Natural menopause and surgical menopause are used interchangeably when conditions of patients are discussed. But they are different entirely. One is a natural stage of life that all women experience, the other is the result of surgery. This prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Z.H. Sikder Women’s Medical College & Hospital, Dhaka from January 2016 to December 2018 over a period of three years to compare the GSM effects in natural and surgical menopause cases. During the study period a total of 275 patients with surgical menopause and 275 patients with natural menopause were enrolled employing purposive sampling method using a predesigned data collection sheet. Age of the most of the patients in surgical menopause group was within 41 to 50 years and most of the patients were >50 years old in natural menopause group. Most of the patients were illiterate in both groups and maximum patients were poor in both groups. Hot flush (48.0% vs 28.0%), dryness of vagina (12.0% vs 0.0%) and dyspareunia (72.0% vs 28.0%) were found significantly higher in surgical menopause than natural menopause. Dysuria (92.0% vs 40.0%) and increased frequency of urination (68.0% vs 36.0%) were significantly higher in surgical menopause than natural menopause group. Urgency, hesitancy and incontinence of urination were significantly lower (p=<0.001) in surgical menopause than natural menopause group. In most of the surgical menopause cases, ovaries were also sacrificed. And this may be the reason of more deleterious effects in surgical menopause than natural menopause. So, it is highly recommended to preserve ovaries in hysterectomies due to benign indications.