Causes & Risk Factors
Causes of menopause can be divided by how your fertilize stopped
“Menopause sometimes may not from natural period”
1. Changes in Menstrual Periods
During the reproductive years, two hormones made by the ovaries—estrogen and progesterone—play important roles in a woman’s menstrual cycle. These hormones cause the lining of the uterus (or endometrium) to thicken and prepare to receive a fertilized egg. If a fertilized egg does not arrive in the uterus, the ovaries stop making these hormones, the uterine lining is shed, and a woman has her menstrual period. Each woman has a unique pattern to her periods.
As a woman reaches perimenopause, changes in both menstrual flow and frequency are common. A few women simply stop menstruating one day and never have another period. However, about 90% of women experience 4 to 8 years of menstrual cycle changes before they reach menopause and their periods permanently ends. Most report irregular periods. These are caused by erratic production of hormones by the ovaries and less frequent ovulation (release of an egg or ovum).
Initially, menstrual cycle changes can be subtle with a wide variety of possibilities. Usually a woman’s cycle gets shorter, with periods occurring more often than the usual 28 days. Bleeding may last fewer or more days, and blood flow may be heavier, lighter, or just spotting. Late in perimenopause, it is common to skip periods, and then resume a normal menstrual cycle again. Although any menstrual pattern is possible, each woman will know that a change has occurred. With early or premature menopause, whether spontaneous or induced, menstrual changes vary.
2. Early or Premature Menopause
Women who experience spontaneous menopause that is early or premature (before 40) go through perimenopause that can last for several years, with estrogen and progesterone hormone levels that initially fluctuate from high to low but eventually decline. Periods become irregular and then stop altogether when estrogen levels are consistently low. Some women also experience hot flashes and vaginal dryness. Sleep disturbances, mood changes, and decreasing sex drive are among the other symptoms reported during perimenopause.
These women will be at greater risk of developing osteoporosis (thinning of the bones) and heart disease later in life without the protective effect of oestrogen. Hence, it is important for these women to see their doctor to determine the cause and discuss hormone replacement therapy. Cigarette smokers generally experience menopause two years earlier than non-smokers.
3. Induce Menopause (Artificial Menopause)
Iatrogenic menopause refers to the experience of induced menopause because of the following reasons:
- Surgical – Induce Menopause. When the ovaries are removed during surgery, the decline in all hormone levels is much more abrupt than with premature spontaneous menopause or chemotherapy-induced menopause. Menstrual periods stop immediately and there is no perimenopause. Women often experience more intense hot flashes and other discomforts. These effects usually occur within days after surgery.
- Chemotherapy-Induced Menopause. The effects of chemotherapy on the ovaries usually occur over time rather than immediately. Women who experience chemotherapy-induced menopause do not go through a typical perimenopause but they may experience a period of slowly declining hormone levels. Menstrual periods may continue for a while, although they may be irregular. The more gradual the decline in hormone levels, the more gradual the occurrence of menopauserelated symptoms.
Some women experience very minor symptoms, others none at all. More dramatic changes in hormone levels, however, especially in younger women who have high hormone levels before treatment, can result in severe symptoms that occur quickly after treatment.
- Pelvic Radiation-Induced Menopause. Levels of estrogen often decline quickly and dramatically following pelvic radiation therapy. This can cause menopause-related symptoms such as hot flashes and vaginal dryness, which may be more severe than those experienced after chemotherapy. Women may also stop menstruating and, if so, menopause results. These changes usually occur within 3 to 6 months of treatment.
- Hysterectomy. A hysterectomy that removes your uterus, but not your ovaries, usually doesn’t cause menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone. But an operation 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.