What causes menopause?

Natural menopause – As you age, your ovarian function begins to decline. The ovaries are responsible for producing key female reproductive hormones including estrogen and progesterone. These hormones regulate your menstrual cycle and also play a role in other systems in your body. As you get closer to reaching menopause, your estrogen and progesterone levels begin to fluctuate, sometimes erratically, which can lead to unpleasant symptoms including hot flashes, moodiness, weight gain, fatigue, and insomnia. Once you reach menopause, your ovaries are no longer functioning and only minimal amounts of estrogen are produced. 

Induced menopause – Certain medical interventions can cause women to enter menopause in a short period of time or even abruptly. Induced menopause can be used to prevent and/or treat uterine, endometrial, ovarian, and breast cancers. Sometimes, induced menopause is also used in women with severe endometriosis and ovarian cysts. Therapies that are used to intentionally induce menopause include:

• Chemotherapy
• Surgical removal of the ovaries (oophorectomy) with or without removal of the uterus (hysterectomy)
•  Radiation
• Ovarian suppression medication can temporarily prevent the ovaries from producing hormones depending on your age

Entering menopause through medical or surgical induction can be especially challenging. If you have surgical or medical induction of menopause you will experience many of the same symptoms as women who enter menopause naturally. However, you do not have a gradual introduction to symptoms associated with minimal levels of estrogen. Women who have their ovaries surgically removed will be in menopause the moment they wake up from surgery as they no longer have ovaries to produce estrogen and progesterone. 

Premenopausal women that undergo induced menopause can experience more severe symptoms and often need more help with symptom management compared to women with natural menopause. Also, induced menopause can be done at an early age so it is important to have ongoing medical care and possibly use some treatment options to lower your risk for health conditions associated with menopause including osteoporosis and heart disease.

Usually, menopause induction is associated with health conditions that can be especially hard to deal with physically, mentally, and emotionally. For some women, the abrupt change from being fertile to now being menopausal can be upsetting, and oftentimes, this can feel like a lonely transition where no one understands what you are going through. If you are struggling to adapt to the changes and symptoms you are experiencing after induced menopause, reach out to your medical provider and seek out support from family, friends, and even support groups with women who share your experience.