Every woman who lives long enough will experience menopause. It’s a universal part of life. Yet every woman’s journey is unique. Some women will be catapulted into menopause by surgery or medical treatment. Other women will experience a long, slow procession to their last periods. Many women, regardless of how it happens, say they feel unprepared and caught off guard by the physical and mental changes brought about by the transition.
There’s so much we don’t talk about when it comes to women’s bodies — and a lot of misinformation. Consider this a primer for the four types of menopause, all of which different women experience in different ways.
Surgical or medical menopause
Surgical menopause, or induced menopause, is the result of a medical treatment, such as the removal of both ovaries, before a natural transition occurs. Cancer treatments such as radiation and chemotherapy can also cause menopause.
With surgical menopause, there is no transition period. When a premenopausal woman has surgery to remove her ovaries, she is menopausal that day. However, menopause is rarely a sudden response to radiation or chemotherapy. It can take weeks or months after treatment starts for symptoms to appear and periods to stop. Symptoms may last for years after treatment is completed, and periods may or may not return.
Hot flashes, night sweats, vaginal dryness, and mood swings are often more severe with surgical or medical menopause.
Premature menopause is defined as ovarian failure before the age of 40. It’s incredibly uncommon — affecting only 1 percent of women — but it happens.
Primary ovarian insufficiency (POI) can be confused with premature menopause. However, with POI, the ovaries may begin functioning again, and it’s even possible to become pregnant with POI. In most cases, the cause of POI is unknown, but family history, genes, certain diseases, cancer treatments, and age can factor into a woman’s risk for the condition.
Perimenopause is the transition leading up to menopause, and it can last for years. The average age of menopause in the United States is 52. Perimenopause usually starts in the mid to late 40s and lasts four years on average.
During this time, the ovaries produce lower amounts of estrogen and progesterone than in peak child-bearing years. Periods become irregular (longer, shorter, heavier, lighter, less frequent). Some perimenopausal women sail right through this transition, but most have hot flashes, night sweats, sleeplessness, vaginal dryness, and other disruptive symptoms.
Once a woman has gone a full year without a period, she’s postmenopause, but that doesn’t necessarily mean that symptoms stop abruptly. More likely, they fade away gradually, just like they started. Some women continue to have hot flashes and vaginal dryness for years after their last periods. The symptoms do eventually subside, however, as the body adjusts to lower hormone levels.
No matter how you get to menopause, once you’re there, you have low levels of female hormones, which raises the risk for health problems, including heart disease, stroke osteoporosis, incontinence, and dental cavities, according to the U.S. Department of Health & Human Services Office on Women’s Health. Talk to your doctor about all of your concerns.
Photo: Alina Rosanova