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Image description. Better Health Channel logo End of image description. Ima ge des crip Menopause - premature and early menopause Menopause occurs when a woman stops ovulating and her monthly period (menstruation) ceases. Most women reach menopause between the ages of 45 and 55, with the average age around 51. However, about one per cent of women experience menopause before the age of 40 years. This is known as premature menopause or premature ovarian insufficiency (POI). Menopause between 41 and 45 years of age is called early menopause. In some cases, early menopause is brought on by surgery to remove the ovaries or by medical treatments such as radiation therapy and chemotherapy. In other cases, the woman’s ovaries spontaneously stop producing eggs and the underlying cause may not be found. For most women, the loss of their fertility is devastating, particularly if menopause occurs before they have had children. Most women will experience a long period of postmenopausal life. Hormone therapy (HT) – also known as hormone replacement therapy (HRT) – may be advised to counteract the health risks of early or premature menopause such as early onset of osteoporosis and cardiovascular disease. Symptoms of premature and early menopause The symptoms of early menopause are the same as for menopause at the typical age and can include: • menstrual cycle changes, including changes to the usual bleeding pattern, particularly irregular bleeding • hot flushes • sweats • urinary problems, such as incontinence or increased frequency of urination • dry vagina • mood changes • weight changes • aches and pains. Causes of early or premature menopause Premature menopause means the woman’s ovaries have spontaneously stopped working before she has reached the age of 40 years. Women can be affected in their teens or early 20s: About one in 1,000 women may reach menopause before the age of 30. Some possible causes include: • Unknown causes – in the vast majority of cases, the cause can’t be found. This is known as idiopathic premature menopause. • Autoimmune conditions – about 10 to 30 per cent of affected women have an autoimmune disease such as hypothyroidism, Crohn’s disease, systemic lupus erythematosus or rheumatoid arthritis. • Genetic conditions – such as familial ovarian failure (FOF) and rarely galactosaemia. About five to 30 per cent of women have an affected female relative, which suggests a genetic link, such as: • Galactosaemia is when the body cannot convert the carbohydrate galactose into glucose. It is thought that the unconverted galactose could be toxic to the ovaries. • Conditions characterised by enzyme problems, such as congenital adrenal hyperplasia, can also bring on premature menopause. Menopause - premature and early menopause Page 1 of 3

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Menopause Premature Early Menopause

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  • Image description. Better Health Channel logo End of image description.

    Imagedescrip

    Menopause - premature and earlymenopause

    Menopauseoccurswhenawomanstopsovulatingandhermonthlyperiod(menstruation)ceases.Mostwomenreachmenopausebetweentheagesof45and55,withtheaverageagearound51.However,aboutonepercentofwomenexperiencemenopausebeforetheageof40years.Thisisknownasprematuremenopauseorprematureovarianinsufficiency(POI).Menopausebetween41and45yearsofageiscalledearlymenopause.

    Insomecases,earlymenopauseisbroughtonbysurgerytoremovetheovariesorbymedicaltreatmentssuchasradiationtherapyandchemotherapy.Inothercases,thewomansovariesspontaneouslystopproducingeggsandtheunderlyingcausemaynotbefound.Formostwomen,thelossoftheirfertilityisdevastating,particularlyifmenopauseoccursbeforetheyhavehadchildren.

    Mostwomenwillexperiencealongperiodofpostmenopausallife.Hormonetherapy(HT)alsoknownashormonereplacementtherapy(HRT)maybeadvisedtocounteractthehealthrisksofearlyorprematuremenopausesuchasearlyonsetofosteoporosisandcardiovasculardisease.

    Symptoms of premature and early menopause

    Thesymptomsofearlymenopausearethesameasformenopauseatthetypicalageandcaninclude:

    menstrualcyclechanges,includingchangestotheusualbleedingpattern,particularlyirregularbleeding

    hotflushes sweats urinaryproblems,suchasincontinenceorincreasedfrequencyofurination dryvagina moodchanges weightchanges achesandpains.

    Causes of early or premature menopause

    Prematuremenopausemeansthewomansovarieshavespontaneouslystoppedworkingbeforeshehasreachedtheageof40years.Womencanbeaffectedintheirteensorearly20s:Aboutonein1,000womenmayreachmenopausebeforetheageof30.

