Menopause Health Center
Medical Causes of Menopause
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.
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. However, it may occasionally 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.
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 cervical cancer that recurs despite treatment with surgery and radiation. It involves the removal of most pelvic organs, including: the uterus, cervix, ovaries, and fallopian tubes, vagina, bladder, urethra, and part of the rectum.
What Medical Treatments Can Cause Menopause?
Medical treatments such as chemotherapy and pelvic 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.
Reviewed by the
doctors at The Cleveland Clinic Women's Health Center.
WebMD Medical Reference provided in collaboration with the Cleveland Clinic![]()
VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.


