Studies show about eight of every 100 women of childbearing age – about 3.9 million women – go through natural menopause before the age of 40. Sometimes early menopause has a genetic basis and a 2006 study has attributed it to certain genes. In these families premature graying of the hair, sometimes as early as the 20s, is often seen. About 3.2 percent of women with premature ovarian failure also have Addison’s disease, an autoimmune disease of the adrenal glands. Addison’s disease is easily treated but it can be dangerous for women who don’t know they have it. If a genetic basis is suspected these women are well advised to consider having their families at an earlier age. If your periods stop and you suspect premature menopause, see an endocrinologist to confirm that it is truly menopause and not a temporary cessation from some other abnormality.
Most people are familiar with autoimmune diseases like hypothyroidism and diabetes, in which antibodies destroy the thyroid or pancreas. A similar process can result from antibodies that damage the ovaries. Certain environmental factors may contribute to premature menopause. If a woman has undergone chemotherapy or radiation for cancer, the treatments may permanently damage the ovaries.
The risk of menopause depends on the type and length of treatment (chemotherapy, radiation) and the age of the woman at the time of treatment. The physical symptoms for younger women are much as they would be at age 50, but the emotional impact is often greater. Women with premature menopause often struggle with depression. If they are still childless, they realize their dreams of giving birth are crushed because their reproductive years are over. They often feel somehow “less of a woman.” It’s like a one-two punch. The body is going through immense changes, and the psyche is being shattered. When menopause comes at such an early age, the woman is subject to a higher risk of heart disease, dementia, osteoporosis and other complications because she is subjected to more years of low estrogen. Because these women will likely receive a longer duration of HRT, it becomes even more important to select topical estrodial, a safer form of HRT.
In an open label, randomized, controlled crossover trial, women with premature ovarian failure were randomly assigned to either topical estradiol and vaginal progesterone or oral ethinyl estradiol and synthetic progestin. After 28 months, the women receiving topical estradiol and vaginal progesterone had lower blood pressure, better kidney function and less activation of the renin-angiotensin system compared to those receiving oral synthetic estrogens and progestins.
Such findings suggest important implications for the future cardiovascular health of women who undergo premature menopause. The North American Menopause Society and the Endocrine Society recommend that the findings from the Women’s Health Initiative (WHI) and the Heart and Estrogen/ progestin Replacement Study (HERS) should NOT be applied to women who experience premature menopause.
Excerpt from “Outliving Your Ovaries” © 2012 by Marina Johnson MD.
In Response To Recent Social Media Question:
Recently I was asked if “all women go through menopause the moment that their period stops?” this is true ONLY if they are truly menopausal. When women’s periods stop, that could also be caused by various endocrine disorders, that when treated may lead to resumption of normal periods.
The point of this blog article is to focus on those women who go through “Premature Menopause” the medical term defined as the occurrence of menopause BEFORE age 40. When menopause occurs at such a young age, it’s even more important that women be evaluated and considered for HRT because they will be subjected to more years of estrogen deficiency.
To obtain a copy of “Outliving Your Ovaries” click here