Most women begin menopause between the ages of 45 and 55. The average age for menopause onset in the United States is 51 years old.
Early menopause usually refers
to onset before age 45. Premature menopause or premature ovarian insufficiency
occurs before age 40.
Menopause occurs when your
ovaries stop producing eggs, resulting in low estrogen levels. Estrogen is the
hormone that controls the reproductive cycle.
Someone is in menopause when
they haven't had a period for more than 12 months. But associated symptoms, such
as hot flashes, start long before menopause during a phase called
perimenopause.
Anything that damages your
ovaries or stops estrogen production can cause early menopause. This includes
chemotherapy for cancer or an oophorectomy (removal of the ovaries).
In these cases, your doctor
will help prepare you for early menopause. But your body can also start
menopause early even if your ovaries are still inside you
WHAT
ARE THE SYMPTOMS OF EARLY MENOPAUSE
Early menopause can begin as
soon as you start having irregular periods or periods that are noticeably
longer or shorter than your typical cycle.
Other symptoms of early
menopause include: Heavy bleeding. Spotting. Periods that last longer than a
week
A longer amount of time
inbetween periods. In these cases, contact your doctor to check for any other
issues that might be causing these symptoms.
Other common symptoms of
menopause include: Mood swings. Changes in sexual feelings or desire. Vaginal
dryness. Trouble sleeping. Hot flashes. Night sweats. Loss of bladder control
WHAT
CAUSES EARLY MENOPAUSE
There are several known causes
of early menopause, but sometimes the cause cannot be determined:
Genetics
If there's no obvious medical
reason for early menopause, the cause is likely genetic. Your age at menopause
onset is likely inherited. Knowing when
your parent started menopause can provide clues about when you'll start your
own. If your parent started menopause early, you're more likely than average to
do the same. However, genes tell only
half the story.
Lifestyle
factors
Some lifestyle factors may have
an impact on when you begin menopause. Smoking affects estrogen and can
contribute to early menopause. Some
research suggests that long-term or regular smokers are likely to experience
menopause sooner. Women who smoke may start menopause 1 to 2 years earlier than
women who don't smoke. Body Mass Index
(BMI) can also factor into early menopause. Estrogen is stored in fat tissue.
Women who are very thin have fewer estrogen stores, which can be depleted
sooner. Some research also suggests that
a vegetarian diet, lack of exercise, and lack of sun exposure throughout your
life can all cause an early onset of menopause.
Chromosome
issues
Some chromosomal issues can
lead to early menopause. For example, Turner syndrome (also called monosomy X
and gonadal dysgenesis) involves being born with an incomplete chromosome. Women with Turner syndrome have ovaries that
don't function as expected. This often causes them to enter menopause
prematurely. Other chromosomal issues
can cause early menopause, too. This includes pure gonadal dysgenesis, a
variation on Turner syndrome.
In this condition, the ovaries don't function.
Instead, periods and secondary sex characteristics must be brought about by
hormone replacement therapy, usually during adolescence. Women with Fragile X syndrome, or who are
genetic carriers of the disease, may also have early menopause. This syndrome
is passed down in families. You can
discuss genetic testing options with your doctor if you have premature
menopause or if you have family members who had premature menopause.
Autoimmune
diseases
Premature menopause can be a
symptom of an autoimmune disease, such as thyroid disease or rheumatoid
arthritis. In autoimmune diseases, the
immune system mistakes a part of the body for an invader and attacks it.
Inflammation caused by some of these diseases can affect the ovaries. Menopause
begins when the ovaries stop working.
Epilepsy
Epilepsy is a seizure disorder
that stems from the brain. Someone with epilepsy is more likely to experience
primary ovarian insufficiency, which leads to menopause. Changing hormone
levels due to menopause can affect seizures in people with epilepsy. An older
study from 2001 found that in a group of women with epilepsy, about 14 percent
of those studied had premature menopause, as opposed to 1 percent of the
general population.
HOW
IS EARLY MENOPAUSE DIAGNOSED
The time leading into menopause
is called perimenopause. During this time, you may have irregular periods and other
symptoms that come and go.
You're generally considered to
be in menopause if you go 12 months without menstrual bleeding, and you don't
have another medical condition to explain your symptoms. This may be an
indicator of early menopause.
TESTING
FOR EARLY MENOPAUSE
Tests aren't usually needed to
diagnose menopause. Most people can self-diagnose menopause based on their
symptoms. But if you think you're experiencing early menopause, you may want to
contact your doctor to be sure.
Your doctor can order hormone
tests to help determine whether your symptoms are due to perimenopause or
another condition. These are the most common hormones to check:
Anti-Müllerian Hormone (AMH).
The PicoAMH Elisa testTrusted Source uses this hormone to help determine
whether you're approaching menopause or have already reached your last
menstrual cycle.
