Surgery, chemotherapy, or radiation therapy for ovarian cancer and other cancers can cause women to start early menopause. It’s also called induced menopause.
What’s Early Menopause?
Menopause usually happens sometime between ages 45 and 55. Your estrogen levels gradually taper off and you stop getting your periods.
Early menopause happens between 40-45. If you go into menopause before age 40, it’s called premature menopause.
Ovarian cancer or other cancer treatments can trigger early menopause. Instead of gradual loss of your hormones, the change may be sudden and cause severe menopause symptoms in some women.
Early menopause may also cause fertility loss. You may not be able to get pregnant. Ask your doctor about fertility-sparing cancer treatments or fertility preservation options before your cancer treatment starts.
Surgical Menopause
Surgery that removes both of your ovaries, or bilateral oophorectomy, can cause early, induced menopause. It’s also called surgical menopause. When your ovaries are removed, you immediately go into menopause. Your periods stop.
You may have more intense menopause symptoms like hot flashes after your surgery. The change can feel drastic for some women. Others have fewer, milder, or no symptoms.
Oophorectomy may or may not be done along with a hysterectomy, or removal of your uterus. It’s used to treat:
- Ovarian or other gynecological cancers
- Benign (noncancerous) fibroid tumors
- Endometriosis
- Twisted ovary
- Women at higher risk for ovarian or breast cancer to reduce cancer risks
Chemotherapy
Some chemotherapy drugs used to treat ovarian cancer and other cancers can cause early menopause. You may stop having your period and notice menopause symptoms like hot flashes or sweats. In some women, this early menopause is temporary.
Some chemo drugs are toxic to your ovaries. Your ovaries may stop functioning normally, leading to early menopause.
Chemo drugs with a higher risk of ovary damage include:
- Alkylating agents like cyclophosphamide
- Taxanes like paclitaxel and docetaxel
- Anthracycline and epirubicin combinations
- Tamoxifen
Newer, targeted cancer drugs like bevacizumab (Avastin) and immunotherapy drugs called tyrosine kinase inhibitors can also harm your ovaries.
You may be able to take gonadotropin-releasing hormone agonists (GnRHa) along with your chemo to help protect your ovaries. Some women start having periods again after chemo when they use this treatment, but it’s not clear if you can regain fertility.
Radiation Therapy
Radiation cancer treatments aimed at or near your ovaries can cause early menopause. Your age, radiation dose, and the distance from your ovaries all affect your risk of early menopause with this cancer therapy.
Radiation aimed at your whole pelvic area can affect your uterus and lead to fertility loss. Radiation to your brain can also affect glands that regulate your periods or ovary function, causing early menopause.
What Does Early Menopause Feel Like?
Early menopause may trigger sudden menopause symptoms such as:
- Hot flashes
- Night sweats
- Vaginal dryness that may make sex painful or uncomfortable
- Low libido or sexual desire
- Weight gain
- More active bladder, so you need to pee more often
These symptoms may feel severe for some women because your hormone loss is instant, not gradual as in natural menopause. It can feel like a drastic change.
Health risks. Early menopause can increase your risk of long-term health problems like cardiovascular disease (CVD), osteoporosis, depression or anxiety, and cognitive dysfunction or memory loss.
Your doctor may give you a DEXA scan to check your bone density. They can prescribe medication to help protect your bone strength.
Treatments
Talk to your doctor if you’re having early menopause symptoms. They can prescribe treatments to ease symptoms and help prevent long-term health risks of early menopause.
Hormone replacement therapy (HRT). Your doctor can prescribe estrogen or progesterone in pills, skin patches, or gels to replace the hormones your ovaries used to make. HRT can ease some menopause symptoms.
Vaginal estrogen. For vaginal dryness that causes discomfort during sex, your gynecologist can prescribe vaginal creams, inserts, or rings that contain estrogen. You can use it with or without HRT.
Other medications. Antidepressants like citalopram (Celexa), paroxetine (Paxil), or venlafaxine (Effexor), as well as the blood pressure medicine clonidine (Catapres), reduce hot flashes and night sweats.
Lifestyle changes can help you manage symptoms and the health risks of early menopause:
Therapy. Cognitive behavioral therapy (CBT) can help ease hot flashes and night sweats, as well as symptoms like poor sleep.
The sudden drop in hormones from early menopause can affect your mood and well-being. You may also feel grief over fertility loss or fear about your long-term health.
Therapy, counseling, support groups for women with ovarian cancer, and talking with your family and friends may help you cope with the emotional effects of early menopause.
