When a women decides to have surgery to remove her ovaries, it brings on early menopause. Angelina Jolie's recent decision to remove her ovaries and eliminate her risk of ovarian cancer has everyone talking about the effects of early menopause. Here's what you need to know. 

Early Menopause Health Risks

• Removal of the ovaries reduces risk of ovarian cancer by 85 to 90%
  • Will also start menopause immediately
• o Angelina Jolie is only 39 - around a decade before the average woman enters menopause naturally
• The average age for menopause in the United States is 51
• Other reasons women might enter menopause early:
  • Their bodies may spontaneously stop ovulating
  • They undergo cancer chemotherapy treatment that disrupts their reproductive organs
• Early menopause is before age 40
  • Regardless of the cause, early menopause is linked with serious medical conditions:
  • Increased risk of heart disease
  • Neurological problems
  • Osteoporosis
  • Depression and anxiety

Estrogen Therapy Post-Menopause

Taking estrogen after removal of the ovaries, which Angelina Jolie is doing, can reduce some, but not all, of these risks. Ovaries produce estrogen, which is critical for bone health, and so low estrogen levels can lead to the development of osteoporosis. If nothing is done to prevent bone loss — either through medications or lifestyle changes — then women will experience bone loss after early menopause

Researchers are still trying to understand why early menopause is linked with an increased risk of heart disease. One theory is that estrogen helps prevent plaques from forming in blood vessels - so a loss of estrogen could increase plaque buildup in the arteries, leading to the hardening of these vessels.

• Risk of heart disease doubles for women who have their ovaries removed at a young age
• Women in menopause can also experience symptoms that affect their quality of life:
  • Hot flashes
  • Mood changes
  • Vaginal dryness
  • Memory loss

For women who've had their ovaries removed surgically, the transition into menopause, and the potential side effects, are more abrupt compared to the transition of women who go through menopause naturally. Women often use hormone therapy to treat early menopause. The decision to use hormone treatments for women in early menopause is made on a case-by-case basis. Doctors will take into account:

• Age
• Menopausal symptoms
• Personal history (prior breast cancer)
  • Hormone replacement therapy has been linked with an increased risk of breast cancer
• Estrogen can stimulate the growth of breast cells
• A woman with a history of breast cancer would not be recommended to take hormone replacement therapy

Ovarian Cancer: What Women Need To Know

Regardless of risk, for women who face a high risk of developing ovarian cancer, the benefits of the surgery to remove the ovaries often outweigh the risks of early menopause.

• Jolie Pitt’s risk of ovarian cancer, which killed her mother, was 50%
• Removing ovaries electively doesn't mean that women will experience more severe symptoms of menopause
• It is often unpredictable how a woman's body is going to respond when the ovaries are removed
• Women who are considering this surgery should ask their doctors to review the possible side effects of early menopause with them beforehand, so they know what to look for after surgery
• Women who've had a mastectomy to prevent breast cancer still have a small risk of developing breast cancer, because some breast tissue remains even after the surgery
• Women who take hormone replacement therapy should be followed closely