Understanding Premature Menopause

By  , Jagran Cityplus
Feb 04, 2011

Premature MenopauseLike every woman would know, there is a stage in the second half of her life that sirens the end of her reproductive life - the menopause. After those bubbly teen years and a long spell of rewarding childbearing years, menopause (when a woman no longer has her monthly period) comes as a natural event, prompting her to shift gears and adapt to physical and emotional changes of her life.


The average age for menopause is in the late 40's or early 50's.  The word menopause refers to the last menstrual bleed. The term premature menopause (premature ovarian failure) is defined as the occurrence of menopause before the age of 40. Many in the age group of mid 40s and below would believe that they are still much too young to have anything to do with the watchword. The truth, however, is that about 1-3% of women will experience menopause before the age 40 years. Premature ovarian failure accounts for about 10% of amenorrhoea (no periods) and 1% of all cases of infertility.


Causes of premature menopause


In the majority of cases no cause can be found. However, some of the known causes include:

  • Congenital, if the ovaries failed to develop and are absent from birth.
  • Chromosomal abnormalities, such as Turner's syndrome, where the ovaries contain only a few or no eggs.
  • Genetic, as some women's ovaries run out of eggs long before their middle age. The incidence of familial premature ovarian failure (POF) varies from 4% to 30%.
  • Ovarian antibodies, where antibodies act against the ovaries.
  • The ovaries are physically damaged by infections, such as the mumps, or by cancer treatment, such as radiotherapy or chemotherapy. This later group is increasing in number because of the longer survival of cancer patients due to advances in both diagnostic modalities and treatment available.
  • The ovaries were surgically removed because of cancer or other causes.

Whatever the cause may be, premature menopause has a huge impact on a woman's physical and emotional well-being. In addition to dealing with the typical anxiety, hot flushes and mood swings several years before the normal menopausal age, a woman with premature menopause often has to deal with a sense of dejection that she cannot bear children like her peers.


Clinically, premature menopause (or early menopause or premature ovarian failure) can be evaluated with the length of time without a period say, six months to 12 months, and hormone level tests at various stages of a woman's menstrual cycle. If the hormone level tests - for follicle stimulating hormone (FSH) and estradiol (the main circulating estrogen) show post-menopausal levels, then there is a possibility that a woman is experiencing premature menopause and her body is not responding to hormonal signals to ovulate adequately.


Changes in the menstrual cycle, irregular bleeding patterns, sleeplessness, mood swings, anxiety, slight depression, weight changes, sweat, hot flushes and urinary problems like incontinence become a common occurrence for women with premature menopause.


Unfortunately, there is no premeditated treatment available for premature menopause. That is, if a woman is diagnosed to have premature menopause, there is no treatment to help her ovaries start working again. Consequentially, she is at an increased risk of having post-menopause related diseases like osteoporosis and heart diseases because of her long post-menopausal life. Nevertheless, there is treatment in the form of Hormone Replacement Therapy (HRT) that would help her arrest the onset of osteoporosis or heart diseases. HRT is recommended for premature menopausal women at least till they reach a typical age of 50 years.


Psychologically, women with premature menopause are known to constantly fear the emotional prospect of getting older before time. This emotional impact could often be devastating.


Psychological counseling and support groups may help her a great deal in coming to terms with herself.



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