An artificial menopause can also be caused by chemotherapy, the drug treatment used against many types of cancer. Chemotherapy directed at any part of the body prior to menopause may result in a chemical menopause, but regrettably many women are not warned about this possibility. Marcia was upset to learn while having chemotherapy for leukaemia that her ovaries would no longer function after the treatment. ‘It was the last thing on my mind at the time I started chemotherapy, and the hot flushes I experienced some weeks later came as a most unpleasant surprise,’ she recalled. ‘Fortunately I have three children and wasn’t intending to have any more. However, I would have appreciated being told earlier about this effect of chemotherapy.’ Menopause may also be caused by radiotherapy to the ovaries, when x-ray treatment is given for a cancer in the pelvis.
Early natural menopause in the absence of any medical intervention is more likely in women who smoke (smokers experience menopause one to two years earlier, on average, than non-smokers and ex-smokers, the reason being that smoking reduces the availability of oestrogen to body tissues). Later menopause is more likely in woman with many children, and women who are heavier than average. Genetic and nutritional factors also seem to play a part: the menopause for Asian women apparently occurs earlier than for those with northern European backgrounds.
Sometimes none of these reasons accounts for spontaneous premature menopause, which on rare occasions can be found in women in their thirties or, even more rarely, in their teens or twenties. Studies suggest that the egg supply of most of these women has run out, but it is not clear whether this is due to a shortage of eggs at birth or, as is more likely, some unknown factor.
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