Radiation-Induced Menopause: Everything You Should Know

Written by Rachel Reiff Ellis
Medically Reviewed by Traci C. Johnson, MD on March 05, 2025
7 min read

Radiation-induced menopause is when treatment with radiation to your pelvic area makes your periods stop. Depending on your age, where you have radiation, and the dose of radiation, this can be a temporary change or a permanent one.

Menopause happens when your ovaries stop producing eggs and your estrogen levels go down. When you’re in menopause, you no longer have your period. Menopause is typically a gradual process. In fact, doctors usually diagnose people with menopause after they haven’t had a period (or any bleeding or spotting) for 12 months in a row.

But when you have radiation treatment on your pelvic area, it can induce menopause (make menopause happen) right away. 

If you’re younger than 40 years old when this happens, it’s called premature ovarian insufficiency (POI). Between the ages of 40 and 45, it’s called early menopause.

Radiation uses high-energy particles or waves to destroy or damage cancer cells by making breaks in their DNA. This helps kill fast-growing cancer cells. 

Nearby normal cells also feel the effects of radiation, but sometimes they heal from this damage and go back to working the way they should. 

When you’re born, your ovaries have about a million immature eggs called primordial follicles. Over your lifetime, this number goes down. At the age of typical menopause, most people have around 1,000 eggs left. 

When cells in your ovaries are hit with radiation, it’s toxic to them. The immature eggs often can’t mature after radiation treatment. If the damage to your ovaries is temporary and your period comes back, it doesn’t necessarily mean you can get pregnant. The damage to your eggs may be too severe, or you may have too few left to have a chance at successful fertilization.

Who might have radiation-induced menopause?

You might have radiation-induced menopause if you have to get radiation. It’s often used as a treatment for cancer. Radiation can also treat noncancerous tumors, certain blood and blood vessel disorders, as well as some nerve disorders. 

You may need radiation to your pelvic area if you have:

  • Lower gastrointestinal tract cancers such as colon cancer, rectal cancer, or anal cancer 
  • Cervical cancer
  • Ovarian cancer 
  • Uterine cancer

Radiation-induced menopause risk factors

You’re more likely to deal with radiation-induced menopause if you’re older and have fewer eggs. The location of your radiation treatment makes a difference in your risk, too. Both internal radiation (a radioactive implant) and external radiation (a beam of radiation pointed at the area) increase your risk of menopause. 

When radiation causes menopause, it can lead to a variety of symptoms because the ovaries stop working abruptly, says Sandra Naaman, MD, PhD, medical director of cancer survivorship and endo-oncology at RUSH MD Anderson Cancer Center.

“These symptoms are similar to those of natural menopause but can be more intense due to the sudden onset,” she says.

Your hormone levels shift suddenly, causing symptoms such as:

  • Hot flashes and night sweats, which are known collectively as vasomotor symptoms
  • Vaginal dryness
  • Disruption of sleep or trouble sleeping
  • Low mood or depression
  • Anxiety
  • Mood swings
  • Loss of confidence and self-esteem
  • Tiredness
  • Thinning bones
  • Loss of interest in sex
  • Pain during sex
  • Having to pee more often or more urgently
  • Issues with memory and concentration
  • Weight gain

“Many people experience weight gain, particularly around the abdomen, and these are often linked to changes in metabolism and body composition,” Naaman says.

Menopause affects your fertility, too. If you’re in menopause, you can no longer become pregnant. In some cases, ovaries heal after radiation and your period starts again. But your fertility still may not return because of damage to the eggs.

If you’re facing radiation treatments and want to preserve or hold on to the chance of becoming pregnant in the future, ask your doctor if you’d be a candidate for egg or embryo freezing. If you can remove your eggs before radiation, they can avoid damage.

In some cases, your doctor may be able to move your ovaries out of the treatment area before radiation. This procedure is called ovarian transposition. A surgeon does it laparoscopically, which means they make a tiny cut and use a camera to see inside your body to remove the ovaries. Ovarian transposition may prevent an early menopause.

Prevention isn’t always possible. If you move into menopause because of your radiation treatment, there are some treatments that can help reduce your symptoms.

