Menopause can result from:
Jan. 07, 2015
Natural decline of reproductive hormones. As you approach your late 30s, your ovaries start making less estrogen and progesterone — the hormones that regulate menstruation — and your fertility declines.
In your 40s, your menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent, until eventually — on average, by age 51 — you have no more periods.
Hysterectomy. A hysterectomy that removes your uterus but not your ovaries (partial hysterectomy) usually doesn't cause immediate menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone.
But surgery that removes both your uterus and your ovaries (total hysterectomy and bilateral oophorectomy) does cause menopause, without any transitional phase. Your periods stop immediately, and you're likely to have hot flashes and other menopausal signs and symptoms, which can be severe, as these hormonal changes occur abruptly rather than over several years.
- Chemotherapy and radiation therapy. These cancer therapies can induce menopause, causing symptoms such as hot flashes during or shortly after the course of treatment. The halt to menstruation (and fertility) is not always permanent following chemotherapy, so birth control measures may still be desired.
- Primary ovarian insufficiency. About 1 percent of women experience menopause before age 40 (premature menopause). Menopause may result from primary ovarian insufficiency — when your ovaries fail to produce normal levels of reproductive hormones — stemming from genetic factors or autoimmune disease. But often no cause can be found. For these women, hormone therapy is typically recommended at least until the natural age of menopause in order to protect the brain, heart and bones.
- Menopause. National Institute on Aging. http://www.nia.nih.gov/health/publication/menopause. Accessed May 22, 2014.
- Lethaby A, et al. Phytoestrogens for menopausal vasomotor symptoms. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001395.pub4/abstract. Accessed May 23, 2014.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed May 27, 2014.
- Nelson LM, et al. Clinical manifestation and evaluation of spontaneous primary ovarian insufficiency (premature ovarian failure). http://www.uptodate.com/home. Accessed May 22, 2014.
- Menopausal symptoms and complementary health practices. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/menopause/menopausesymptoms. Accessed May 22, 2014.
- Lindh-Astrand L, et al. Effects of applied relaxation on vasomotor symptoms in postmenopausal women: A randomized controlled trial. Menopause. 2012;20:1.
- Colpani V, et al. Association between habitual physical activity and lower cardiovascular risk in premenopausal, perimenopausal, and postmenopausal women: A population-based study. Menopause. 2012;20:1.
- Rada G, et al. Non-hormonal interventions for hot flushes in women with a history of breast cancer. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004923.pub2/abstract. Accessed May 23, 2014.
- Daley A, et al. Exercise for vasomotor menopausal symptoms. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006108.pub3/abstract. Accessed May 23, 2014.
- For better sex: 3 ways to strengthen your pelvic floor. The Northern American Menopause Society. http://www.menopause.org/for-women/menopauseflashes/for-better-sex-3-ways-to-strengthen-your-pelvic-floor. Accessed May 22, 2014.
- The North American Menopause Society. The 2012 hormone therapy position statement of The North American Menopause Society. Menopause. 2012;19:257.
- MenoNote: Vaginal dryness. The North American Menopause Society. http://www.menopause.org/docs/for-women/mndryness.pdf. Accessed May 22, 2014.
- Welt CK, et al. Pathogenesis and causes of spontaneous primary ovarian insufficiency (premature ovarian failure). http://www.uptodate.com/home. Accessed May 22, 2014.
- Welt CK, et al. Ovarian development and failure (menopause) in normal women. http://www.uptodate.com/home. Accessed May 22, 2014.
- Menopausal hormone therapy (MHT). Office on Women's Health, U.S. Department of Health and Human Services. http://www.womenshealth.gov/menopause/symptom-relief-treatment/menopausal-hormone-therapy.html. Accessed May 23, 2014.
- Menopause and menopause treatments fact sheet. Office on Women's Health, U.S. Department of Health and Human Services. http://womenshealth.gov/publications/our-publication/fact-sheet/menopause-treatment.html. Accessed May 23, 2014.
- Committee on Gynecological Practice and the American Society for Reproductive Medicine Practice Committee. Compounded bioidentical menopausal hormone therapy. ACOG. http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Gynecologic_Practice/Compounded_Bioidentical_Menopausal_Hormone_Therapy. Accessed May 22, 2014.
- Tella SR, et al. Prevention and treatment of postmenopausal osteoporosis. Journal of Steroid Biochemistry and Molecular Biology. 2014;142:155.
- Eden JA. Phytoestrogens for menopausal symptoms: A review. Maturitas. 2012;72:157.
- Dodin S, et al. Acupuncture for menopausal hot flushes. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007410.pub2/abstract. Accessed May 23, 2014.