Menopause & Induced Menopause.Your Questions Answered by Internal Specialist, Dr. Mera

The term induced menopause describes menopause caused by a medical treatment. Certain drug and radiation therapies can damage the ovaries and cause menopause. The most common cause is the surgical removal of both ovaries because of a medical problem. Hysterectomy, the removal of the uterus but not the ovaries, does not cause menopause. Women who experience induced menopause do not have the typical perimenopause—the gradual transition leading up to their final menstrual period when hormones wax and wane.

With surgical menopause, menopause occurs abruptly, on the day of surgery. With menopause induced by drug treatments, there may be a short transition as the damaged ovaries shut down production of hormones over a period of time. The abrupt loss of ovarian hormones usually causes more drastic symptoms than those seen with natural menopause.

Induced menopause can occur at any age after puberty and before natural, spontaneous menopause occurs. Induced menopause that occurs at a much earlier age than natural menopause (typically, age 51) may result in increased risk for some diseases due to the loss of protection from estrogen and other ovarian hormones. For example, the protective effect of estrogen on bone health is lost, resulting in increased risk for osteoporosis and fracture.

And just as the experience is different with induced menopause, so is the treatment. Women with induced menopause might require treatment for menopause-related symptoms such as hot flashes and vaginal dryness more often than women who reach menopause spontaneously. In addition, treatment for a longer duration and perhaps at higher doses is often necessary, not only to control the symptoms but also to lower the risk of diseases later in life. For women who are unable or unwilling to use estrogen therapy, many nonhormonal medications, including selective serotonin reuptake inhibitors, complementary and alternative medicine and supplements, are available that may effectively relieve symptoms or prevent or treat disease.

Regular reevaluation by a healthcare practitioner is of vital importance for women who experience induced menopause to:

• Monitor the condition that resulted in induced menopause
• Ensure adequate symptom relief as needed
• Reassess health status and risks for disease
• Determine the best disease prevention or treatment strategies.