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Medically induced menopause reference list

Source : Health Direct Australian govt: 
Early menopause 
You may get early (or premature) menopause. This is when menopause happens before the age of 45 years. It can occur due to: 
Source: Breast Cancer UK Registered charity: 
 Medically induced menopause is caused by medical necessity as opposed to the natural ageing process. 
Medical menopause 
Medical menopause, or medically-induced menopause, happens when the ovaries: 
are surgically removed — called surgical menopause 
are shut down with medicine, such as Lupron (chemical name: leuprolide) or Zoladex (chemical name: goserelin) — called medical menopause 
stop working because of chemotherapy, hormonal therapy, or another type of treatment for a medical condition 
  
Source: Cedars SInai US hospital : 
 https://www.cedars-sinai.org/blog/how-to-manage-medical-menopause.html#  
What Is Medical Menopause? 
Medical menopause happens when treatments such as radiation, chemotherapy or surgery temporarily or permanently shut down the ovaries, which then cuts off production of estrogen and other hormones.  
   
Source: Health Direct Australian govt 
https://www.healthdirect.gov.au/early-menopause  
Early menopause is when menopause happens between 40 to 45 years. 
 Premature menopause is when menopause happens before 40 years. 
  
Source: Australasian Menopause Society 
Menopause in women younger than 40 years of age is called premature menopause. If this happens spontaneously it is called premature ovarian failure. Premature ovarian failure affects about 1 in a 100 women. Around 8 per 100 women have premature menopause due to other causes such as chemotherapy or surgery. Menopause occurring between 40-45 years of age is called early menopause, affecting approximately 5% of women. Menopause can occur spontaneously or can be a result of chemotherapy (See AMS information sheet:- Early Menopause Due to Chemotherapy) or ovarian surgery.  
  
Source: Medline Plus, US National Library of Medicine 
 https://medlineplus.gov/primaryovarianinsufficiency.html 
  With POI, some women still have occasional periods. They may even get pregnant. In most cases of POI, the cause is unknown.  
  
Source: Daisy Network Registered UK charity 
 https://www.daisynetwork.org/about-poi/what-is-poi/ 
POI is different to menopause that occurs at around the average age (52 years). Not only does it occur at a very young age, but the ovaries often don’t completely fail. This means that ovarian function can fluctuate over time, occasionally resulting in a period, ovulation or even pregnancy, several years after diagnosis. Because of this intermittent temporary return of ovarian function, approximately 5-10% of women with POI may still conceive.  
 
Source: Jean Hailes for Women’s Health 
Premature menopause is when your final period happens before the age of 40 years. Early menopause is when your final period happens between the ages of 40 and 45. 
Up to 8% of women have had their final period by the time they are 45. This percentage is likely to be higher if we include menopause caused by surgery and cancer treatment. 
Premature ovarian insufficiency (POI) 
Premature ovarian insufficiency (POI) can cause premature and early menopause. 
POI is when your periods stop suddenly at an earlier than expected age. 
The causes of POI are not always clear. In about 60% of women, a cause cannot be found. 
The first symptoms of POI may be: 
  • irregular periods
  • no periods after stopping the oral contraceptive pill
  • inability to get pregnant. 
After POI is diagnosed, your doctor may ask you to do more tests to check for possible causes and associated conditions. 
POI and fertility 
If you have been diagnosed with POI and do not want to become pregnant, you should use contraception. Many women are unable to conceive a baby naturally after POI; however, there is a one in 50 chance of a spontaneous pregnancy. 
  
Medical menopause 
Medically induced menopause includes menopause that is caused by medical treatment for cancer and other diseases or disorders. This can include surgery to remove ovaries, hormone therapy and therapies such as chemotherapy and radiation. 
  
Source: Cancer Council Victoria 
Reducing chemo-induced early menopause 
 
Source: Australasian Menopause Society 
Surgical removal of both ovaries (bilateral oophorectomy) before the average age of natural menopause is referred to as surgical menopause.  

