Most women expect to continue having a monthly period and be able to have children well into their 40s, though maybe with greater difficulty. So it can be a nasty shock for some women when they start having menopausal symptoms in their 30s. This can be devastating, and happens in about 1% of women.
What is early menopause?
Early (premature) menopause refers to a situation where a woman stops menstruating completely before the age of 40 years. It is also known as premature ovarian failure.
Causes of early menopause
- Removal of the ovaries through surgery – This is the commonest cause of early menopause. For menopause to occur, both ovaries must be removed completely. Possible reasons for surgical removal of both ovaries include:
- ovarian cancer
- severe pelvic infection which may damage the ovaries
- during a hysterectomy for other problems
Oophorectomy (removal of the ovaries) has been attracting a lot of controversy in recent years. Some gynecologists do this routinely when performing a hysterectomyto avoid development of disease if the ovaries are left behind e.g. an ovarian cyst or cancer. Others argue that most women will not develop these diseases in their lifetime and so are subjected unnecessarily to the effects of menopause by removing ovaries that are still functional.
- Radiation treatment –
- Some women may need radiation therapy for treatment of cancer in the abdomen or pelvis. Which damages the ovaries. Shielding the ovaries may help to prevent this.
- Some women may opt to have some of their eggs removed and stored to stop them from being damaged during radiation treatment. These can be used later for in vitro fertilization.
- Note that even routine x-rays of the pelvis may damage the ovaries.
- Removal of the uterus (hysterectomy) – After a hysterectomy, you may experience menopause several years earlier than if your uterus was left intact. This is because the procedure inevitably damages the blood supply to the ovaries which eventually shrink and stop functioning.
- Infections – Mumps in early childhood may damage the ovaries leading to early menopause.
- Auto-immune diseases – These are diseases where your body’s defense system starts to attack organs and tissues of the body, thinking that they are foreign, meaning that they lose the ability to recognize self. This can lead to rheumatoid arthritis, some types of thyroid disease and SLE (lupus). The ovaries may also be attacked and destroyed.
- Genetic abnormality – Some women who have incomplete chromosomes may experience early menopause.
This is menopause which takes place after the age of 55 years. If you are overweight or have uterine fibroids, it would not be unusual for you to still be menstruating in your 50s.
Dangers of late menopause
- increased risk of breast cancer
- increased risk of uterine cancer
If you are still having periods in your 50s, have a medical check-up just to rule out any health problems. If your doctor gives you the all clear then assume this is your own normal pattern.
When will you have your menopause
There are a good number of us that would like to know the answer to that question and soon there may be an answer.
Research into the hormone anti-Mullerian hormone (AMH) suggests that analysis of this hormone may be able to predict when menopause will occur.
AMH is produced in women and can be detected from the onset of puberty. It is currently being used in women undergoing infertility treatment to estimate how many ovarian follicles they have left. This helps to give an indication of how successful infertility treatment will be.
Naturally, some experts are still very skeptical and are waiting for the results of the study. For you and me, it could be very useful to know, especially for women who have postponed having children for one reason or another.
Premature menopause may increases lung cancer risk
Although smoking cigarettes is the major cause of lung cancer, several factors can increase the risk of developing this disease. A new study has found that early artificial menopause may increase a woman’s risks of getting lung cancer.
The study suggests that medically induced menopause, especially through removal of both ovaries, can double younger women’s chances of developing lung cancer. It’s possible that female hormones may have a role to play in worsening the effects of cancer-causing agents in tobacco. Already,it has been found that women who smoke have lower estrogen levels.
There is already evidence that smoking is more dangerous for women. It is possible that a sudden drop in estrogen levels or prolonged use of hormone replacement therapy may make women more susceptible to lung cancer.
All this research can be summed up in two sentences. If you smoke, stop. If you don’t smoke, don’t start!