When Will It Happen?
Predicting when you will go through your menopause is definitely not an exact science. According to the North American Menopause Society (NAMS), the average age of natural menopause in the Western world is fifty-one. This of course is only an average, and women may experience menopause when they are as young as thirty, or well into their sixties. The good news about menopause is that the end of childbearing can mean the beginning of other sorts of productivity. With more leisure time, older, independent children, and a perspective broadened by experience, women can begin to engage in satisfying activities that they have either abandoned with the onset of responsibilities, or never been able to explore. Since most American women born after 1950 can expect to live until their mid-eighties, the majority of menopausal women in the United States today have one-half to one-third of their lives to live after they've gone through menopause. Many factors determine your age at menopause, including which type of menopause you experience.
As its name implies, natural menopause refers to the natural process of ceasing to menstruate. It occurs as your ovaries stop producing hormones, and usually occurs between the ages of forty-eight and fifty-five, with the average at about fifty-one and a half years.
Induced menopause occurs when a woman has her ovaries surgically removed (with or without a total hysterectomy) or when ovaries stop functioning as a result of chemotherapy, radiation, drug therapy, other medical treatments. Because induced menopause is the result unexpected physical conditions or deliberate health decisions such surgery or chemotherapy, it can happen at any age.
Whenever induced menopause is a possible side effect of medical care, it should be discussed with your medical provider so that you can prepare yourself for the sudden change in hormone levels. Because the onset of induced menopause is so abrupt, there is no gradual adjustment period to prepare for postmenopausal changes. Women who have had both ovaries surgically removed, for example, may experience dramatic, abrupt menopausal symptoms.
Having a hysterectomy doesn't mean you'll go through menopause. If your uterus is removed but your ovaries remain, your body will continue to produce hormones. In this case, you don't experience menopause as a result of your surgery, even though you won't have monthly menstrual bleeding. On the other hand, women who have a surgical menopause (ovaries removed) have a more sudden hormone change and don't have the same time to adjust to the changes. Their symptoms may be more dramatic!
Surgical removal of the uterus alone will not cause menopause as long as the ovaries remain in place and are not damaged by the surgery. What does disappear, however, is the visible signal that you are going through menopause — changes in your monthly cycle. While you stop bleeding each month — often a welcome effect of surgery — you may not realize that your perimenopause is underway.
Chemotherapy, the use of drugs to treat cancer, may not result in immediate menopause, but it can damage the ovaries. Depending upon the types of drugs your treatment involves, your ovaries might recover and function normally some time after treatment ends. In some cases, chemotherapy damages ovaries so severely that they cannot produce adequate amounts of hormones. In those cases, menopause may occur months or even years after the therapy has ended. Doctors can't always predict whether damaged ovaries will recover.
Pelvic radiation therapy can cause permanent ovarian failure (and therefore, premature menopause) when the ovaries are the target of high doses of radiation, for example, as treatment for cervical cancer. Since radiation therapy is a tightly targeted therapy, it often has no effect on ovarian function. If ovaries receive only low doses of radiation, they're likely to fully recover their functions.
Other Factors Influencing the Timing of Menopause
There are some factors that may influence the timing of your menopause. Often women will go through menopause at the same age as their mothers or sisters do, suggesting a genetic link to the timing. If you are overweight or have had more than one pregnancy, you may experience menopause a bit later than you would have otherwise. On the other hand, if you have never had a baby, if you have cardiac disease, or if you were treated for certain types of childhood cancer, you may have your menopause earlier. And if you are a smoker, you may experience menopause as much as two years earlier than if you hadn't smoked at all.