Estrogen. Your doctor may check
your levels of estrogen, also called estradiol. In menopause, estrogen levels
decrease.
Follicle-stimulating hormone
(FSH). If your FSH levels are consistently above 30 milli-international units
per milliliter (mIU/mL), and you haven't menstruated for a year, it's likely
that you've reached menopause. However, a single elevated FSH test can't
confirm menopause on its own.
Thyroid-Stimulating Hormone
(TSH). Your doctor may check your levels of TSH to confirm diagnosis. If you
have an underactive thyroid (hypothyroidism), you'll have TSH levels that are
too high. Symptoms of the condition are similar to the symptoms of menopause.
The North American Menopause
Society (NAMS) reports that hormone tests are sometimes unhelpful because
hormone levels still change and fluctuate during perimenopause.
Even so, if you're concerned
about signs of menopause, NAMS suggests requesting a full checkup with your
doctor.
HOW
IS EARLY MENOPAUSE TREATED OR MANAGED
Early menopause generally
doesn't require treatment. However,
there are treatment options available to help manage the symptoms of menopause
or conditions related to it. They can help you deal with changes in your body
or lifestyle more easily. Premature
menopause is often treated because it occurs at such an early age. This helps
support your body with the hormones it would typically make until you reach the
age of natural menopause. The most
common treatment includes Hormone Replacement Therapy (HRT). Systemic hormone
therapy can prevent many common menopausal symptoms. Or you may take vaginal
hormone products, usually in low doses, to help with vaginal symptoms.
Hormone Replacement Therapy
(HRT) does have risks though. It can increase your chances of: Heart Disease,
Stroke & Breast Cancer.
Talk with your doctor about the
risks and benefits of your individual care before starting HRT. Lower doses of
hormones may decrease your risk of experiencing these conditions.
LIFESTYLE
AND HOME REMEDIES
Although you can't prevent
menopause from happening, you can take action to help your symptoms: Eating a healthy diet and exercising
regularly can help manage menopause symptoms. If you smoke, consider quitting
to manage your symptoms as well. There
is mixed evidence on using natural products to manage menopause symptoms. Some
people prefer vitamins and herbal supplements over conventional medication.
Check with your doctor about which treatment is right for you.
CAN
EARLY MENOPAUSE BE REVERSED
For now, available treatment
can help delay or reduce the symptoms of menopause, but there is no sure way to
reverse early menopause.
However, researchers are
investigating new ways to help people in menopause have children.
In 2016, scientists in Greece
announced a new treatment that enabled them to restore menstruation and
retrieve eggs from a small group of women who were in perimenopause.
This treatment made headlines
as a way to "reverse" menopause, but little is known about how well
it works.
The scientists reported
treating more than 30 women, ages 46 to 49, by injecting platelet-rich plasma
(PRP) into their ovaries. PRP is sometimes used to promote tissue healing, but
the treatment hasn't been proven to be effective for any purpose.
The scientists claimed the treatment worked for two-thirds of the women treated. However, the research has been criticized for its small size and lack of control groups.
Though the research might have
potential for the future, it's not a realistic treatment option right now.
CAN
EARLY MENOPAUSE CONTRIBUTE TO OTHER CONDITIONS
Infertility is often a big
concern when you start menopause 10 or more years early. Yet, there are other
health concerns. A steady stream of
estrogen to your tissues has many uses. Estrogen increases "good" HDL
cholesterol and decreases "bad" LDL cholesterol. It also relaxes
blood vessels and prevents bones from thinning.
Losing estrogen earlier than
typical can increase your risk of: heart disease, osteoporosis, depression,
dementia & premature death
If you have concerns about
these symptoms, speak with your doctor. Because of these risks, people who
enter menopause early are often prescribed HRT.
CAN
EARLY MENOPAUSE PROTECT YOU FROM OTHER CONDITIONS
Starting menopause early can
actually protect you from other diseases. These include estrogen-sensitive
cancers such as breast cancer.
People who enter menopause late
(after age 55) are at greater risk of breast cancer than those who enter the
transition earlier. This is because their breast tissue is exposed to estrogen
for a longer time.
EASING
THE TRANSITION TO MENOPAUSE
A genetic test may one day
determine a person's likelihood of early menopause. For now, though, only time
will tell when you'll start your transition.
Contact your doctor for regular
checkups, and try to be proactive about your reproductive health. Doing so can
help your doctor ease the symptoms or decrease your risk factors for early
menopause.
Seeing a therapist can also
help you cope with any pain or anxiety you may feel during menopause.
If you're interested in having
children, you still have a few options for growing your family. These include:
Adoption. Receiving an egg donation. Having a surrogate carry your child.
A fertility specialist may also
suggest procedures that can help you have children. Talk with your doctor about
the options available to you for becoming a parent. Their risks and successes
can be affected by many factors, including your age and overall health.
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