Medically induced menopause – what to ask your doctor

Making informed decisions

When it comes to medicines and surgery, it’s important to make the right decision for you. Asking the right questions and getting the information you need from your health care team is a key part of that. You don’t have to ask all the questions below – use them as a guide and ask the questions that are important for you.

Find out more about whether your medically induced menopause will be temporary or permanent.

Questions for surgery

If you’re considering surgery to treat or reduce your risk of cancer, or to treat a condition such as endometriosis or ovarian cysts, these questions can be helpful to ask your health care team.

Treatment options 

• What exactly is the surgery you are recommending for me? Will you take out my uterus (womb), ovaries, fallopian tubes or cervix? If I’m having a hysterectomy, what kind of hysterectomy is it? 
• What are the pros and cons of each of my options? 
• Why is this surgery recommended for me? Is it because of my health condition or because I have a high risk of cancer due to an inherited gene mutation?   
• What are the benefits of the surgery for me? 
• What are the potential risks? How likely are they? 
• How would you expect the surgery to affect my overall health and quality of life?  
• What is the most recent evidence for this treatment? 
• If you are recommending surgery for cancer risk reduction, what will my residual cancer risk be after this surgery? 
• What are the alternatives to surgery?  What happens if I don’t do anything? 

Ovary removal and hysterectomy 

• What are the risks and benefits of removing only the ovaries and fallopian tubes for cancer risk reduction? Could I remove only one ovary and my fallopian tubes?   
• Can I remove my fallopian tubes and delay removing my ovaries? 
• What specific surgical procedure are you recommending, and why? Will it be laparoscopic, robotic or open surgery, or something else? Am I a good candidate for the less-invasive laparoscopic surgery, as opposed to a full abdominal incision? 
• What are the risks and benefits of this surgical approach? 
• Will I have any scars? 
• How long will the surgery take? 
• What type of anaesthetic will be used? 
• What are the pre-operative steps I need to follow? For example, do I need to fast or take medications? Will I need to provide a blood sample before the procedure? Will I need to stop taking any current medications? 
• Will you check the tissue you remove for cancer cells or other abnormalities? 
• What are the risks of complications during and after surgery? Is there anything we can do to reduce the risk? 

Your surgeon's experience

• How many of these procedures have you performed – particularly for women in my specific situation? 
• What is your success rate with this type of surgery? 
• Are you a specialist in gynaecological surgery? 
• What are your qualifications and certifications? 
• Are you a fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG)?  

Surgery, menopause and fertility 

• Will this surgery cause me to go into immediate menopause or have an earlier menopause? (Make sure you ask if your treatment will also include chemotherapy, radiation therapy or hormone therapy.)  
• How likely is it to be a temporary or permanent menopause? 
• If I am currently taking menopausal hormone therapy (MHT), will I need to stop taking it before treatment and will I be able to return to using it after? 
• Is there anything we can do to increase my chance of avoiding an earlier menopause? 
• Is there anything we can do to preserve my fertility? For example, freezing eggs or embryos. 
• What are my options if I want to have children or more children in the future?  

Preparing for recovery 

• How soon do I need the surgery? Is there anything I can do in that time to improve my chances of a better recovery? For example, with diet, exercise or counselling.
• Should I see a menopause specialist to talk through my options prior to surgery, and can you refer me to a menopause specialist? 

Care after the surgery 

• What is the expected recovery time? 
• Is it likely I’ll experience pain after surgery? And if so, what pain management strategies will be used? 
• Are there any precautions I should take as I recover? Will you give me written instructions to follow about things like wound care? 
• What are the signs of post-operative complications I should watch out for? 
• When can I expect to be released from hospital? 
• When can I get back to regular activities, including work, sex and exercise? Will I have any restrictions on lifting, driving or other activities? 

Follow-up care for menopause

• If I can take menopausal hormone therapy (MHT), should I have it planned and ready for when I leave hospital after my surgery?  
• Should I see a menopause specialist to talk through my options prior to surgery?  
• Will I need follow-up appointments, and how often? How often would you want to see me after surgery? 
• How would we work together to manage my follow-up care? Would you manage all aspects of that care, or would you prefer that I see another doctor as well? How would the 2 of you communicate? 
• What should I do if I have problems or questions in between appointments? Who will be able to answer my questions? 
• If I feel that I need to consult with other health care professionals, will you be able to provide me with referrals? 
• How soon would I be able to go back to GP care? (Find out more about getting menopause support from your GP.)

Questions for treatment-induced menopause

If your medically induced menopause is caused by medical treatment such as chemotherapy, radiation therapy or anti-oestrogen medicine, this is also known as treatment-induced menopause. These questions can be helpful to ask your health care team.

