When Menopause Arrives Too Soon

2/24/2014

The effects of a period aren’t a picnic, from bloating to cramps, but having a regular menstrual cycle is, for the most part, a sign that all things are functioning normally for women. The absence of it can be a symptom of much larger problems. Premature menopause occurs more often than once thought, and can lead to devastating consequences. Diagnosing it can be difficult, but as with all health conditions, understanding what is happening can bring relief on its own.

In the United States, the average age for menopause is 51. But for about 1 in 100 women, menopause knocks on their door earlier than normal, before the age of 40, resulting in premature menopause. “It’s also referred to as premature ovarian failure,” said Scott Bergstedt, MD, ob/gyn with OBG-1 of West Calcasieu Cameron Hospital. “These two aren’t exactly the same, but the symptoms are similar.”

The research can be varied when it comes to defining ovarian function. Most of the studies show that with true premature menopause, the ovaries cease to function, thus eliminating the possibility for pregnancy. There is some research, though, that suggests a small percentage of women have become pregnant, usually with the help of hormone replacement therapy. With premature ovarian failure or POF, the ovaries in about half of the women may ovulate occasionally. So, although the name implies a complete shut down in the ovary department, some women with POF can successfully get pregnant.

“Because these ovarian disorders affect women in their childbearing years, their 20s and 30s, it can be devastating to hear that having children or expanding their family may be much more difficult, or even impossible,” said Dr. Bergstedt.

In some cases, women have been able to conceive through egg donation and then go on to experience a normal pregnancy and delivery. Other women opt for fertility treatments to induce ovulation. It doesn’t usually reverse premature ovarian failure, but it may help them realize a dream to have a child.

For women facing premature menopause, decisions about expanding the family is a serious issue, and so is managing menopausal symptoms that arrive about 15 years early. When hot flashes, mood swings and major headaches begin happening in a woman’s 20s or 30s, it causes major concerns, to say the least. “Symptoms of menopause can be difficult to deal with, but women know it’s going to happen and sort of psych themselves up for it,” said Dr. Bergstedt. “Because premature menopause is not as well known, women can be alarmed by the symptoms and unsure of the cause.”

Causes for premature menopause include:

• Genetics. Women with a family history of premature menopause are more likely to have early menopause themselves.

• Autoimmune diseases. Thyroid disease and rheumatoid arthritis are two diseases related to the body’s immune system. Instead of fighting off diseases, the body mistakenly attacks a part of its own reproductive system.

• Chemotherapy or pelvic radiation treatments for cancer. This depends on the type of chemotherapy used, and the age of the woman when she gets treatment. The younger a woman is, the less likely she will go into menopause.

When the ovaries shut down, there are increased health risks in women. “The reality of premature menopause is that women are facing these health risks at an earlier age. Serious conditions like osteoporosis and heart disease become more of a possibility,” said Dr. Bergstedt. The risk of thyroid disorders also increases, as does the risk for Addison’s disease. This autoimmune disorder suppresses the body’s ability to handle physical stress from injury or illness due to problems with the adrenal glands.

A blood test measuring the follicle stimulating hormone is usually the determining factor in diagnosing premature menopause. If this value is over 40 mIU/ml on at least two occasions over a four week period, then the diagnosis is made. Other diagnostic tests may be used to determine if there are any other related abnormalities.

Hormone replacement therapy is a treatment method that gives women the estrogen and other hormones their bodies are not making. Young women taking HRT may return to having normal menstrual cycles, and their risk for osteoporosis is decreased. There have been controversial studies about the long-term effects of HRT, so women are advised to thoroughly discuss the pros and cons with their physician.

Premature menopause causes serious concerns both physically and emotionally for women facing this medical crisis. Talking through available options with a qualified physician, as well as relying on a strong support system, will help women make choices that are right for them.

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