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Causes

By Mayo Clinic staff

Menopause can result from:

  • 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 — your ovaries stop producing eggs, and you have no more periods.
  • Hysterectomy. A hysterectomy that removes your uterus but not your ovaries (partial hysterectomy) usually doesn't cause 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.
Complications Symptoms
References
  1. Menopause. National Institute on Aging. http://www.nia.nih.gov/HealthInformation/Publications/menopause.htm. Accessed Dec. 7, 2012.
  2. Innes KE, et al. Mind-body therapies for menopausal symptoms: A systematic review. Maturitas. 2010;66:135.
  3. 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 Dec. 6, 2012.
  4. Nelson LM, et al. Clinical manifestation and evaluation of spontaneous primary ovarian insufficiency (premature ovarian failure). http://www.uptodate.com/index. Accessed Jan. 1, 2013.
  5. Menopausal symptoms and complementary health practices. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/menopause/menopausesymptoms#hed2/. Accessed Dec. 7, 2012.
  6. Lindh-Astrand L, et al. Effects of applied relaxation on vasomotor symptoms in postmenopausal women: A randomized controlled trial. Menopause. 2012;20:1.
  7. 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.
  8. Warnecke E. What works? Evidence for lifestyle and nonprescription therapies in menopause. Australian Family Physician. 2011;40:286.
  9. Kelley KW, et al. Evaluating the evidence for over-the-counter alternatives for relief of hot flashes in menopausal women. Journal of the American Pharmacists Association. 2010;50:e106.
  10. 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 Dec. 7, 2012.
  11. The North American Menopause Society. The 2012 hormone therapy position statement of The North American Menopause Society. Menopause. 2012;19:257.
  12. MenoNote: Vaginal dryness. The North American Menopause Society. http://www.menopause.org/publications/educational-materials-for-women/menonotes. Accessed Oct. 31, 2012.
  13. Welt CK, et al. Pathogenesis and causes of spontaneous primary ovarian insufficiency (premature ovarian failure). http://www.uptodate.com/ index. Accessed Jan. 1, 2013.
  14. Welt CK, et al. Ovarian development and failure (menopause) in normal women. http://www.uptodate.com/ index. Accessed Jan. 1, 2013.
  15. Marnach ML (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 7, 2013.
  16. Faubion SS (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 11, 2013.
  17. Dickson GM. Menopause management: How you can do better. The Journal of Family Practice. 2012;61:138.
  18. 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 Jan. 11, 2013.
DS00119 Jan. 24, 2013

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