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What is Medical Menopause?

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Updated March 12, 2009

ovaries, uterus, and fallopian tubes

Comparison of older and younger female productive system

Illustration © A.D.A.M.
Question: What is Medical Menopause?
Being diagnosed with breast cancer was a jolt, and hearing that I would have to have adjuvant chemotherapy was scary. Little did I know that I was approaching natural menopause, and that chemo would instantly drop-kick me into medical menopause, with the full range of symptoms. So that you will know what that might mean for you, let me explain about different kinds of menopause.
Answer: Understand Different Types of Menopause

Natural menopause is a gradual process during which a woman's fertility decreases. During natural menopause, a woman's ovaries stop maturing eggs, and her body creates less estrogen and progesterone, her menstrual cycles taper off and eventually cease. When the menopause process is complete, a woman is no longer able to become pregnant.

Surgical menopause occurs when a woman's ovaries are surgically removed, or she has a total hysterectomy (removal of uterus and ovaries), and her estrogen levels drop dramatically. Without ovaries or uterus, a woman is not fertile.

Both conditions -- natural and surgical menopause -- are permanent. A woman's fertility will not return if she has gone through either circumstance. Symptoms of natural menopause progress slowly and gradually, while the effects of surgical menopause are immediate.

Medical menopause is the result of medical treatments that may damage a woman's ovaries or suppress her estrogen and progesterone levels. Chemotherapy, anti-estrogen hormone therapies, and pelvic radiation treatments can cause a sudden drop in female hormone levels, resulting in temporary or permanent menopause. This type of menopause may be referred to as:

  • Medical menopause
  • Medically-induced menopause
  • Chemotherapy-induced amenorrhea
  • Chemical menopause
  • Chemopause

Temporary medical menopause may be prescribed for you, if you were diagnosed with breast cancer as a young premenopausal woman. In order to keep your estrogen and progesterone low, and keep your ovaries healthy, you may be given drugs to "turn off" your ovaries. These drugs include Lupron, Zoladex, or Prostap. These drugs help suppress the pituitary gland, which create hormones that signal the ovaries and control your monthly cycle. When these drugs are discontinued, menstrual cycles may resume. But while the drugs are being used, hormones are kept low, thus reducing the risk of recurrence for estrogen-positive breast cancer.

Do use contraception while in treatment for breast cancer, even if you experience medical menopause. There is a small chance that you may conceive during treatment, and the drugs might harm your baby. Do not use birth control pills or any kind of hormonal contraceptives. Do consider using a copper IUD, condoms, spermicide, or other barrier methods to prevent conception.

Does this mean you will have menopause twice? Well, maybe. If you are just a few years away from natural menopause, then treatments may carry you from medical menopause into post-menopause. If you think this may be your situation, learn about how treatments affect your fertility. But if your natural menopause is five or more years in your future, then your periods may return after treatment, and your fertility may rebound. In that situation, you may get to experience menopause twice. At least when the second time around arrives, you will be ready with all your coping strategies, having survived medical menopause already.

Sources:

National Institutes of Health, Medical Encyclopedia. Menopause. Update Date: 12/31/2008.

Expert Opinion on Therapeutic Targets, Volume 12, Number 8, August 2008, pp. 1065-1071(7). Jack Cuzick, author.

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