Treatment options

• What treatment or treatments are you recommending for me, and why? 
• What are the benefits? What are the potential risks, and how likely are they? 
• How would you expect the treatment to affect my overall health and quality of life?  
• Will the treatment increase the risk of my condition coming back?
• Are there any alternatives? 
• What happens if I don’t do anything? 
• How soon does the treatment need to start – and is there anything I could do before or during to help me cope well? 
• If I am currently taking menopausal hormone therapy (MHT), will I need to stop taking it before treatment and will I be able to return to using it after? 
• What are the chances my health condition might come back if I use MHT? For example, for my kind of cancer, or my endometriosis or fibroids?   
• Are there any studies or trials I could be part of that contribute to research in this area? 

Fertility preservation

• How likely is temporary menopause compared to permanent menopause in my situation? 
• What chemotherapy medicines would I be having and how toxic are they to my ovaries? 
• What radiation therapy would I need and how close to my ovaries would it be targeted? 
• What hormone medicines would I need and how would it affect my ovaries? 
• Is it possible to make the menopause more likely to be temporary in my situation? If so, what steps are involved? 
• Is there a way to have a less toxic chemotherapy approach? 
• Is it possible to shield my ovaries from radiation? For example, having surgery to move them? (This is called ovarian transposition.) 
• Is there a hormone medicine protocol to treat my condition that is less likely to bring on permanent menopause? 
• What are the chances of my ovaries working again after treatment? 
• What fertility preservation options are available to me before treatment? For example, egg freezing, embryo freezing or ovarian tissue freezing. 
• What is the success rate of these fertility preservation methods for someone of my age and health? 
• What are the risks and benefits of each fertility preservation option? 
• How long would I need to wait after treatment before trying to get pregnant, if it was possible? 
• Are there other treatments I might need that may cause menopause as a side effect? 

Short-term symptoms and side effects 

• What are the most common short-term side effects of this treatment – and how long do they usually last?  
• What are the most common menopausal symptoms that happen alongside the side effects? 
• How will you help me to manage these so I can get through treatment? 
• How will they affect my ability to get on with daily life?  

Follow-up care

• Will I need follow-up appointments, and how often? How often would you want to see me during and after treatment? 
• How would we work together to manage my follow-up care? Would you manage all aspects of that care, or would you prefer that I see another doctor as well – for example, about any menopausal symptoms? How would the 2 of you communicate? 
• What should I do if I have problems or questions in between visits? Who will be able to answer my questions? 
• If I feel that I need to consult with other health professionals, will you be able to provide me with referrals? Could you refer me to a menopause specialist, for example? 
• How soon would I be able to go back to GP care? (Find out more about getting menopause support from your GP). 

Your health care team’s experience

• How experienced are you in managing treatment-induced menopause? 
• What is your experience with fertility preservation? 
• How often do you treat patients who might experience this side effect? 

Questions about managing menopausal symptoms

• How is medically induced menopause different to natural menopause? Is it more severe or sudden? 
• What are my options for managing menopausal symptoms?  
• What are the risks and benefits of menopausal hormone therapy (MHT), and what kind could be suitable for me? For example, are patches or gels better than pills? Is vaginal oestrogen OK for me? 
• Would I need to use MHT for longer than someone who hasn’t had treatment – and if so, what are the risks for me? 
• What are my options if MHT is not suitable for me? 
• What are the chances my health condition might come back if I use MHT? For example, for my kind of cancer, or for my endometriosis or fibroids? 
• What non-hormonal treatments are there? 
• What effective lifestyle approaches are there? 
• What will the impact be on my sexual and vaginal health? Are there any treatments that can reduce the risk of problems for me? Is there anything I can do? 
• Are there other health professionals who can help me manage my menopausal symptoms? For example, a dietitian or exercise physiologist?  
• How can I best support my mental health and relationships during this time? 
• How will I know if my symptoms are related to menopause or the treatment?

Questions about long-term health risks

• What are the potential long-term risks of the treatment or surgery on my hormonal health and my health overall? I’m concerned about the impacts of menopause on my bone, heart and brain health. 
• Is there anything I can do to reduce those risks before, during and after the treatment or surgery? 

Questions about emotional health

• Can you help me deal with my main worries about the treatment or surgery? (You will need to think about what these are and be able to share them with your medical team.)
• How can I manage the emotional and mental health impacts of this treatment or surgery, including potential feelings of loss around fertility, fears about my condition coming back, or changes in body image?
• Are there support groups or counselling services available to help me cope with the emotional aspects of the treatment or surgery?

Questions about financial costs

• What is the total cost of the surgery? What is the total cost of the treatment itself, and the menopause treatment afterwards? 
• Are there any out-of-pocket expenses I should be aware of? For example, anaesthetist fees, hospital excess.
• What are the costs of any follow-up appointments and treatments?
• Will I need to pay for any medications after the surgery?
• Will I need to pay for any medications to offset side effects of the treatment? 
• What are the costs of MHT?
• Will I need to consider and budget for medical tests and checks to monitor my health, such as bone density scans (DEXA scans)? 

Find out more about potential medical costs with the Australian Government's medical costs finder.