Menopause

What causes menopause?

While menopause is a natural process, there are other factors that can influence menopause. It can be the result of the following:

• Naturally declining reproductive hormones – Hormone production begins to decrease in your late 30s as your ovaries begin making less estrogen and progesterone, and fertility begins to decline.

• Surgery that removes the ovaries (oophorectomy) – Ovaries produce hormones, including estrogen and progesterone, that regulate the menstrual cycle. Surgical removal of the ovaries causes immediate menopause. Your periods stop, and you’re likely to experience hot flashes as well as other menopausal signs and symptoms. Signs and symptoms may be more severe as hormonal changes occur abruptly rather than gradually over several years. Surgery that removes your uterus but not your ovaries usually doesn’t cause immediate menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone.

• Chemotherapy and radiation therapy – Cancer therapies can induce menopause, which can cause hot flashes during or shortly after the course of treatment. If

menstruation does stop following chemotherapy, it is not always permanent. Radiation therapy only affects ovarian function if radiation is directed at the ovaries. Radiation therapy to other parts of the body shouldn’t affect menopause.

• Primary ovarian insufficiency – About 1% of women experience menopause before age 40, which is known as premature menopause. Premature menopause may result from the failure of your ovaries to produce normal levels of reproductive hormones, which can be caused by genetic factors or autoimmune disease. However, sometimes there is no identifiable cause of premature menopause. For these women, hormone therapy is typically recommended at least until the age of natural menopause in order to protect the brain, heart, and bones.