difficulty with falling
asleep and staying asleep, and more nighttime awakenings,
researchers report in Menopause.
Women who had surgery were also more likely to have habits that can
contribute to sleep troubles, such as drinking coffee, eating large
meals at night or napping during the day.
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The study can't prove whether or how surgical menopause has a
different impact on sleep than natural menopause.
Even so, it makes sense that a sudden loss of all hormone production
with surgical removal of the ovaries would produce more pronounced
symptoms than natural menopause, when the ovaries slow down but
don't entirely stop hormone production, said Susan Davis, president
of the International Menopause Society and chair of women's health
at Monash University Melbourne in Australia.
"Disturbed sleep is a common, possibly the most common, menopausal
symptom as it is experienced by women who do not have flushes or
sweats," Davis, who wasn't involved in the study, said by email.
One thing that may help women get more rest after menopause is to
focus on sleep hygiene: habits designed to make it easier to fall
asleep and remain asleep, Davis said. That can include reducing
caffeine, eating right, exercising regularly and having a consistent
bedtime routine.
While hormones may not be safe for women who have their ovaries
removed because of cancer, most women who have ovaries removed to
lower their risk of cancer or to treat other conditions can take
hormones, said Dr. Mary Jane Minkin, a professor of obstetrics,
gynecology and reproductive sciences at Yale Medical School in New
Haven, Connecticut, who wasn't involved in the study.
"I am certain that the vast majority of women who had surgical
menopause did not have it for cancer, but I'll bet the majority of
women just had their ovaries out as part of a hysterectomy for
fibroids or some other benign disease," Minkin said by email.
"Because they had their ovaries out for benign disease, there is no
reason that they couldn't have received hormone therapy," Minkin
added.
SOURCE: https://bit.ly/2TcBAUY Menopause, online November 12, 2018.
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