Reasons for Surgical and Forced Menopause

Forced menopause or surgical menopause can happen as the result of cancer treatment. It is different from the natural process of menopause, in which the menstrual cycle and the ability to conceive a child slowly ends. Natural menopause can take years to complete from peri-menopause to post-menopause. However, for some women undergoing cancer treatment, menopause occurs in a single day or several weeks because of surgery, chemotherapy, or pelvic radiation therapy. This is called surgical or forced menopause and can be either a permanent or temporary side effect of treatment.

Why Forced Menopause Occurs

The ovaries serve as a major hormone production center for estrogen and progesterone, two essential hormones that support the menstrual cycle and fertility. Cancer treatment can impair the function of the ovaries. Without the hormones produced in the ovaries, the menstrual cycle cannot continue as normal. It may slow or shut down. This can be temporary with some treatments but is permanent with others.

Surgical Menopause

Women undergoing a total hysterectomy or bilateral oophorectomy to treat gynecological cancer undergo immediate surgical menopause. The ovaries are removed and there is an immediate decrease in the hormone levels in the body. When both ovaries are removed, this is a permanent effect.

Chemotherapy and Forced Menopause

Chemotherapy can damage the ovaries, leading to a permanent or temporary menopause. This is called forced menopause and it can cause a woman's period to stop for several months, even after treatment has ended. Some women are surprised to find their period has returned months after treatment. This is why it is important to use a birth control method until you know for certain that you are post-menopausal.

Sometimes inducing menopause may be part of the cancer treatment (in hormone receptor positive breast cancer for example.) Induced menopause is intentional versus forced menopause which is a side effect of cancer treatment.

Radiation Therapy and Forced Menopause

Radiation therapy to the pelvis is also a source of forced menopause. The effects can be permanent or temporary, based on the treatment regimen. Like chemotherapy, radiation therapy causes damage to the ovaries, limiting their function.

Physical Changes That Occur

Diminished hormone levels in the body can cause many physical and emotional changes. Women who undergo sudden menopause because of cancer treatment (especially surgical menopause) sometimes experience these effects more intensely than women who undergo menopause naturally.

Effects of Menopause

• Hot flashes
• Night sweats
• Mood swings
• Depression
• Vaginal dryness
• Low libido

Help for the Effects of Menopause

Hot flashes and night sweats can be the most common effect and the most bothersome. Some women may be given hormone replacement therapy (HRT) to relieve these symptoms, but HRT is not for all women. You should discuss the risks and benefits of taking hormone replacement therapy with your healthcare provider.

Before taking any over-the-counter (OTC) menopause remedies or herbs, talk to your healthcare provider. Some OTC products may interfere with your cancer treatment.