What Is Medical Menopause?

Medical or induced menopause is when a woman stops producing eggs and her menstrual cycle ceases prematurely due to certain medical treatments, such as chemotherapy and surgery. Unlike with natural menopause, which can take years, this process either occurs over a short period of transition time or abruptly, depending on the cause. Likewise, the cause of medical menopause determines if it is temporary or permanent.

Causes of Medical Menopause

Several procedures and treatments can induce medical menopause. If you're considering any of them, you should discuss this with your doctor ahead of time.

Surgery

Surgical menopause occurs when a woman's ovaries are surgically removed (oophorectomy) or she has a total hysterectomy (removal of uterus and ovaries). These procedures may be done for different reasons, such as:

Without ovaries or a uterus, a woman is not fertile and no longer produces estrogen. Surgical menopause is immediate and permanent, and is often more symptomatic than natural menopause due to the suddenness of the change.

Radiation

Radiation to the pelvic area, which may be prescribed to treat cancers occurring in that area (such as ovarian, colorectal, or uterine cancers), can damage your ovaries.

This damage can cause a sudden drop in hormone levels, resulting in temporary or permanent menopause. Your odds of recovering your fertility may decrease due to:

  • Age
  • How close the radiation was to your ovaries
  • Total dose of radiation

Pelvic irradiation also may impact uterine function and contribute to a loss of fertility.

Chemotherapy

Chemotherapy works by destroying fast-dividing cancer cells. Because the ovaries contain rapidly-dividing cells, they are also affected by chemo. Depending on how old you are and what types and dosage of medications you receive, your ovaries may or may not recover from this damage.

It is hard to know if your periods will stop temporarily during chemotherapy or for good, and the period of time before you find out can vary. Your doctor will periodically perform blood tests to check your hormone levels.

If you are in your late 40s at the time you go through chemotherapy, your medical menopause may carry you into post-menopause without a recurrence of your menstrual cycle. If you are 30 or younger at the time of treatment, however, you may resume your periods and experience natural menopause in the future.

The older you are, the higher your risk that chemo-induced medical menopause will be permanent.

Ovarian Suppression Therapy

The use of medications to temporarily shut down the ovaries in order to suppress the production of estrogen is known as ovarian suppression therapy and may be used in women with hormone receptor-positive breast cancer.

Medications that shut down the ovaries temporarily include Zoladex (goserelin) and Lupron (leuprolide). These are both luteinizing hormone-releasing hormone (LHRH) agonists, and they work by telling the brain to stop the ovaries from making estrogen. The medicines are given as injections once a month over the course of several months or every few months.

Once you stop taking the medicine, the ovaries usually begin functioning again. The time it takes for the ovaries to recover can vary from woman to woman. The younger you are, the more likely it is that your ovaries and estrogen levels will bounce back.

There have been cases of women getting pregnant while on ovarian suppression medications, so if you are premenopausal and have a male partner, it's important to use non-hormonal birth control such as condoms, a diaphragm, or a non-hormonal IUD.

Symptoms

Medical menopause causes the same symptoms as natural menopause, but the symptoms may come on more abruptly than they would with a more gradual, natural transition. For younger women who have their ovaries removed, which reduces hormone levels literally overnight, menopausal symptoms can be particularly intense.

Symptoms and side effects of medical menopause include:

  • Hot flashes
  • Vaginal dryness
  • Vaginal or bladder infections
  • Night sweats
  • Changing libido
  • Memory problems
  • Mood changes
  • Insomnia
  • Infertility
  • Weight gain
  • Aches and pains
  • Headaches
  • Heart palpitations
  • Osteoporosis
  • Skin and hair changes

Reduced estrogen levels are also associated with an increased risk of heart disease, which can lead to stroke, heart attack, and may affect heart function.

Treatment

Women who experience natural menopause often use hormone replacement therapies (HRT) to treat unpleasant symptoms of menopause. HRT can be taken orally or via a patch; creams containing hormones can also be placed in the vagina to relieve dryness.

However, HRT is not recommended for women who've experienced medical menopause as a result of breast cancer, as it's been shown to increase the risk of recurrence. Options for these women include:

  • Neurontin (gabapentin) to control hot flashes
  • Antidepressants to help with depression
  • Over-the-counter vaginal lubricants or vitamin E oil to help with dryness
  • Melatonin or prescription sleep aids to relieve insomnia
  • Alternative treatments, such as acupuncture, cognitive behavioral therapy, mindfulness-based stress reduction, or hypnosis
  • A healthy diet and exercise program to manage weight gain

A Word From Verywell

In addition to the physical changes brought on by induced menopause, the emotional effects can be profound, especially if you are young and no longer fertile and had hoped to get pregnant in the future. Talk to your doctor, who may be able to refer you to a support group of women going through the same experience.

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Article Sources

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