For most women, menopause usually begins between the ages of 45 and 55, with a mean age of 51 years. This is an irreversible interruption of the period, making it impossible to produce new eggs.
Menopause occurs when a woman’s ovaries stop producing normal amounts of estrogen. About 10% of women have premature menopause when their period stops before the age of 45. This can occur on its own or as a symptom of an autoimmune disease e.g. of the thyroid gland or due to rheumatoid arthritis. It can also occur as a side effect of certain treatments. Surgical removal of both ovaries causes, of course, menopause.
If you are under 45 and have noticed that your period is becoming less frequent you should talk to a doctor. Compared to menopausal women near the age of 51, women with premature menopause spend most of their lives without the protective benefits of estrogen, which puts them at greater risk for health problems.
The cause of premature ovarian failure is often unknown but can occur in women whose relatives went through menopause at a very young age, in other words there may be hereditary reasons. One study showed that menopause can range in age from 40 to 60, with genes and mitochondrial function playing a role.
Generally, menopause starts earlier in those women who smoke (1-2 years earlier) and in those who have been exposed to toxic agents and radiation. Radiation therapy and chemotherapy can cause premature ovarian failure, which can be permanent or temporary. Nutrition can also play a role. In one study, women with the highest intakes of vitamin D and calcium had a 17% reduced risk of premature menopause .
What are the indications?
In early menopause, periods become more sparse or stop altogether. Some women may experience the typical symptoms of menopause:
- hot flashes (sudden feeling of warmth that spreads to the upper body).
- Irregular or missed periods.
- Periods that are heavier or lighter than usual.
The above symptoms are due to the decrease in estrogen production. Other symptoms may occur such as:
- night sweats.
- bladder irritability and worsening of bladder control loss (incontinence).
- dry skin, eyes or mouth.
- vaginal dryness.
- difficulty sleeping.
- emotional changes (irritability, mood swings, mild depression and anxiety).
- decreased sexual desire (libido).
- problems with memory and concentration.
Like all menopausal women, those with premature menopause have lower estrogen levels that can lead to changes in their overall health and increase the risk of certain conditions, such as osteoporosis. Other risks associated with estrogen loss include colon and ovarian cancer, periodontal disease (eg gingivitis) and cataracts.
Premature ovarian failure and treatment
A condition called premature ovarian failure has common symptoms with menopause. One in 1,000 women under the age of 30 and one in 100 by the age of 40 has ovarian dysfunction that prevents them from having children. Women with premature ovarian failure may have an irregular period for several years.
Doctors are trying to find ways to help women who are close to menopause (perimenopause) to have a child. In 2016, Greek doctors announced a treatment that restored menstruation in a group of women. As the treatment allowed the eggs to recover, it caused headlines that spoke of a “reversal” of menopause. The treatment involved injecting plasma that was rich in platelets into 30 women aged 46-49 years with “tired” ovaries. The treatment worked for two-thirds of women and to date, more than 1,000 women have benefited from having children.
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