Early menopause and HRT

The menopause
The word 'menopause' refers to a woman's final menstrual period. It is also commonly used to describe the time during which a woman's body is changing in preparation for the menopause, otherwise known as 'the peri-menopause’ or 'the change of life'. Women usually go through the menopause between the ages of 45 and 55, but it can start at any age and occasionally be as late as 60 years of age. The changes leading up to your final period may last a few months or several years, and it’s unlikely that your periods will just suddenly stop [1]. Instead, some might be missed or late, and they might become heavier and more painful before stopping completely. A woman is classed as being postmenopausal when she has had no menstrual periods for 12 months.

During the menopause, the levels of key hormones (oestrogen and progesterone) needed for menstruation and pregnancy start to fall and in some women this triggers a variety of menopausal symptoms. These may last for a few months or several years. Your risk of osteoporosis (bone thinning) also increases when hormone levels drop during the menopause. There are treatments that can help and your doctor will be able to advise on which might be best for you.  

Going through the menopause means that you will no longer be able to have children naturally. However, there are now a number of options that you can discuss with your doctor that aim to preserve your fertility while you are being treated for cervical cancer. If you think you might want to have children in the future, you should speak to your doctor about the possibility of freezing your eggs, creating (through in vitro fertilisation) and freezing embryos and freezing your ovarian tissue. You should be given the opportunity to discuss how likely these are to work for you.

Cervical cancer and early menopause

Some treatments for cervical cancer can trigger the menopause. Pelvic radiotherapy, for example, affects the ovaries and this can sometimes bring on the menopause, usually about three months after the treatment starts. Furthermore, if both ovaries need to be removed during surgery, your body enters the menopause immediately after the operation. If one or both of your ovaries are left intact, it's possible that you will go into the menopause earlier then you otherwise might have. If these treatments cause you to enter the menopause before the age of 45 years, you are classed as being in 'early menopause'.

How is an early menopause different to a natural menopause?
During a natural menopause, your levels of oestrogen and progesterone fall gradually, menstrual periods become less frequent, and you may have mild or moderate menopausal symptoms that build up over time. If you enter early menopause because of treatment for cervical cancer, your hormones drop more quickly, your periods stop sooner and you will probably experience menopausal symptoms straight after treatment [2].

 
References
  1. The NHS, 2014. Menopause – Sypmtoms of the menopause. www.nhs.uk/Conditions/Menopause/Pages/Symptoms.aspx. Accessed: 06.11.2015.

  2. Hinds L et al., 2010. Menopause, hormone replacement and gynaecological cancers. Menopause International 16 (2), 89–93.

 
Date last updated: 
06 Nov 2015
Date due for review: 
06 Nov 2017

Have a question? Need to talk?

Our helpline is currently closed, find out when it’s next open.

Or submit your question via our Ask the Expert online service