Premature Menopause - Symptoms, Risks, Diagnosis and Treatment

What Is Premature Menopause?

The normal age of onset for menopause is 51. But, still, due to genetics, illness, or medical procedures, some women may go through menopause before the age of 40. Menopause that occurs before this age, either natural or induced, is known as premature menopause.

Premature menopause and early menopause are the conditions where a woman goes through menopause earlier than is expected. Both conditions can occur in women being unable to become pregnant. When there is no apparent medical or surgical cause for premature menopause, it is called primary ovarian insufficiency (POI).

Both premature menopause and early menopause can have the exact causes, but the only difference is at which age it occurs. Menopause that happens before the age of 45 is called early menopause, and menopause that occurs before the age of 40 is called premature menopause.

Who Is More Likely to Get Premature Menopause?

Premature menopause can be caused in women due to a medical condition, any treatment, or it may be due to an unknown cause. But, the possible factors that can cause premature menopause include:

• Surgical removal of the ovaries, called a bilateral oophorectomy, can cause menopausal symptoms, and the periods will stop soon after this surgery. The hormonal levels will also drop quickly. These women may have strong menopausal symptoms, like hot flashes and less sexual desire.

• Women who smoke go through menopause as much as two years before nonsmokers.

• If surgical removal of the uterus (hysterectomy) happens, women who underwent hysterectomy will no longer have periods and cannot get pregnant. But she will probably not go through menopause right away because her ovaries will continue to make hormones. Later she might have natural menopause a year or two earlier than expected.

• Infections like mumps.

• Women having a family history of menopause at an early age are more likely to have early or premature menopause.

• Side effects of chemotherapy or pelvic radiation treatment for cancer can damage the ovaries and cause the periods to stop forever or just for a while. These women may also have trouble getting pregnant or not be able to get pregnant in the future. Not all women undergoing chemotherapy or radiation will go through menopause. It is very rare for a younger woman to go through menopause.

• Having certain medical conditions, like:

1. Chromosomal abnormalities (Fragile X and Turner’s syndrome).

2. Infections like mumps are the commonest infection that is associated with premature menopause. Its effect is maximum during the fetal and pubertal periods. Pelvic tuberculosis infection can also cause secondary amenorrhea and ovarian failure.

3. Autoimmune diseases like rheumatoid arthritis, thyroid disease, and inflammatory bowel disease can cause premature menopause. The body’s immune system, which usually fights diseases, can sometimes wrongly attack the ovaries and keep them from making hormones.

4. HIV (human immunodeficiency virus).

5. AIDS (acquired immunodeficiency syndrome).

6. Women being born with missing chromosomes or problems with chromosomes can go through menopause at an earlier age.

7. Women with myalgic encephalomyelitis or chronic fatigue syndrome may have extreme tiredness, weakness, unrefreshing sleep, memory loss, muscle and joint pain, headache, and other symptoms. Women with these syndromes are more likely to have early or premature menopause.

What Can Be the Symptoms of Women With Premature Menopause?

The symptoms of women with premature menopause may include:

• Hot flashes.

• Headaches.

• Night sweats or cold flashes.

• Vaginal dryness.

• Discomfort during sex.

• Changes in libido (sex drive).

• Hair loss or thinning.

• Breast tenderness.

• Weight gain.

• Dry skin, dry eyes, or dry mouth.

• Urinary urgency.

• More urinary tract infections.

• Difficulty sleeping (insomnia).

• Emotional changes like irritability, mild depression, mood swings, and worsening anxiety.

• Racing heart.

• Joint and muscle aches and pains.

• Difficulty concentrating and memory lapses (often temporary).

How Is Premature Menopause Diagnosed?

Women having the symptoms of menopause before the age of 40 should approach their healthcare provider. They may be asked to do several tests and ask questions to help diagnose premature or early menopause. The tests can include:

• How regular will you get your periods?

• Do you have a family history of menopause at an early age?

The healthcare provider will check the levels of the hormones like estrogen, follicle-stimulating hormone (FSH), and gonadotrophin and will also look for other possible medical conditions that may be contributing to the symptoms.

How Can Premature Menopause Be Treated?

The symptoms, health risks, and emotional issues of premature menopause can be managed in a similar method used for natural menopause. But there is no such treatment that can reverse or prevent premature menopause. Management of the condition also varies depending on the cause of premature menopause. Hormone therapy can be given to help relieve the symptoms of premature menopause. Depending on the health conditions associated with early menopause, hormone replacement therapy (HRT) is regularly recommended for all women with premature menopause unless there is a compelling reason it cannot be used. But, still, there is a lot of confusion about the safety of hormone therapies.

What Are the Health Risks of Premature Menopause?

Loss of estrogen at a younger age may be associated with increased risks of various medical problems like:

• An earlier death.

• Sexual dysfunction.

• Various neurological diseases.

• Women having premature menopause have higher risks of getting severe health problems, like heart disease and osteoporosis. Women can talk to their doctor or nurse about the steps to lower their risks for these health problems.

• Women will have severe menopause symptoms.

• Mood disorders like sadness or depression over the early loss of fertility or changes in their bodies can occur. Women can talk to their doctor if they have symptoms of depression, like less energy or a lack of interest. Doctors or nurses can suggest specialists who can help them to deal with their feelings.

Can Women With Premature Menopause Still Get Pregnant?

Women with primary ovarian insufficiency (POI) can have intermittent ovulation, which may or may not have a menstrual bleed. Other women who do not ovulate can get pregnant through in vitro fertilization with egg donation. Therefore, it is very important to work with a fertility specialist to explore options.

If a woman wants to have children in the future, in a few cases, fertility may be restored, and pregnancy can be made possible. Techniques like assisted reproductive technology (ART), along with in vitro fertilization (IVF), might be considered. If women do not want to get pregnant while under hormone-replacement therapy, they can get advice from their doctor about contraceptive options.

Conclusion:

Premature menopause is unfortunate for many women before they are ready, and it is not a rare condition. It can lead to many risks and complications, but treatments are available to manage them. The public must be made aware of such situations, and improved techniques can even help the affected women mother a baby if needed. Talk to your doctor to handle them effectively. You can also consult an online specialist regarding your health issues.