Medically induced menopause can be temporary or permanent. Some women will get their periods and fertility back after chemotherapy, radiation and hormone treatments for cancers and conditions such as endometriosis. Some women will go into permanent menopause.
So, what are the factors that increase the chances of medically induced menopause being temporary? And what makes it more likely that you’ll be in menopause permanently? Here’s what you need to know.
Can you know if medical menopause will be permanent?
Temporary menopause from hormone medicine
When is chemotherapy induced menopause temporary?
Is radiation therapy induced menopause reversible?
Types of surgery and likelihood of menopause
Chemotherapy, radiation therapy and permanent menopause
Everyone is unique, so you will need to talk to your health care team to understand your own situation. For example, some chemotherapy, radiation or hormone treatments for cancers and conditions such as endometriosis will stop periods and bring on menopausal symptoms.
How long these symptoms last for you may not be clear before you start treatment. There is no test to predict whether your medically induced menopause will be temporary or permanent. Your doctors will be able to look at your individual situation and talk you through what may be more likely for you.
Injections to create a temporary menopause are key treatments for a wide range of conditions. The injections are called gonadotrophin-releasing hormone (GnRH) analogue injections. They stop your ovaries making the hormones oestrogen and progesterone, and stop your menstrual cycle.
You may be prescribed GnRH injections to help manage symptoms of:
If you have not been through menopause, ovulation and periods usually come back within 6 to 10 weeks after stopping treatment with GnRH.
The longer you’ve been on treatment, the longer it might take for your periods to return.
Oestrogen levels start to rise again after the last injection wears off. That means your menopausal symptoms might also improve.
The older you get while you take the treatment, the closer you get to your natural menopause. You may find you are in perimenopause when you stop treatment.
If you have been through natural menopause while taking the treatment, your periods will not come back.
The following factors can make it more likely that you get back your periods and fertility after chemotherapy.
The younger you are, the more likely you are to have more eggs in your ovaries. One study suggested over 70% of women under 35 got their periods back – the study included women between ages of 20 to 35 whose periods stopped during treatment. Some sources suggest women under 45 may get their periods back 2 years after treatment.
Some chemotherapy drugs are less damaging to the ovaries (gonadotoxic) than others. Having the least damaging medicine types, lower doses and a lower number of medicines as part of your treatment can also increase the chance of chemotherapy menopause being temporary.
Sometimes, lower doses of chemotherapy are used for conditions including lupus and rheumatoid arthritis.
After radiation treatment, there are some things that will increase the chance of your menopause being temporary. These include the following:
Different kinds of surgery can create an earlier menopause, or cause menopause to happen straight away. Here’s what the latest research tells us.
Surgical menopause means the removal of both of your ovaries. If you have both ovaries removed you will experience permanent menopause immediately.
A hysterectomy is an operation to remove your uterus and does not necessarily include the removal of the ovaries. However, sometimes ovary removal is recommended at the same time as a hysterectomy.
If you have a hysterectomy and keep both ovaries, you are likely to reach menopause at the expected age. However, in some women, a hysterectomy even without ovary removal may still lead to earlier menopause.
If you also have one ovary removed with your hysterectomy, you have a higher chance of a natural menopause. There is also a small chance that you may have an immediate menopause after your operation. You may also reach menopause earlier than you would have done without the operation. This may be because blood flow to your ovaries can be affected, or scarring can happen due to the operation.
Usually, removing only the fallopian tubes (an operation called a bilateral salpingectomy) would not cause menopause. But there is some evidence that removing the fallopian tubes during a hysterectomy may increase your chance of menopausal symptoms one year after surgery. More research is needed in this area.
Your individual circumstances will affect whether your chemotherapy or radiation treatment causes a permanent earlier menopause, and how soon after treatment it starts.
Here are some key factors to consider and talk through with your health care team.
The older you are, the closer you are likely to be to your natural menopause. This means you have fewer eggs in your ovaries already. The chance of medically induced menopause being permanent increases with age.
If you have chemotherapy as well as radiation therapy to the belly (abdomen), pelvis or whole body, it is more likely to cause a permanent menopause.
Taking medicines that are more damaging to the ovaries (gonadotoxic) than others, taking higher doses, or taking more than one medicine can also increase the chance of chemotherapy menopause being permanent.
These chemotherapy medicines are more likely to cause permanent menopause:
Higher doses and radiation directly to your ovaries or pituitary gland (a gland in your brain) is more likely to create permanent menopause.
Find out more about the causes, symptoms and treatment options for medically induced menopause.
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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