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Op-Ed: What It's Like to Go Through a Chemical Menopause

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Rachel Charlton-Dailey is a journalist specializing in chronic conditions and disability. Her work is featured in publications such as Healthline, Huffpost, Metro UK, The Guardian, and Business Insider. Charlton-Dailey often uses her platform to spotlight issues that affect disabled people, as well as reproductive health issues. Here, she shares her first-hand experience with medically-induced menopause.

After suffering from heavy periods for a decade, I was sick of going back and forth to gynecologist offices and never finding a solution. I’d been patronized and treated like I was making it up for nearly a third of my life, and just wanted to get rid of what was causing the pain. I decided I was ready for a hysterectomy—but I was only 28. My doctors decided my best bet was something called chemical menopause, also referred to as medically induced menopause.

Chemical menopause is a temporary (and reversible) treatment that involves a class of medications called gonadotropin-releasing hormone (GnRH) agonists—drugs which act to suppress ovulation and production of the hormones estrogen and progesterone. They may be used to treat conditions like:

As a result of hormonal suppression, GnRH agonists cause your body to experience the symptoms of menopause. This phenomenon is also referred to as medically-induced menopause.

GnRH agonists are used when you haven't been able to find relief from less invasive treatment, such as birth control. GnRH agonists can also be used to see if you would benefit from having your ovaries "turned off," or eventually, removed. Surgical removal would involve a hysterectomy (uterus removal) with a bilateral oophorectomy (ovary removal).

Because my doctor thought I was too young for a hysterectomy, they agreed to put me on monthly Zoladex (goserelin) injections to see if my body would benefit from having my ovaries shut off. While the recommended duration of this treatment regimen is six months, my doctor would only allow me to stay on it for four months. This is because I have lupus and had previously experienced a transient ischemic attack (TIA), placing me at a higher risk of developing blood clots from the medication.

Initial Reaction & Bodily Changes

I remember a near immediate reaction after my first Zoladex injection four years ago. I began to feel fatigued while traveling home on the bus, and was hit with a wave of nausea and sickness. Over the next few days, the nausea settled, but in its place came symptoms of menopause. I experienced incredible mood swings that would flip at the drop of a hat. 

The biggest thing I noticed was my cravings. I would have classed myself as someone who liked cheese a normal amount, but cheese became a full-blown obsession. I could not get enough of cheese. I put on 6 pounds in the first month of my treatment regimen, and I’m still convinced it was all from cheese!


As the menopause kicked in, I noticed my body changing. My breasts shrank, but they were tender. My hips widened. My voice deepened. My doctor told me it was all from a lack of estrogen. It was a shock to me and didn't help my already struggling body image. 

As the end of the month neared and my next injection was approaching, I was saddened to find that my pelvic pain came back and I was battling with my hormones again. This time, though, it seemed like I was going through my period and menopause at the same time. I had cramps, mood swings, and hot flashes simultaneously. The heightened sex drive I experienced during a period arrived, but at the same time, I was experiencing vaginal dryness from menopause. It was a super confusing time.

"As the menopause kicked in, I noticed my body changing. My breasts shrank, but they were tender. My hips widened. My voice deepened. My doctor told me it was all from a lack of estrogen. It was a shock to me and didn't help my already struggling body image."

Taking the Good With the Bad

Every time I got a new Zoladex injection, it took a few days for my system to settle. During those days, I'd have to adjust my routine. I rushed off buses to be sick; I made sure I dressed in layers that could be easily taken off in case a hot flash struck; I was never too far from home in case my energy ran out.

It was also a ridiculous time to start a relationship with my now-husband. But it happened!

This same pattern continued for the duration of my time on Zoladex. But overall, it helped my pain. 

After four months, I was cut off—and the withdrawal was tough. My body was flooded with hormones. As a result, I spent days crying in bed. I had the heaviest period I’d ever experienced,  which left me screaming in pain on the bathroom floor. 

Ultimately, this meant my body was better off without a period. Satisfied with how my body had reacted to Zoladex, my gynecologist allowed me to get a hysterectomy. By April 2016, I was finally rid of my uterus. But the doctor was hesitant to also remove my ovaries because of my young age.

Uterus Gone, Pain Remains

Although the pain eased for a short while, it soon came back. I attributed this to the fact that I was still ovulating since the doctor hand't removed my ovaries. I hadn't realized ovulation was possible without your uterus, which just shows how little we’re taught about our bodies. 

My doctor prescribed the Depo-Provera birth control shot, which had worked for me in the past. But I had a bad reaction to this time. I experienced constant cramps and couldn’t sleep, I also felt increasingly depressed. After a discussion with my gynecologist, we agreed to try Zoladex again.

My second round of Zoladex lasted four years instead of four months. While chemical menopause is supposed to be a short-term solution—no longer than two years—my gynecologists thought it was the best way to keep my pain at bay while they couldn't offer me further help during the pandemic. What this meant, thought, was that my body became heavily reliant on it. Side effects at the end of each month, right before I'd be due for a new dose, became severe. Once, when the pandemic delayed one of my injections by a week, crippling cramps kept me in bed for days.

Thankfully, partway through this Zoladex regimen, my doctors prescribed a synthetic steroid called tibolone in tandem, which is not available in the United States. It's an alternative to hormone replacement therapy, and helped balance out my hormones, reduce headaches, and ease nausea.

Still, I didn't not have complete relief. In September 2020, I was finally granted an oophorectomy during a telephone appointment. I took the call in a local supermarket, and remember being so overcome with emotion that I had to sit down on a low shelf to cry. To anyone passing by, it probably looked like I was crying about the toilet paper shortage at the time.

By February 2021, I had my ovaries removed. During the procedure, my gynecologist found lumps of endometriosis—a diagnosis I had never received before, and a diagnosis which explains that pain.

Now that I no longer have my ovaries, I’m going through actual menopause, as opposed to chemical menopause. It’s not so different from what I’ve already been through; it's just a lot more intense.

In a strange way, I’m thankful to the chemical menopause for preparing me for menopause. My body is more resilient than I ever thought it could be.

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2 Sources
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  1. Zoladex 3.6 mg prescribing information. Reviewed December 2020.

  2. Ângelo ML, de Lima Moreira F, Araújo Santos AL, Nunes Salgado HR, de Araújo MB. A review of analytical methods for the determination of tibolone: pharmacokinetics and pharmaceutical formulations analysis and application in doping control. CPA. 2020;17(1):31-39. doi. 10.2174/1573412916666191025143214. Published October, 2019.