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Bilateral salpingo-oophorectomy is total removal of the ovaries and the fallopian tubes. This surgery may be necessary if there is significant impairment in these structures, if cancer is present in the ovaries, or if it is part of an elective procedure to prevent cancer. Recovery from this procedure is split into physical and emotional elements, which are not entirely separate. Physical recovery from the wounds of surgery is easiest, but ongoing physical challenges remain because a bilateral salpingo-oophorectomy induces surgical menopause by removing the organs that most produce female hormones. This frequently creates sexual dysfunction, premature deterioration of bone, and a variety of psychological issues like depression.
The initial physical recovery from a bilateral salpingo-oophorectomy tends to be relatively smooth. The surgery may be performed open or laparoscopically, and it may accompany hysterectomy or be done alone. Laparoscopic procedures without a hysterectomy may offer the shortest recovery time because they are less invasive. Initial recovery time in a hospital might be anywhere from a day to several days, and most women are able to resume regular activities within a few weeks.
At the same time the body recovers from surgery, changes occur dramatically. If a woman having a bilateral salpingo-oophorectomy is pre-menopausal, she immediately begins menopause, and this is not a gradual process. For most women, reducing symptoms may depend on using hormone replacement therapy (HRT). Paradoxically, HRT can create more problems if certain reproductive cancers were already present, and it may not be used.
With a sudden onset of menopause, often much earlier than would normally occur, comes a variety of physical and emotional symptoms. Hot flashes, depression, anxiety, and changes in skin and hair, bone density, sexual desire or ability to achieve orgasm may be part of this. Depression can be complicated by a sense of loss or sadness about inability to conceive or physical symptoms associated with surgical menopause. In part, HRT may be effective, but it doesn’t necessarily reduce all symptoms.
For this reason, many doctors advise pre-menopausal women who undergo bilateral salpingo-oophorectomy to seek out psychotherapy after surgery. There may be some benefit to using medications like antidepressants, too, but many of these have sexual side effects that can worsen existing problems. Having a supportive counselor during this time of transition is considered highly advisable to cope with emotional and physical changes.
Some women also find assistance in support groups, since they may meet others like themselves who are experiencing similar sensations and side effects. Small communities may not have that many women who have recently undergone bilateral salpingo-oophorectomy at the same time to make a support group viable, but there are online communities, too. Another option is to read self-help books or websites on this topic, but ultimately, direct interaction with a counselor or therapist is often most beneficial.