One year or 12 months after the last menstrual period in a woman, is considered menopause. It signals the end of menstrual period in a woman. Menopause can happen any time after age of 40 years due to natural physiological process. However, it can happen much earlier due to medical conditions such as due to surgical removal of uterus. It is usually a natural biological process and all women go through it. However, some women develop various signs and symptoms of menopause that can be troublesome and need medical attention.
What can cause menopause?
Menopause can be due to following causes,
- As natural physiological process: As you reach in your early 40s or late 30s, your ovaries start producing less hormones (estrogen and progesterone) and fertility decreases. Menstrual cycles may become irregular, longer or shorter duration and at some point in late 40s or in 50s your menstrual cycles stops permanently, this is menopause. It is a natural physiological process and happens in all women at some point in life. For some women, although menopause is a biological natural process, may be accompanied by various troubling signs and symptoms.
- Hysterectomy: surgical removal of uterus due to some medical condition is hysterectomy. If only uterus is removed and ovaries are left intact, your ovaries keep producing hormones and menopause do not occur immediately, although no menstrual bleeding occurs, because uterus is removed. However, if hysterectomy is accompanied by removal of both ovaries along with uterus (hysterectomy with bilateral oophorectomy), that menopause occurs immediately along with stoppage of hormone (estrogen and progesterone) production and there is possibility of having signs and symptoms of menopause. The possibility of menopausal symptoms is high, because hormonal deficiency occurs abruptly, unlike natural process of menopause, where hormonal deficiency occurs gradually over several years.
- Chemotherapy and radiotherapy: cancer chemotherapy and radiotherapy near abdomen (especially if it is close to ovaries) can cause menopause. However, stoppage of menstruation due to chemotherapy and radiotherapy may be temporary and menstruation may start after stopping treatment. Hence, contraception is desirable during this time to avoid pregnancy.
- Primary ovarian insufficiency: as many as 1% of women may develop premature menopause, i.e. menopause before age of 40 years. This may be due to failure to produce adequate hormones (estrogen and progesterone), due to autoimmune disease, genetic problem etc. These women with premature menopause benefit well with hormone replacement therapy.
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