Women tend to have worse sexual and urinary symptoms if they enter menopause because of surgery as opposed to naturally, a new study says.
Women with surgical menopause needed to pee more often, had painful urination, and suffered sexual symptoms like dryness and reduced desire at a higher rate than women in natural menopause, researchers reported recently in the journal Menopause.
“Our findings emphasize that genitourinary syndrome of menopause (GSM) extends beyond vaginal dryness and constitutes a multidimensional syndrome involving urinary symptoms and sexual function,” concluded the research team led by Dr. Samican Ozmen of Torbali State Hospital in Turkey.
For the study, researchers compared 218 women with surgical menopause against 204 women in natural menopause.
Surgical menopause occurs when both ovaries are removed, causing an immediate and severe drop in hormone levels, researchers said in background notes.
GSM is a clinical condition caused by declining levels of estrogen, which prompts changes in women’s urinary tracts and genitals. Between 27 percent and 84 percent of women in menopause experience GSM, researchers said.
Results showed that women with surgical menopause had higher total GSM symptom scores.
“These women may benefit from earlier and more proactive initiation of GSM-targeted therapies,” researchers wrote.
These treatments include hormone therapy and vaginal lubricants or moisturizers, according to Brigham and Women’s Hospital in Boston. Women also are encouraged to avoid personal hygiene products that might irritate their genitals.
“This study showed that GSM symptoms and exam findings were worse in women who experienced menopause due to removal of both ovaries compared to those who underwent menopause naturally,” Dr. Stephanie Faubion, medical director for The Menopause Society, said in a news release.
“Given the prevalence of GSM in menopausal women, and the fact that it is undertreated, clinicians caring for midlife women should be more proactive in assessing for and managing GSM in general,” continued Faubion, who was not involved in the study. “In women with surgical menopause, this may be even more critical and should prompt early evaluation and treatment of symptoms.”
Black women are 2.4 times more likely to undergo hysterectomy at younger ages than white women, often because of uterine fibroids. Additionally, Black women frequently report greater symptom burden during the menopausal transition but are less likely to receive comprehensive menopause counseling or hormone replacement therapy.
Earlier surgical menopause can mean longer exposure to estrogen deficiency and its downstream effects. Symptoms affecting sexual health and urinary function may go underreported because of stigma, limited access to menopause specialists, or competing health priorities.
For patients considering hysterectomy with bilateral oophorectomy, preoperative counseling should extend beyond the immediate surgical risks to include the long-term effects of surgical menopause. Clinicians should discuss the possible impact on sexual function, vaginal health, urinary symptoms, and overall quality of life, while also reviewing strategies to manage these changes.
For eligible patients without contraindications, hormone replacement therapy may help reduce menopausal symptoms and should be included as part of shared decision-making. Early education can help patients make informed treatment choices and better prepare for life post-surgery.
As previously mentioned, Black women are more likely to undergo hysterectomy — typically at younger ages due to uterine fibroids — yet disparities in menopause care can leave many without adequate symptom management or follow-up. Sexual dysfunction, vaginal discomfort, and urinary symptoms may be underreported or overlooked during routine visits, particularly when patients face barriers to specialty menopausal care.
Implementing proactive screening for GSM, asking about sexual health, and providing culturally responsive counseling can help clinicians identify symptoms earlier and connect patients with evidence-based treatments that improve quality of life.
Here are some key takeaways for clinicians treating Black women with menopause:
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