Hormone replacement therapy (HRT) is usually the first line treatment for women in surgical menopause. However for some, it either isn't a choice they have or they choose not to take it.
(For more information on the benefits, risks and different types of HRT, please read our HRT info sheet.)

Whether you take HRT or not it is especially important to discuss and engage in evidence-based, healthy lifestyle choices. Having a holistic outlook will help to maintain bone health, cardiovascular health, mental health and improve your overall well-being.

Things to consider include:

Diet
It is extremely important to re-evaluate your diet after a hysterectomy. Making healthy choices and nourishing your body with healthy foods can make a big difference to your overall well-being.

Small changes that can make a big difference include:
- cutting out processed foods
- reducing your intake of sugar, caffeine and alcohol
- not skipping meals
- eating smaller but more regular meals with protein.

Read our interview with Catherine O’Keeffe who talks in more detail about diet and nutrition. It provides a lot of helpful and practical information to get you started down the right path.

Exercise
For the initial weeks and months following your surgery, it is important not to overdo physical exercise and to avoid heavy lifting. Long term, it is so important to incorporate exercise into your daily life. It will help with both your bone and cardiovascular health and it will also improve your mental health - which is of particular importance for women in surgical menopause.
Whether it’s walking, running, dancing, team sports, pilates, or whatever it may be - what counts is to find something you enjoy and to build some good habits into your daily life.

Bone health
Women who have had an oophorectomy (ovaries removed) are more at risk of osteoporosis. It is important to consider an all-round approach when it comes to looking after your bone health. With this in mind, we recommend you think seriously about:
Hormone Replacement Therapy (speak to a menopause specialist to explore your options with regards to HRT)
Maintaining a healthy body weight
Eating a healthy balanced diet
Consider a good quality Vitamin D supplement especially in the darker months (October – April). Vitamin D helps your body to absorb calcium.
Reduce your alcohol, salt and fizzy drink intake
Lead an active lifestyle – including weight-bearing exercise

Smoking
We all know that cigarette smoking increases the risk of cardiovascular and lung disease, but did you know that it can affect the intensity of the symptoms of menopause? Smoking has an impact on your nervous system which can worsen symptoms such as anxiety, hot flushes and mood swings.
The menopause affects skin too, so if you're smoking it can really have a detrimental effect on the quality and the look of your skin.

Vaginal health
We would encourage you to discuss with your doctor any issues that you are having with vaginal dryness symptoms. These symptoms could be: soreness, itchiness, dryness, bleeding, painful sex, multiple night time toilet trips, stress urinary incontinence, UTIs and any other vaginal, bladder and pelvic floor symptoms. It is important that you do not self- diagnose.
There are various treatments for vaginal dryness to help alleviate and manage symptoms. Taking local oestrogen and also using the right kind of moisturisers and lubricants can help. Read our interview with Jane Lewis, the author of Me and My Menopausal Vagina, for lots of helpful information relating to vaginal dryness (otherwise known as Genitourinary Syndrome of Menopause).

Consider psychological support
In simple biological terms, we have oestrogen receptors all over the body and in the brain, so immediate symptoms are going to present themselves following removal of the ovaries. This can be very overwhelming and frightening.
These symptoms can be further compounded by the fact that for many women in surgical menopause their peers are simply not going through this and as such know very little about it.
Having a hysterectomy and oophorectomy can feel so final - there’s no going back and that can bring a sense of loss. We strongly believe that all women should be offered counselling both before and after entering surgical menopause. Read our interview with menopause counsellor and campaigner Diane Danzebrink.

Mental health & self-care
We cannot stress enough how important it is to be mindful of your own mental well-being in surgical menopause. You may find your threshold for coping with everyday annoyances and stressful situations is not as good as it was pre-surgery. You might experience symptoms such as anxiety, irritability and low moods. This is largely due to the sudden drop in hormones, particularly oestrogen.
We feel it is really important that you take time out for you and don’t feel guilty about it. Whether it’s a walk, a relaxing bath, seeing a friend, whatever it is – we encourage you to do it. Practising self-care is so important - do things that make you feel happy! It is so easy to put everyone else first and neglect yourself, especially in a family household with so much going on.
Exercise, eating well, counselling, finding peer support and good sleep hygiene are all things that can help your mental and emotional well-being. Remember to be kind to yourself.

Peer support
Peer support can help you feel more knowledgeable, confident and happy as well as less isolated and alone. It involves sharing knowledge and experience with each other.
Both of us have found it so comforting and useful interacting with other women on Instagram and sharing experiences and helping each other through the tough days.
We’ve gained so much knowledge and it is so comforting to know you’re not alone. You can find us on Instagram @together_in_surgical_menopause as well as so many other great women’s health accounts.