Menopause can be caused by cancer treatment or some operations like hysterectomy or ovary removal. When this happens, it’s called medically induced menopause.
You may be dealing with a cancer diagnosis, endometriosis or pelvic organ prolapse. Some medical treatments, such as chemotherapy, radiation or surgery, can cause temporary or permanent menopause.
Find out what you need to know about medically induced menopause, and what you can do to ease symptoms and reduce health risks.
What is medically induced menopause?
Is medically induced menopause the same as surgical menopause?
Reasons for medically induced menopause
Is medically induced menopause temporary?
What to expect with medically induced menopause
What to ask your doctor
Medically induced menopause is when menopause happens because of surgery or treatment, rather than naturally. For example, because of chemotherapy, or surgery to remove the ovaries.
It happens earlier than you would normally have gone through menopause and is the direct result of an operation, treatment or medicine.
Medically induced menopause is different to a natural early menopause (which occurs between the ages of 40 and 45) or premature menopause (which occurs before the age of 40). These types of menopause happen earlier than the average age of 51, without medical treatment or surgery.
It is also different to premature ovarian insufficiency (POI), which occurs when the ovaries work at a lower level before the age of 40. In POI, periods may stop or be irregular. The ovaries might work from time to time.
There are lots of ways and words people use to describe having medically induced menopause. The terms ‘medically induced menopause’ and ‘medical menopause’ are commonly used, and they mean the same thing. Other terms you might hear include:
Some health conditions might need treatment or surgery that brings about a medically induced menopause. Your doctor should be able to talk to you about all your options and explain if medically induced menopause could happen because of your treatment. Always ask as many questions as you can before you start your treatment.
You might hear about women going through medically induced menopause after treatment for cancer, including breast, ovarian, vaginal, uterine or cervical cancer. It’s important to know that treatment for other cancers can also bring on menopause.
Certain chemotherapy drugs can damage the ovaries, which may lead to medically induced menopause. Chemotherapy works by targeting and killing cells that divide quickly. This includes cancer cells but may also affect cells in your ovaries.
Certain types of radiation therapy are more likely to affect your ovaries and can cause medically induced menopause, including:
Some hormone medicines used to treat cancers, including some breast cancers, can cause medically induced menopause.
Anti-oestrogen treatments affect the ovaries and usually cause menopausal symptoms. These include medicines such as tamoxifen, goserelin and aromatase inhibitors.
Surgery to reduce your risk of an inherited cancer, or to treat cancer, may cause menopause. It will do so if both ovaries are removed. This type of surgery is used to treat or reduce the risk of ovarian cancer in women with a strong family history or gene mutations such as BRCA1, BRCA2 or Lynch Syndrome. Sometimes it is recommended as part of treatment for breast cancer.
Read Rochelle's story about how she's navigating medically induced menopause after having surgery to lower her cancer risk.
Hormone medicines or surgery such as a hysterectomy might be needed to treat conditions such as painful or heavy periods. Sometimes these can cause medically induced menopause.
Severe endometriosis or adenomyosis might need surgery to remove the ovaries or other organs such as the uterus (womb). Sometimes, you might need medicines that stop your ovaries working. They prevent the monthly hormone changes that make these health conditions worse.
When treating fibroids, you may be prescribed medicines that cause menopause. They stop your ovaries making hormones that encourage fibroids to grow. This can also help with heavy periods. These injections are sometimes used to shrink fibroids before an operation to remove them.
A small number of women may experience medically induced menopause after a treatment called uterine embolisation which cuts off the blood supply to fibroids. However more research is needed to understand this better. This type of menopause is more likely after the age of 45.
Sometimes hormone injections that stop your ovaries working can help severe mood changes for people living with premenstrual dysphoric disorder (PMDD). This is usually only used if other medicines haven’t worked.
Large or painful cysts might need surgery that also removes one or both ovaries or the fallopian tubes.
