Which of the following are potential risks of surgical menopause?

• A. Early osteoporosis
• B. Cardiovascular disease
• C. Cognitive decline
• D. All of the above

Answer: (D)

Surgical menopause causes an abrupt drop in estrogen because the ovaries are removed, removing a key source of hormonal protection. That sudden estrogen deficiency accelerates several health risks that estrogen helps to manage. First, without estrogen, bone remodeling shifts toward resorption, so bone density declines quickly and osteoporosis risk increases, leading to a higher chance of fragility fractures. Second, estrogen contributes to maintaining favorable lipid profiles and healthy blood vessels; its abrupt loss after oophorectomy raises the risk of cardiovascular disease compared with the gradual change seen in natural menopause. Third, estrogen has neuroprotective effects, and its sudden withdrawal can be associated with cognitive changes and potentially greater risk of cognitive decline in some women. Because all of these potential risks can follow surgical menopause, the option reflecting all of the above best captures the spectrum of concerns.