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For most women, menopause Occurs naturally around age 49 menopauseThe quality and quantity of eggs decline over time. Then the ovaries stop releasing eggs completely.
At this time, the ovaries also stop producing the sex hormones estrogen and progesterone. This ends menstruation. When you have no periods for 12 months, you are in menopause.
But some women will begin menopause soon after the ovaries are removed in surgery. If medical treatment, such as other people, will transition to menopause over a longer time frame Chemotherapy Or radiotherapyDamage their ovaries.
So what can you expect from menopause due to surgery or medical treatment?
Which treatments can cause menopause?
Surgical menopause occurs when women have their ovaries removed to treat conditions such as ovarian cancer,
Some women with a genetic predisposition to ovarian and breast cancer, such as Angelina Jolie, who has the BRCA1 gene, may also have their ovaries removed to stop estrogen production. This reduces the risk of ovarian and breast cancer, which are considered estrogen-dependent cancers.
Other pelvic surgeries can damage the ovaries and trigger menopause, such as removal or treatment of ovarian cysts. endometriosis,
Medical treatments that severely damage or are toxic to the ovaries can also trigger menopause. These include chemotherapy or radiotherapy For cancer, and treatment for rheumatological conditions such as lupus.
Whether or not you become menopausal after medical treatment will depend on your age, underlying ovarian reserve, as well as the type and dose of chemotherapy or radiotherapy. Younger women generally have greater ovarian reserves so they can withstand greater damage.
when does it happen? How is it diagnosed?
Medical treatment may cause menopause to occur earlier than the normal age of natural menopause. When menopause occurs between 40 and 45 years of age, it is called early menopause. About 12% of women will have early menopause.
Before 40, early menopause is called “premature ovarian insufficiency.” This is because women whose periods stop on their own still have a chance of their ovarian function returning. But this is less likely if menstruation stops due to the effects of medical treatment. And this is impossible after surgical menopause. Premature ovarian insufficiency occurs in approximately 4% of women.
The diagnosis of surgical menopause is clear. But menopause may be more difficult to diagnose after medical treatment. Diagnosis is based on no or irregular menstruation for four months or more, as well as high follicle-stimulating hormone levels, determined using a blood test.
what are the symptoms? How are they different?
Symptoms of estrogen deficiency, such as hot flushes, usually begin soon after surgical menopause. Other symptoms, such as vaginal dryness, may develop more slowly. The symptoms of surgical menopause are often more severe than those of natural menopause.
But every person’s experience is different. And symptoms can vary within and between people. It can also be difficult to tell which symptoms are due to menopause and which are due to an underlying health problem or treatment, such as the effect of chemotherapy on cognition.
Low estrogen from premature ovarian insufficiency can cause vaginal dryness, decreased libido, muscle decline and bone loss, and can also impair brain function. It may also increase the risk of heart disease and stroke, with a higher risk after surgical menopause than after spontaneous premature menopause.
Premature ovarian insufficiency can also result in poor mental health and quality of life, and may impact your ability to work.
Women with surgical menopause cannot get pregnant, while women with premature ovarian insufficiency are unlikely to get pregnant naturally.
How is it treated?
Our previous research has shown that women with early menopause and premature ovarian insufficiency often receive poor health care. There is a large variation in quality among health providers.
To help health care professionals provide best practice care, in 2024, we updated evidence-based guidelines with 145 recommendations for treating early menopause and premature ovarian insufficiency.
About the authors
Caroline E. is Associate Professor in Cancer Survivorship and Primary Care at the Caring Futures Institute at Flinders University, Western Sydney.
Amanda Vincent is Adjunct Clinical Associate Professor and Endocrinologist at Monash University.
This article is republished from Conversation Under Creative Commons license. read the original article,
hormone replacement therapy (hrt), which replaces the missing estrogen (as well as progesterone if you still have a uterus), which is the mainstay of treatment for women with premature ovarian insufficiency and early menopause.
Women who have undergone surgical menopause or are experiencing premature ovarian insufficiency may consider HRT for symptom relief and bone protection.
However, HRT cannot be used if you have certain health conditions, such as hormone-sensitive breast cancer.
It is important that you talk to your health care provider about the advantages and disadvantages of HRT in your situation.
Other treatment options include:
- Vaginal estrogen, which may help with vaginal dryness
- Cognitive behavioral therapy (CBT), which helps manage hot flashes, sleep, and mood.
Although Chinese herbal medicine may reduce menopausal symptoms in some women, overall there is not enough scientific evidence that complementary treatments can effectively manage premature ovarian insufficiency.
Health practitioners should talk to patients about the potential symptoms and risks of surgical menopause and premature ovarian insufficiency before starting any treatments that may cause these conditions.
Options for reducing these risks and preserving fertility should also be discussed and may require referral to a specialist.