What Is Medical Menopause?

Natural vs Surgical vs Medical Menopause: Temporary or Permanent

In This Article

Natural menopause is a gradual process during which a woman's ovaries stop producing eggs, and her menstrual cycles taper off and eventually cease. Menopause can also be a result of certain medical treatments, such as surgery and chemotherapy. This is known as induced, or medical menopause; depending on the specific situation, it can be temporary or permanent.

Causes of Medical Menopause

The following procedures and treatments can induce medical menopause:

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:

  • A diagnosis of ovarian cancer
  • As a preventive measure for women at high risk of ovarian and breast cancer, due to having the BRCA1 or BRCA2 gene
  • A diagnosis of uterine (endometrial) cancer, in some cases
  • Endometriosis

Without ovaries or a uterus, a woman is not fertile and no longer produces estrogen. Surgical menopause is 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 cause a sudden drop in hormone levels, resulting in temporary or permanent menopause.

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. Your periods may stop temporarily during chemotherapy or they may stop for good. The older you are, the higher your risk is that this 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 and Side Effects

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 menopause. 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
  • Night sweats
  • Memory problems
  • Mood changes
  • Insomnia
  • Infertility
  • Osteoporosis
  • Weight gain
  • 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 has been shown to increase risk of the disease. Options for women who've had breast or ovarian cancer 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 or hypnosis
  • A healthy diet and exercise program to manage weight gain

A Word From Verywell

With chemotherapy-induced medical menopause in particular, it is hard to know whether the menopause will be temporary or permanent, and the period of time before you know 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 at the time of treatment, however, you may resume your periods and experience natural menopause in the future.

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. Talk to your doctor, who may be able to refer you to a support group of women going through the same experience.

Was this page helpful?

Article Sources