A Surgeon's Brain in Menopause

Until recently, surgeons in the operating room have been primarily men. While surgical subspecialties are still predominately male, the field of obstetrics and gynecology is now overwhelmingly female. As a woman surgeon, I can attest to the fact that the expertise of a surgeon does not depend on their sex but more on their hand-eye skills, willingness to use the assistance of others in the room, and ability to think 2–3 steps ahead. However, I have recently discovered that women have one drawback that male surgeons do not... menopause.

While menopause is defined as the absence of a period for one full year starting sometime in your early 50’s, the reality for a surgeon is much more complex. While you may not need to worry about scrubbing out to change your pad/tampon during a long case, you may need to have a nurse wipe steam off of your protective goggles after you have had a hot flash while intensely concentrating on an unexpected source of bleeding. The Bair Hugger that keeps your patient warm during surgery can make your gown feel like a steam room gone wild.

And then there is the brain-fog of menopause. It is difficult to describe if you haven’t experienced it, but interferes with word recall and ability to complete a full sentence. I find it most distressing when I know the instrument that I need during a surgical case, but need to think a few seconds to remember the name of that particular piece of metal. I need to keep a sense of humor because sometimes what I ask for is not what I wanted, and I only realize this when the OR tech hands me the asked for instrument with a smirk and then replaces it with what I really need.

While I am talking to patients in the office about the risks and benefits of a particular procedure, it is tremendously helpful that I have repeated that same conversation thousands of times and it is ingrained in my long term memory. Pre-menopause, I could be making a mental grocery list as well as planning the evening homework routine with my kids while staying attuned to my patient and the medical conversation we are having. Post-menopause, I need to stay more focused or I may stop mid-sentence if I can’t remember if I was discussing risks or benefits. Multi-tasking, both at home and at work, often makes me less productive these days as I never finish one task completely before starting something new that seems to need more urgent attention. I jokingly inform my patients that are experiencing similar problems that post-it notes were invented by a menopausal woman.  

Menopause also brings experience. I have been in the operating room more than 30 years and encountered a vast majority of complications as well as altered anatomy. I have discovered which surgical techniques are helpful and which can get you into more trouble. I am continually challenged with new instruments and techniques that require me to use other parts of my brain. Experience with all types of gynecologic surgery allows me to compare the benefits of a new laparoscopic procedure with a previously used vaginal approach.

Women in the operating room will only become more prevalent as both general surgery and surgical subspecialties see an increase in female residents. Operating while pregnant as well as menopausal requires some adjustments but will ultimately make the operating room a better place for all.

Dr. Leslee Jaeger is an Ob/Gyn and a 2018–2019 Doximity Author. She is also a mom to 3 bio and 2 adopted children, an advocate for women’s health domestically and internationally, and she loves good food and good books. She currently blogs about her family and work at jaegerleslee.wordpress.com.

Image: Cartoon Resource / shutterstock

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