Identifying Premature Menopause and Possible Causes
Surgery to Remove the Ovaries
Surgical removal of both ovaries, also called a bilateral oophorectomy, puts a woman into menopause right away. She will no longer have periods, and hormones decline rapidly. Symptoms of menopause may appear right away, such as hot flashes and diminished sexual desire.
Women who have a hysterectomy but have their ovaries left in place will not have induced menopause because their ovaries will continue to make hormones. However, because the uterus is removed, these women no longer have their periods and cannot get pregnant. They might have hot flashes, since the surgery can sometimes disturb the blood supply to the ovaries. In time, they may go through natural menopause a year or two earlier than expected.
Chemotherapy or Radiation Treatment
Chemotherapy for cancer or pelvic radiation therapy for cancers of the reproductive system can cause ovarian damage. These treatments may cause women to stop getting their periods, have fertility problems, or lose their fertility. This can happen right away or take several months. With cancer treatment, the chances of going into menopause depend on:
- The type of chemotherapy used
- How much was used
- The age of the woman when she receives treatment.
The younger a woman is, the less likely she will go into menopause.
If your doctor suspects that you are going through premature menopause, he or she will ask you if you've noticed any premature menopause symptoms, such as:
- Hot flashes
- Irregular periods
- Sleep problems
- Vaginal dryness.
Normally, menopause is confirmed when a woman hasn't had her period for 12 months in a row. However, with certain types of premature menopause, these signs may not be enough to make a diagnosis. A blood test that measures follicle stimulating hormone (FSH) can be done. Your ovaries use this hormone to make estrogen. FSH levels rise when the ovaries stop making estrogen. When FSH levels are higher than normal, you've reached menopause. However, your estrogen levels vary daily, so this test may need to be repeated for an accurate diagnosis to be made.
You may also have a test for levels of estradiol (a type of estrogen) and luteinizing hormone (LH). Estradiol levels fall when the ovaries fail. Abnormally low levels of estradiol are a sign of menopause. LH is a hormone that triggers ovulation (the release of an egg from the ovary). If you have higher-than-normal levels of LH, it means you've gone through menopause.
(Click Diagnosing Premature Menopause for more information.)