Understanding Early Menopause: Causes, Symptoms, and Treatment Options
Early Menopause, also known as premature Menopause or Premature Ovarian Insufficiency (POI), is a condition that affects women before the age of 40.
Menopause is a natural biological process that occurs when the ovaries stop functioning.
This leads to a cessation of menstrual cycles and a decline in reproductive hormone production.
Early Menopause can have significant physical and emotional effects on a woman’s life.
In this article, we will learn about the symptoms, causes, and treatments associated with Early Menopause.
Early Menopause: An overview
Early Menopause refers to the end of the menstrual cycle before age 40.
While the average age of natural Menopause is around 51, Early Menopause can occur in women as young as their 30s or 40s.
The condition results from a decline in the production of reproductive hormones, primarily Estrogen and Progesterone, by the ovaries.
The hormone change can be caused due to various reasons, including Chemotherapy and Oophorectomy (removal of ovaries).
Symptoms of Early Menopause
Early Menopause can start as soon as you start having irregular periods or noticeably shorter or longer periods than the general cycle.
Other symptoms of Early Menopause are as follows:
- Heavy bleeding
- Spotting
- Periods that last more than a week
- Longer time in between periods
In these cases, contact your doctor and check for any other issue that might be causing this issue.
Some other common symptoms of Menopause are:
- Mood swings
- Changes in sexual desire
- Vaginal dryness
- Trouble sleeping
- Hot flashes
- Loss of bladder control
Causes of Early Menopause
There are various known causes of Early Menopause, but the exact cause cannot be determined.
Following may be the reasons for Early Menopause:
Genetics
If there’s no clear medical explanation for Early Menopause, it’s probably because of your genes.
The age at which you go through Menopause is often inherited from your parents.
If your parent experienced Early Menopause, it’s more likely that you will too.
Lifestyle factors
Certain lifestyle factors can influence when Menopause starts.
Smoking can lead to Early Menopause as it affects Estrogen levels.
Long-term smokers may experience Menopause 1 to 2 years earlier than non-smokers.
Body mass index (BMI) also plays a role. Underweight women have fewer Estrogen reserves, which can lead to earlier Menopause.
Moreover, a vegetarian diet, lack of exercise, and insufficient sun exposure throughout life may also contribute to an earlier onset of Menopause.
Chromosome issues
Some chromosomal issues can lead to Early Menopause.
One example is Turner syndrome, where a woman is born with an incomplete chromosome, affecting the functions of the ovaries and causing premature Menopause.
Another condition is pure Gonadal dysgenesis, which also affects the ovaries’ function and requires hormone replacement therapy during adolescence to induce periods and secondary sex characteristics.
Women with Fragile X syndrome or those carrying the genetic disease may also experience Early Menopause, which can run in families.
If you or your family members have experienced Early Menopause, you can discuss genetic testing options with your doctor to understand more about the potential causes.
Autoimmune disease
Premature Menopause can be linked to autoimmune diseases like thyroid disease or Rheumatoid Arthritis.
In autoimmune diseases, the body’s immune system mistakenly attacks a part of the body.
This leads to inflammation that can affect the ovaries, which may further lead to Premature Menopause.
Epilepsy
Epilepsy is a brain-related seizure disorder. People with this disorder may experience primary ovarian insufficiency, which leads to Menopause.
Menopause can affect seizures in those with Epilepsy due to changing hormone levels.
A study from 2001 found that among women with Epilepsy, about 14 percent experienced Premature Menopause, compared to only 1 percent in the general population.
Tests for Early Menopause
In most cases, tests are not necessary to diagnose Menopause.
Many people can recognize Menopause based on their symptoms.
However, if you suspect Early Menopause, it’s a good idea to talk to your doctor to be certain.
Your doctor can perform hormone tests to determine if your symptoms are linked to Perimenopause or another condition.
Following are some tests that your doctor may recommend:
- Anti-Mullerian hormone (AMH): The PicoAMH Elisa test is used to check a hormone that helps determine if you are nearing Menopause or have already had your last menstrual cycle
- Estrogen: Your doctor may check your Estrogen levels, also known as Estradiol. During Menopause, Estrogen levels decrease
- Follicle-stimulating hormone: If your FSH levels are consistently more than 30 mIU/mL (milli-international units per milliliter) and you are not menstruated for a year, you have likely reached Menopause. But, a single FSH level test cannot determine that you have reached Menopause
- Thyroid-stimulating hormone (TSH): Your doctor may test levels of TSH for diagnosis. If you have Hypothyroidism, you will have high TSH levels. The symptoms of Hypothyroidism are the same as the symptoms of Menopause
As per the North American Menopause Society (NAMS), hormone tests are sometimes not helpful because hormone levels change and fluctuate even during Perimenopause.
Early Menopause treatment
Your doctor may recommend treatment based on your condition, but these treatments are focused on handling the symptoms.
Some of the common treatments for Early Menopause are as follows:
Hormone replacement therapy (HRT)
Supplemental Estrogen and Progestin can help replace the reproductive hormones your body no longer produces naturally during Menopause.
These hormones are often prescribed to manage the uncomfortable symptoms of Early Menopause.
They are typically taken until around the age of 50, which is the average age of Menopause.
Moreover, this treatment can also help prevent bone loss and support heart health.
Supplements
Calcium and vitamin D can prevent Osteoporosis if you get them in your diet.
As per the National Institutes of Health, women aged between 19 to 50 years need 1000 mg of calcium daily.
Women who have crossed the age of 50 must take 1200 mg of calcium daily in their diet.
If your age is between 19 to 50 years, you also need 600 IU/day of vitamin D daily through food or supplements.
Dealing with infertility
Women with Early Menopause can still become pregnant naturally without any treatment.
Some women may consider options like in-vitro fertilization using donor eggs and adoption.
Side effects of Early Menopause
There are various risks associated with Premature Menopause, from which infertility is the biggest concern.
Estrogen provides many benefits to your body. It raises “good” HDL cholesterol levels while lowering “bad” LDL cholesterol.
Additionally, it helps relax blood vessels and prevents bones from becoming thin and weak.
But Estrogen levels decrease when you reach Menopause and may increase your risk of the following:
- Osteoporosis
- Depression
- Heart disease
- Dementia (memory loss)
- Premature death
Conclusion
Early Menopause affects women before the age of 40 when the ovaries stop working, leading to a decline in hormone production.
It can cause physical and emotional effects. Recognizing symptoms helps diagnose it, and hormone tests can confirm the early onset of Menopause.
Treatment like hormone replacement therapy may help manage the symptoms.
Women can take steps to support bone health and consider options like in-vitro fertilization or adoption for infertility.
Premature Menopause also increases the risks of heart disease, memory loss, and early death.
Seeking medical advice and staying informed can help women navigate early Menopause and lead fulfilling lives.
