Premature Menopause

Premature menopause often widens the stare of women whenever I discussed this topic with them.

Menopause is troublesome enough and early menopause obviously triggers some concerns among women.

I will discuss the definition, causes, symptoms and treatments of this condition.

What Is Premature Menopause?

In the U.S., the average age of onset for “natural” menopause is 51.
When menopause occurs in a woman younger than 40 years, it is considered
to be early or premature. It affects about 1 % of the general
population.

It is also called Premature Ovarian Failure (POF).
Note that it is not normal or natural menopause. It is an early loss of
the functions of the ovaries which are the production of hormones and
ova.

Causes

Why should the ovaries stop functioning before the expected time?
There are many causes that may lead to this loss of function. However,
what is common amongst these causes is the destruction of the ovaries.

Common causes include

• Idiopathic: This means no cause is identified.
• Autoimmune disorders: only mature follicles are destroyed. others are left. hypothyroidism, Graves’ disease, or lupus.
• Genetic abnormalities: Turner and Fragile X syndromes
• Surgery:
  Removal of the ovaries. Removal of the uterus called “hysterectomy”
  does not usually cause immediate menopause though it brings natural
  menopause earlier than expected.
• Radiation of the pelvic treatment for the treatment of cancer.
• Chemotherapy usually destroys all the follicles of the ovaries.
• Endometriosis: Endometrial tissue in the ovaries in this case.
• Infection with subsequent destruction of the ovaries.

Signs Of Early Menopause

The age of onset can be as early as the teenage years but varies widely depending on the cause.

The
signs of early menopause are often the same as those experienced by
women undergoing natural menopause and may include irregular or heavy
periods and hot flashes. They are usually more severe than those of
natural menopause.

There may be also the symptoms associated with
the underlying cause. Therefore not all the symptoms are associated with
the early menopause.

Diagnosis Of Premature Menopause

The diagnosis of early menopause has to be made by the physician.
Usually, this involves a clinical examination and some few lab tests.

The
most important lab test used for the diagnosis of both menopause and
early menopause is the blood levels of Follicle Stimulating Hormone(
FSH). It is produced by the pituitary gland of the brain and causes the
ovaries to produce estrogen.

Menopause causes low levels of
estrogen and the FSH therefore increases in order to help increase the
estrogen levels back to normal.This high levels of FSH is what is
diagnostic of Menopause.

When should I think of the possibility of premature menopause?

• I
  usually do not advice women to be fast in thinking of early menopause
  quite early. This may create unnecessary distress. It is a diagnosis
  made by your physician after the common illness have be considered
  first. Common things first.
• Its diagnosis often
  comes up during evaluation of infertility or associated finding of low
  estrogen in the blood. A first degree relative (mother or sister)
  diagnosed with this abnormality increases the chances of its occurrence.

Treatment

The treatment of early menopause follows three basic principles.

1. Treatment of the underlying condition if any, such as Grave’s disease.
2. Management of the symptoms of menopause with similar measures as natural menopause treatments.
3. Handling
   fertility issues which are a common concern amongst this group. This is
   usually a difficult problem to handle and the doctor will inform you of
   the options available.

Can Premature Menopause Be Reversed?

Unfortunately, this condition is very unlikely to be reversed once it has been initiated.

Fertility Issues

This is a major issue amongst most women with early menopause. Though
it is a difficult issue to handle, 5 to 10% of women may become
pregnant spontaneously without any specific treatment.

Furthermore, there is no approved treatment to increase fertility at the moment for these women.

Complications

Early menopause has an additional health risk that it brings.
Remember, it is a “risk” and not all of them are “written on stone”,
that is, must occur in all women.

• Infertility: Most women will experience this.
• Natural menopause complications such as increased heart disease and osteoporosis.
• Increased risk of other autoimmune diseases such as thyroid and adrenal gland disorders.
• Shorter years of menstruation and longer years of postmenopause may mean less protective effects of female hormones against some gynecological cancers.

Return From Premature Menopause To Menopause and Menstruation

Return From Premature Menopause to Menopause to Menstruation

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