Early menopause or when the period disappears before the age of 40


Early menopause or when the period disappears before the age of 40

Menopause is the disappearance of menstruation and indicates the end of a woman’s fertile period. Under normal circumstances, this stage arrives between 48 and 54 years (the average age being 51 years), but in 1% of cases, the withdrawal of the period occurs before the age of 40.

It is what is known as early menopause or premature ovarian failure , a condition that, in addition to sterility, can cause the appearance of other disorders and diseases in women. We explain why it occurs and how it is treated.

One in 100 women suffers from early menopause or premature ovarian failure before the age of 40

The arrival of menopause is a natural process that women go through and is characterized by the cessation of menstruation, because the ovaries stop producing the hormones estrogen and progesterone. The end of ovarian activity does not come abruptly, but takes place little by little and progressively from 45-48 years old, and up to 50-54 years old.

However, in one in 1,000 women, menopause occurs before the age of 30, and in one in 100, before the age of 40. This is what is called early menopause or premature ovarian failure.

However, clinicians prefer to refer to this progressive decline in ovarian function with the term ‘primary ovarian insufficiency’ , as they feel this word allows them to view the entire spectrum of ovarian dysfunction.

The symptoms that characterize early menopause or premature ovarian failure are due to a lack of estrogen, and are the same as those of women with natural menopause:

  • The first symptom is usually irregular menstruation and changes in bleeding patterns, although to speak of premature ovarian failure the period must disappear for at least four months.
  • Hot flashes and night sweats.
  • Sleep disturbances.
  • Trouble concentrating and/or minor memory loss.
  • Mood swings and periods of depression.
  • Decreased sexual desire and/or pain when having sex.
  • Other symptoms, such as headaches, dry skin, vaginal dryness, urinary incontinence…

Why does early menopause occur?

Although in most cases the causes of early menopause are unknown , in other cases, premature ovarian failure is caused by:

  • Genetic inheritance : the risk of presenting premature ovarian failure increases if there is a direct family history.
  • Some treatments to combat other diseases , such as radiotherapy and chemotherapy, can cause destruction of the ovarian reserve, which in some cases can be reversible. Premature menopause derived from this reason occurs in 3.5-4.5% of women before the age of 40.
  • Removal of all or part of the ovaries causes premature ovarian failure.
  • Certain autoimmune diseases ( thyroid diseases, adrenal gland diseases, Crohn’s disease, systemic lupus erythematosus, rheumatoid arthritis…), as well as diseases associated with congenital defects of chromosomes or genes (Turner’s syndrome, Fragile X syndrome …) are also associated with premature ovarian failure
  • Some toxic agents such as excessive tobacco consumption, use of pesticides, solvents…

The diagnosis will be made through the patient’s medical history, a physical and gynecological examination , a blood test to measure the levels of estradiol and follicle-stimulating hormones, and in some cases a study of the chromosomes (karyotype) may also be necessary.

How does premature ovarian failure affect women?

When ovarian failure occurs at the height of the woman’s childbearing age, the main problem it entails is the impossibility of having children with her own eggs , since ovulation stimulation treatments do not work in these cases.

Thus, in vitro fertilization with donor eggs seems to be the only alternative to achieve a pregnancy, although important scientific advances are being made in this field . Not surprisingly, a year ago we shared the news of a pioneering technique launched at the Hospital Clinic in Barcelona, ​​which had allowed a woman with early menopause to become a mother with her own eggs. Recently, we also told you about the case of a 32-year-old woman with menopause, who had become pregnant with twins using her own eggs.

However, when ovarian failure is spontaneous and there are no alterations in the karyotype , natural pregnancy can occur in 5-10% of cases, if the ovary still shows a certain degree of intermittent activity. Check out more interesting stories on at our Tesla Blog.

In the case of women who must undergo aggressive treatments that can affect their ovarian reserve, there is also the option of freezing the eggs before starting treatment, in order to be able to become mothers later.

Other risks associated with early menopause are:

  • Osteoporosis, as the bones become more brittle.
  • A low level of estrogen increases cardiovascular risk in a young woman.
  • Depression, as this diagnosis can be a severe emotional blow, especially in the case of women who wanted to be mothers
  • Associated with ovarian failure, alterations in other glands such as the thyroid and adrenal glands may appear, so it is necessary to go to regular check-ups with the specialist.

How Premature Ovarian Failure Is Treated

Once premature ovarian failure or early menopause has been diagnosed, the woman must receive a multidisciplinary treatment that allows her to address the problems derived from the hormonal deficit and the psychological and emotional consequences that it entails.

Hormone replacement therapy is usually the usual and most recommended treatment, both to avoid the symptoms associated with early menopause, as well as the derived problems that may appear in the future. The doctor will indicate the most appropriate treatment and its duration, depending on the characteristics of the patient and her age.

At the same time, and as we mentioned above, it is necessary for the woman to have a regular health check-up, as well as to have psychological support from a professional.

On the other hand, it is also important to take care of your diet and maintain healthy lifestyle habits , through a balanced diet rich in calcium and vitamin D, physical exercise, and avoiding tobacco and alcohol consumption. In the event that sexual intercourse is painful, you can use specific products that help improve vaginal lubrication.

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