Source: Australasian Menopause Society 
Women with iatrogenic menopause includes women with benign disease and those having treatment for cancer (hormonal, chemotherapy and/or radiotherapy) which has brought about an early menopause. In most women the cause of an early menopause is unknown. 

Source: University of Melbourne Medical School 
For individuals with iatrogenic early menopause or premature ovarian insufficiency, the change in circulating sex steroid concentrations occurs suddenly, and often in the context of treatment burden (eg, from chemotherapy) for a recent disease diagnosis, such as breast cancer. Some studies of women with iatrogenic premature ovarian insufficiency report low social support,49 moderate-to-severe emotional distress,50 and high rates of depression.51  
 
Source: British Menopause Society 
https://thebms.org.uk/wp-content/uploads/2024/10/13-BMS-TfC-Surgical-Menopause-SEPT2024-D.pdf 
 Symptoms of surgical menopause are generally similar to that of a natural or chemically induced menopause, with a few established differences 

Source: HealthTalk Australia, charity  
Finding out about medically-induced early menopause 
Early menopause (EM) can be caused by medical treatment, including chemotherapy, radiotherapy, bone marrow/stem cell transplants, or surgical removal of both ovaries (bilateral oophorectomy). In some cases, surgical removal of the uterus (without removing the ovaries) or ovarian surgery (for example to remove cysts) can lead to EM.  
 
Source: Canadian Cancer Society 
Treatment-induced menopause can be caused by: 
  • surgery to remove both ovaries 
  • chemotherapy 
  • radiation therapy to the pelvis 
hormone suppressive therapy 

Source: Leukaemia Care UK registered charity 
Some cancer treatments can affect the way the ovaries work, and this can cause an early menopause for some women. This is called treatment-induced menopause. 
  • Treatment-induced menopause can be caused by: 
  • Surgical removal of both ovaries 
  • Chemotherapy 
  • Radiotherapy to the pelvis 
  • Hormonal therapy 
Source: Taylor and Francis online: Women & Therapy Volume 29, 2006 - Issue 1-2 
Most premenopausal women diagnosed with breast cancer receive adjuvant chemotherapy or tamoxifen. These treatments help to prevent the recurrence of breast cancer but have potentially permanent menopausal side-effects, termed chemically-induced menopause (CIM).  
 
Source: Stella, consumer menopause app/website 
Surgical menopause is when you have your ovaries removed, either due to cancer or to prevent ovarian cancer. Removing both ovaries leads to permanent and immediate menopause 
Medically induced menopause 
  • Medically induced menopause is an umbrella term that includes surgical menopause as well as menopause due to medication, such as chemotherapy, stopping your ovaries from functioning. Sometimes it is permanent, and sometimes it is not. 
Source: Balance menopause consumer app/website 
What is a chemical menopause? 
You may be familiar with the term surgical menopause – where an operation such as a hysterectomy or bilateral oophorectomy (removal of ovaries) induces menopause. A chemical menopause is another type of induced menopause caused by certain medications, including hormone blockers (it can also be known as a medical menopause). 
Chemical Menopause 
Menopause can be induced “temporarily” using hormone blockers – usually as part of treatment for other gynaecological issues like endometriosis or PMDD. These drugs block the release of chemicals from the brain that tell the ovaries to prepare an egg for release. We also commonly use these drugs in women undergoing treatment for breast cancer if the cancer was hormone receptor positive. 
  
Source: US National Cancer Institute (govt) 
Chemotherapy (especially with drugs called alkylating agents) can affect the ovaries, causing them to stop releasing mature eggs and producing estrogen. This consequence of chemotherapy is called primary ovarian insufficiency (also called premature ovarian failure). Sometimes it’s temporary and your menstrual periods and fertility return after treatment. Other times, damage to your ovaries is permanent and you may experience premature menopause. Symptoms may include hot flashes, night sweats, irritability, vaginal dryness, and irregular or no mens