If other approaches to treat your health condition have not worked, a hysterectomy may be an option. This is an operation to remove your uterus (womb). If you have a hysterectomy, you will not be able to get pregnant in the future and you will no longer have periods. But this doesn’t mean you are in menopause. The latest research shows there are different chances of medically induced menopause following hysterectomy.
A hysterectomy can be a treatment for certain cancers, but also for conditions and symptoms such as:
If you have both ovaries removed (this is called a double oophorectomy) as well as a hysterectomy, you will have a medically induced, permanent menopause.
If you still have one or both ovaries after your operation, you might experience medically induced menopause. You have a higher chance of natural menopause, though it may happen earlier than it would have without the surgery.
Medically induced menopause can be temporary or permanent. Everyone is different and so you will need to talk to your health care team to understand your own situation.
Learn about the factors that increase the chances of medically induced menopause being temporary or permanent.
Every woman is different when it comes to natural menopause, and it’s the same with medically induced menopause. Talk to your health care team about what you can expect ahead of time.
This can depend on the treatment or surgery that causes the menopause, as well as your individual situation. Medically induced menopause often happens faster than natural menopause. This is because in natural menopause you go through a phase called perimenopause, where hormone levels are changing but you still have periods. For some women, perimenopause can last for years.
In medically induced menopause you do not always get the same kind of perimenopause phase. Here’s what the latest research tells us about timings.
Symptoms of medically induced menopause are the same as those for natural menopause. They include:
Find out more about menopausal symptoms.
Everyone’s experience is different. Medically induced menopause can be particularly challenging due to a number of key things.
This can make the experience more intense and feel like more of a shock.
After ovary removal, for example, the sudden drop in oestrogen can make some symptoms more intense. This includes loss of sex drive and more severe sleep problems.
Women going through menopause due to breast cancer treatment can have more severe symptoms. Research suggests 50% to 75% of young women going through menopause due to breast cancer treatment may experience dry or itchy vagina, painful sex, or UTIs. They may also be more likely to experience depression and anxiety.
If you are coming to terms with earlier and unexpected loss of fertility, or dealing with a diagnosis of cancer, it can add extra emotional distress.
Just as natural menopause increases some risks of health conditions, so does medically induced menopause. You may have a higher risk if it comes earlier than your natural menopause would have. More research in this area is needed.
There may be increased risks to:
The good news is that there are lots of ways to decrease your risks – including considering menopausal hormone therapy (MHT) or other medicines, doing regular exercise, having a healthy diet and stopping smoking.
Menopausal hormone therapy (MHT) is often recommended for medically induced menopause for women under the age of 45, unless you’ve had a hormonal cancer diagnosis. You need to be sure it will not increase your risk of your condition returning if you have a cancer, endometriosis or fibroids, for example. It is important to talk to your doctor about your specific situation. The good news is that recent research shows some types of MHT may be suitable for some women, depending on individual circumstances and risks.
Vaginal oestrogen can help with vaginal dryness and itching, painful sex and other urinary issues like needing to wee more often or urgently. This treatment can be prescribed for women after breast cancer depending on individual circumstances.
Non-hormonal medicines are available to help with symptoms such as hot flushes and night sweats.
Regular exercise, a healthy diet, stress management, and getting enough quality sleep can help you manage menopausal symptoms and look after your bones, heart, brain and vaginal health – which all need more support the earlier your menopause takes place.
Dealing with vaginal dryness
Non-hormonal vaginal moisturisers and lubricants can help with vaginal dryness and itching, and painful sex – including for women after breast cancer treatment.
Sexual activity, including masturbation can improve blood flow to your vaginal tissues and ease dryness.
If you're considering treatment or surgery that may bring on menopause, it's important to ask the right questions so you can get the information you need. We've created a list of questions to use as a guide for conversations with your doctor and specialists.
This information was developed in partnership with Inherited Cancers Australia.
This content has been reviewed by a group of medical subject matter experts, in accordance with Jean Hailes policy.
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