Early menopause – and associated health risks

Posted on 28 August 2019

Like all menopausal women, women in premature menopause experience low oestrogen levels. When your oestrogen levels drop, you are more exposed to certain diseases. So what can you do to stay healthy?

 

‘As you age, your body starts to produce less oestrogen and progesterone, which are the main hormones involved in female reproduction,’ says Dr Natalia Novikova, a gynaecologist and endoscopic surgeon at Mediclinic Cape Town.

‘When these hormones drop to a low level, you will stop menstruating. Menopause officially begins 12 months after your last period, which is usually between the ages of 45 to 55. The average age for menopause is 51’.

If you’re between the ages of 35 and 45 – and have missed your period for more than three months, you may be going through menopause earlier than normal. ‘Of course, there are many other reasons why your cycle might be interrupted, such as stress, illness, changes in diet, extreme exercise and in response to certain medication,’ says Dr Novikova.

‘The symptoms of early menopause are similar to regular menopause,’ Dr Novikova adds. ‘Some common symptoms include: hot flushes, night sweats, mood swings, vaginal dryness, forgetfulness, difficulty sleeping, mental fogginess and a decreased libido.’

 

What causes early menopause?

‘Early or premature menopause can happen for two reasons: follicle depletion or follicle dysfunction,’ says Dr Novikova. An ovarian follicle is a fluid-filled sac that contains an immature egg, or oocyte.  ‘In other words, anything that damages your ovaries or stops oestrogen production can cause early menopause.’

This includes certain cancer treatments such as chemotherapy. ‘Chemotherapy medications are developed to destroy fast-dividing cancer cells and they do not always distinguish cells in the ovary from the cancer cells,’ Dr Novikova adds.

Other factors, such as genetics and lifestyle, might also play a role. ‘If there is no obvious medical reason for early menopause, you might have inherited this predisposition from your mother,’ says Dr Novikova. ‘Lifestyle factors such as a low Body Mass Index (BMI), excess exercise and some chromosomal defects (such as Fragile X and others), auto-immune diseases, and endocrinological (hormonal) diseases may also contribute.’

 

How will my doctor diagnose whether I am suffering from early menopause?

‘After taking your history and performing an examination, your doctor will do a blood test to check hormonal levels of follicle-stimulating hormone (FSH) which is elevated in menopause,’ says Dr Novikova. ‘Once diagnosis is confirmed, your doctor will look for causes of early menopause.’

 

Should I be concerned?

Like all menopausal women, women in premature menopause experience low oestrogen levels. Low levels of oestrogen can increase you risk for certain medical conditions, such as osteoporosis, colon and ovarian cancer, gum disease, tooth loss, and cataracts.

‘However, because women undergoing premature menopause spend a greater portion of their lives without the protective benefits of their own oestrogen, they are at greater risk of  these menopause-related health problems,’ Dr Novikova explains. ‘In addition, starting menopause later in life (after 55), may be associated with increased risk of breast and ovarian cancer due to more exposure to oestrogen.’

 

What treatment is available?

‘Treatment for women with early menopause includes following a healthy lifestyle,’ Dr Novikova explains. ‘Diet and exercise can help to prevent osteoporosis and heart disease – and  hormone replacement therapy (HRT) can prevent the negative effects of low oestrogen on your body. Regular assessments will include check for symptoms of menopause and its effects on the body such as osteoporosis, heart disease, genito-urinary syndrome.’