APRIL 2006




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Quick Change:
The Effects of Induced Menopause

The term “induced menopause” describes menopause caused by a medical intervention. Although certain drug or radiation therapies that damage the ovaries can cause induced menopause, the most common cause is surgical removal of both ovaries (bilateral oophorectomy).

Women who experience surgical menopause don’t slowly work their way through the typically gradual transition of perimenopause. With surgical menopause, menopause occurs immediately on the day of surgery. With induced menopause caused by medical treatments, there may be a short transition as damaged ovaries shut down production of hormones over a period of time. Induced menopause can occur at any age after puberty and before natural, spontaneous menopause occurs.

And just as the experience is different, so is the treatment. Women with induced menopause require treatment for menopause-related symptoms more often than women who reach menopause spontaneously. In addition, treatment for a longer duration and perhaps at higher doses is often required, not only to control the menopause-related symptoms such as hot flashes and vaginal dryness, but also sometimes to lower the risk of menopause-associated diseases such as osteoporosis later in life.  

With induced menopause, all ovarian function is lost, resulting in lowered levels of estrogen (as with natural menopause) as well as lowered levels of androgens, other hormones produced by the ovary. Differences between women experiencing induced menopause versus natural menopause include the following:

  • Hot flashes -- This symptom is experienced by up to 90% of women after surgically induced menopause, about 25% more than with natural menopause. Reports suggest that surgically induced menopause also causes more frequent and/or severe hot flashes.  Menopause-related symptoms may be more intense after pelvic radiation than after chemotherapy. With both types of therapy, symptoms may occur concurrently with cancer treatment or within 3 to 6 months afterward.
  • Sexual function -- Due to the sudden drop in all ovarian hormone levels, surgical menopause may significantly lower sexual drive (libido). The drastic reduction in estrogen levels may also cause severe vaginal symptoms, including dryness, irritation, and atrophy (thinning of the vaginal tissues). Induced menopause may also affect the clitoris, causing a decline in sensation, touch perception, and, for some, a noticeable decrease in  size. If the uterus is removed (hysterectomy), some women report decreased orgasmic ability -- while others report improved sexual sensations and libido, partly due to relief from pelvic pain, heavy uterine bleeding, worries about contraception, etc. Side effects of cancer treatments, such as inflamed vaginal tissues, may further reduce sexual desire and function.
  • Mental health -- Procedures that result in permanent infertility may precipitate a range of emotions. Women who undergo surgical menopause may have lingering feelings of doubt about the necessity of the surgery. Women who experience induced menopause after treatment for a serious illness may have additional emotional concerns related to the illness. For example, cancer therapies often produce an array of side effects, including weight gain, fatigue, hair loss, and flu-like symptoms. Physical illness or discomfort may cause emotional distress, which may negatively affect the body’s ability to heal and remain healthy. Women experiencing induced menopause that results from treatment for a life-threatening disease such as cancer will be facing different concerns than women with induced menopause that results from a benign (non-cancerous) condition.

Sometimes, treatment with hormones is not recommended for women who have experienced induced menopause, limiting the choice of effective treatment options for menopause-related symptoms and long-term risks. However, help is available with nonhormonal approaches.

Counseling from healthcare providers is an essential component of care, both before and after medical intervention that results in induced menopause.

More information is available in the NAMS Early Menopause Guidebook. Click here to access this publication.

Last reviewed: April 2006



 

Welcome
Symptoms. Studies. Supplements. Solutions. Just some of what you’ll find in this issue of Menopause Flashes, your e-source for credible menopause information.
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This e-newsletter, developed under the direction of the Consumer Education Committee
of The North American Menopause Society (NAMS), provides current information,
but not specific medical advice. It is not intended to substitute for the judgment
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