Premature Menopause and Early Menopause
If you experience menopause before the age of 40, you are said to be in premature menopause. It can take place any time from the teenage years up to 40. This can be a traumatic development for young women...
Is premature menopause common?
Premature menopause is a relatively rare condition. There are no numbers for Ireland, but in Britain the statistics for women experiencing premature menopause are as follows:
- One in 100 women under the age of 40
- One in 1,000 women under the age 30
- One in 10,000 under the age of 20
What causes women to experience premature menopause?
Premature menopause occurs when our ovaries are not functioning properly and they stop producing eggs or produce very few eggs for years or even decades before we reach midlife.
The term 'early menopuse' applies to women with the same condition aged between 40 and 45.
Causes of premature menopause
For most women there is no known reason or cause for this condition.
For some, however, there is a link between the onset of premature menopause and the following:
- A family history of early menopause
- The surgical removal of the ovaries or a hysterectomy
- Medical treatments such as radiotherapy and chemotherapy, even when the ovaries are not removed.
- A history of tuberculosis, mumps, malaria, shingles or chickenpox (very rare cases)
- Medical conditions such as enzyme deficiencies, Down’s syndrome, Turner’s syndrome, Addison’s disease and hypothyroidism
What are the symptoms of premature menopause?
The symptoms of premature menopause are similar to the symptoms of the menopause but are often more severe/acute.
Many of the symptoms can look like common complaints: irregular or few periods, infertility, hot flushes, anxiety, insomnia, palpitations, weight gain, headaches or joint/muscle pain.
As with symptoms of the menopause, symptoms of premature menopause are often put down to stress, life events or other factors. The misdiagnosis of premature menopause by doctors is widespread as there is a belief that menopausal symptoms only manifest themselves as we reach late 40s and early 50s. This can lead to frustrating delays in diagnosis.
Women going through premature menopause will produce lower levels of oestrogen in their ovaries. This can lead to reduced numbers of eggs being released and, as a result, intermittent periods. It does not mean that no eggs are produced and some women may still be able to conceive. However, infertility is common and can be a devastating consequence of premature menopause for those who wish to have children.
The Daisy Network offers excellent information and support on premature menopause.
Overall health risks and treatment of premature menopause
The reduced production of the hormone oestrogen during premature menopause can affect a women's overall health as oestrogen has an impact on almost all the tissues in the body. Most affected are our bones, the cardiovascular systems and the brain. Bone thinning may occur and this can cause osteoporosis. It is therefore very important to follow exercise and nutrition guidelines for osteoporosis. In order to boost low levels of oestrogen it is common for women in early menopause to undergo hormone replacement treatment (HRT).
Premature ovarian failure (POF)
There is a lot of confusion out there surrounding POF. The first thing is that Premature Ovarian Failure and Premature Menopause are not separate conditions but terms used for when the ovaries stop functioning properly before the age of 40. It it a different process to the natural menopause, but brings about the same symptoms (often more severe) than than normal menopause. It is also known as Primany Ovarian Insufficiency, which is a more accurate description as it can come about due to a disfunction of the eggs. The term 'early menopuse' applies to women with the same condition between 40 and 45.
Premature Ovarian Failure (POF) is also known as Premature Ovarian Insufficiency. It may be the diagnosis for some women who have FSH levels above the level of 40. It's a rare condition that affects 1-4% of women in the US and the world.
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Siobhan’s story – unexplained early menopause
I was 35 and going through a bad time with very heavy periods, which never seemed to end. I was having dreadful night sweats; I was up five or six times a night. I also had uncontrolled hot flushes at work during the day. My moods were very erratic and my temper was wild – I’d fly off the handle for no reason. I really didn’t know what was going on with me at the time. I thought I was just finding life extra hard. I felt out of control and very lacking in confidence to make decisions, which made my temper all the worse. Eventually, I was diagnosed as having early menopause.
It was a total shock. Because now I knew, I definitely couldn’t have children. This was devastating news, as I hadn’t had children. And I got the news at a time when all the talk among my friends was of how so many women were having babies into their 40s. I wanted children, I really love children, I work with children. I have three nieces that I absolute adore, but would love to have had my own. This confirmation of the fact that I couldn’t have any children of my own was very, very hard to accept.
Having the diagnosis gave me an explanation, which was very, very helpful. At least knowing that it was premature menopause gave it a name and made me realise that I wasn’t just going mad. I was given HRT, mainly because my night sweats were so bad and it also helped with my temper. I’d advise others to find out all about HRT because there is a lot of new information out there.
I managed to get over it with a lot of work, once I realised what I was going through. I think you need to get treatment and help and then get on with your life as soon as possible.
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Dana’s story – premature menopause brought on by chemotherapy treatment for breast cancer
I was unceremoniously plunged into menopause when I was diagnosed with breast cancer last year. In addition to having to cope with starting chemotherapy, losing all my hair and also losing a breast, I was subject to horrible hot flushes. They were very intense at first, and would inevitably happen just as I was falling asleep. I would suddenly be uncomfortably hot and prickly and drenched in sweat. So I would throw off the duvet, and my pyjamas and the beanie I was wearing to keep my bald head warm and wait to cool down, until I could sleep for an hour or two before waking up yet again, drenched in sweat. So for the months that I was undergoing treatment, I had very little quality sleep.
The hot flushes happened during the day as well. I remember how, as a child, I would laugh at women fanning themselves with sheaves of paper, and then that was me, at the dinner table, in the synagogue, while chatting to my friends. I would be desperately trying to coax a breeze from whatever piece of paper was available.
It was unpleasant, but I consider myself fortunate in that the symptoms were manageable and lessened a little over time. I never had to explore treatment for the symptoms. But more importantly I was nearly 50 when I was diagnosed and began my chemotherapy. I would have been menopausal anyway. In the months that I was receiving treatment at the oncology centre I met several women in their 30s and 40s and even one woman in her 20s who were menopausal as a result of their chemotherapy treatment. For these younger women the transition was premature and deeply painful.
Many of the female cancers are hormone driven. This means that women who have had breast cancer or ovarian cancer cannot be treated with hormone replacement treatment. Even natural hormones and many herbal remedies are not considered to be altogether safe as they may feed the cancerous cells. Low doses of SSRIs (anti-depressants) are apparently effective in managing hot flushes, but do little to improve the mood swings and anxieties that often accompany menopause. For cancer survivors the best hope seems to be a combination of counselling, and biofeedback training to manage the emotional and physical fallout of menopause.