“The American Cancer Society and the American Society of Clinical Oncology suggest non-hormonal treatments, especially for women with hormone-sensitive cancers,” Naaman says. 

These treatments include medications like SSRIs, SNRIs, and gabapentin. Certain lifestyle changes can also support symptom relief. 

Medications to help radiation-induced menopause

You may need prescription medication to help reduce the symptoms that may come with radiation-induced menopause. Ask your doctor about medications to help treat: 

Sleep issues. Gabapentin is an anti-seizure medication that slows down abnormal excitement in the brain and may help you get more and better sleep. It can also help reduce night sweats and hot flashes that disrupt restful slumber.

Hot flashes. There are two FDA-approved medications for hot flashes that don't use hormones, including Paroxetine (Brisdelle) (in a low dose) and fezolinetant (Veozah). Other antidepressants such as citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil, Pexeva), and venlafaxine (Effexor XR), are also used as treatment to help reduce hot flashes without using estrogen. Gabapentin and pregabalin, another type of anti-seizure medication, can also help some people with hot flashes. 

Painful sex. Ospemifene is a medication used to treat vaginal dryness and pain during intercourse, particularly in postmenopausal women. It works as a selective estrogen receptor modulator (SERM), meaning it acts like estrogen in certain tissues (such as the vaginal lining) to help relieve dryness and discomfort, without the systemic effects of estrogen.

“[Ospemifene] is often used when other treatments, like lubricants or moisturizers, aren’t enough to manage symptoms of vaginal atrophy,” Naaman says. “Ospemifene is typically prescribed for women who can't use estrogen therapies, such as those with a history of breast cancer, but it should always be prescribed and managed by a health care provider and only after consulting with your oncologist first.”

Lifestyle changes to help radiation-induced menopause

When you pay attention to certain things and build certain habits into your day, you can make a difference in some of the effects of menopause. 

  • Keep cool by drinking lots of water and dressing in loose layers you can take off when you get warm. 
  • Avoid hot flash triggers such as spicy foods, caffeine, alcohol, and cigarette smoke.
  • Exercise regularly.
  • Practice stress-lowering techniques such as meditation, deep breathing, massage, or yoga.
  • Try a water-based lubricant during sex to make it more comfortable.
  • Do Kegel exercises to strengthen your pelvic floor muscles.
  • Keep good sleep hygiene, such as going to bed and waking up at the same time every day, making your bedroom cool, dark, and free of distractions, and avoiding screen use an hour before bed.

Cognitive behavioral therapy (CBT) is a therapy method that can help change behavior patterns linked to mood and sleep problems.

Radiation-induced menopause happens when radiation treatment to the pelvic area causes the ovaries to stop functioning, leading to menopause either temporarily or permanently. The risk depends on things like age, radiation dose, and location. Symptoms can be intense due to the sudden loss of estrogen and may include hot flashes, mood swings, vaginal dryness, sleep disturbances, and bone thinning. Treatment options include non-hormonal medications like SSRIs and SNRIs and lifestyle changes such as exercise, stress management, and dietary adjustments. 

Is radiation-induced menopause permanent?

Sometimes radiation-induced menopause is temporary, and your period will return some time after treatment is over. Whether your radiation-induced menopause is temporary or permanent depends on things like your age, the dose of your radiation, and where your radiation area is.

What does radiation-induced menopause feel like?

The symptoms of radiation-induced menopause and natural menopause are the same and can include hot flashes, night sweats, vaginal dryness, mood swings, trouble sleeping, and more. 

Is chemo-induced menopause worse than typical menopause?

Symptoms of radiation-induced menopause may be more intense than symptoms of natural menopause because the shift in hormones happens suddenly. 

Can your ovaries start working again?

With smaller doses of radiation, your ovaries may heal after treatment ends. You may get your period again, but your fertility may still be impacted.

Is radiation-induced menopause or premature menopause a disability?

Radiation-induced menopause comes on suddenly, and the side effects can be more severe than those of natural menopause. The Americans with Disabilities Act defines an impairment as any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more body systems, including the reproductive system. This may qualify radiation-induced menopause as a disability under the ADA.