Natural menopause is the permanent ending of menstruation that is not brought on by any type of medical treatment. For women undergoing natural menopause, the process is described in three stages: perimenopause, menopause, and postmenopause.
Perimenopause may begin in a woman’s 40s. During this time, she may experience hot flashes and irregular periods due to declining ovarian function. Menopause is defined as the absence of a menstrual period for 12 consecutive months. However, not all women undergo natural menopause. Some women experience induced menopause as a result of surgery or medical treatments, such as chemotherapy and pelvic radiation therapy.
What is surgical menopause?
Surgical menopause occurs when a premenopausal woman has her ovaries surgically removed in a procedure called a bilateral oophorectomy. This causes an abrupt menopause, with women often experiencing more severe menopausal symptoms than if they were to experience menopause naturally.
Why would someone have a bilateral oophorectomy?
In most cases, bilateral oophorectomy is performed because of cancer, including cervical, endometrial (cancer of the uterus), and ovarian cancer. Prophylactic bilateral oophorectomy may be performed in patients who are at increased risk for breast and ovarian cancer who carry a mutation in the BRCA gene. Occasionally, however, it may be done to treat non-cancerous conditions such as uterine fibroids, endometriosis, or infections.
Which surgical procedures involve bilateral oophorectomy?
Hysterectomy (the surgical removal of the uterus) can sometimes, though not always, include bilateral oophorectomy. Hysterectomy that does not involve removal of the ovaries usually does not result in menopause (although women who undergo a hysterectomy may experience menopause a few years earlier).
Other surgeries that may involve the removal of both ovaries include:
- Abdominal resection. This is a surgical procedure done to treat colon and rectal cancer. While this surgery usually involves the removal of the lower colon and rectum, it can also include partial or total removal of the uterus and ovaries, as well as the rear wall of the vagina.
- Total pelvic exenteration. This procedure is usually only performed in cases of genitourinary cancers, such as cervical cancer, that recur despite treatment with surgery and radiation. It involves the removal of most pelvic organs, including the following:
- Fallopian tubes
- part of the rectum
What medical treatments can cause menopause?
Medical treatments such as chemotherapy and radiation therapy can cause menopause by damaging the ovaries. However, not all premenopausal women undergoing these procedures will experience induced menopause. Additionally, even if the ovaries are damaged, the damage is not always permanent.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/29/2010...#10335