    Somepossiblecausesinclude:

    Unknowncauses inthevastmajorityofcases,thecausecantbefound.Thisisknownasidiopathicprematuremenopause.

    Autoimmuneconditionsabout10to30percentofaffectedwomenhaveanautoimmunediseasesuchashypothyroidism,Crohnsdisease,systemiclupuserythematosusorrheumatoidarthritis.

    Geneticconditionssuchasfamilialovarianfailure(FOF)andrarelygalactosaemia.Aboutfiveto30percentofwomenhaveanaffectedfemalerelative,whichsuggestsageneticlink,suchas:

    Galactosaemiaiswhenthebodycannotconvertthecarbohydrategalactoseintoglucose.Itisthoughtthattheunconvertedgalactosecouldbetoxictotheovaries.

    Conditionscharacterisedbyenzymeproblems,suchascongenitaladrenalhyperplasia,canalsobringonprematuremenopause.

    Menopause-prematureandearlymenopause Page1of3

  • Othergeneticconditions,suchasTurnerssyndrome,whereachromosomalabnormalitycancauseearlymenopause,butthisisusuallyevidentbeforepuberty.FragileXsyndromemaybeanothercause.

    Viralinfectionstheevidenceisinconclusive,butitisthoughtthataviralinfection,suchasmumpsorcytomegalovirus,couldtriggerprematuremenopauseinsomewomen.

    Induced menopause

    Menopausecanbespecificallyinducedformedicalreasons,suchascancersurgery.Forexample,awomanwithovariancancerwillrequiresurgerytoremovetheovaries.

    Earlymenopausecanalsobetriggeredbyradiationtherapyorchemotherapy.AboutoneintwowomentreatedforleukaemiaorHodgkinsdiseasewillexperiencemenopauseearly.

    Incasesofprematuremenopausecausedbycytotoxictreatmentssuchaschemotherapy,theovariescansometimesstartworkingagainafteraperiodoftime.Thisdependsonmanyfactors,includingthewomansage,thetypesofdrugsusedandthedosage.Chemotherapyforbreastcancerinpremenopausalwomenmayalsoleadtoearlymenopause.

    Diagnosis of premature or early menopause

    Prematureandearlymenopauseisdiagnosedusinganumberoftestsincluding:

    medicalhistory,familyhistoryandmedicalexamination investigationstoruleoutothercausesofamenorrhoea(absenceofperiods),suchas

    pregnancy,extremeweightloss,otherhormonedisturbancesandsomediseasesofthereproductivesystem

    investigationsintootherconditionsassociatedwithprematureorearlymenopause,suchasautoimmunediseases

    geneticteststocheckforthepresenceofgeneticproblemsassociatedwithprematureorearlymenopause

    bloodtestsatvariousstagesofthemenstrualcycletocheckhormonelevels.

    Treatment for early or premature menopause

    Thereisnotreatmentavailabletomaketheovariesstartworkingagain.

    Womenwithearlymenopausehavealongperiodofpostmenopausallife,whichmeanstheyareatincreasedriskofhealthproblemssuchasearlyonsetofosteoporosisandheartdisease.

    Itmayberecommendedthathormonetherapy(HT)betakenuntilthewomanreachesthetypicalageofmenopause(around51yearsold)totreathermenopausalsymptomsandtoreducetheriskofearlyonsetofosteoporosisandheartdisease.

    Rarely,theovariesmayspontaneouslystartworkingagain,forreasonsunknown.Accordingtosomestudies,aboutonein10womenwhoarediagnosedwithspontaneousprematuremenopausegetpregnant,forreasonsthatarenotyetclear.

    Emotional impact of early or premature menopause

    Prematuremenopausecanbeemotionallydevastating.Someofthecommonissuesawomanmayfaceinclude:

    griefattheprospectofnothavingchildren fearofgrowingoldbeforehertime fearsthatherpartnerwontfindhersexuallyattractiveanymore self-esteemproblems.

    Psychologicalcounsellingandsupportgroupsmayhelpthewomancometotermswithherexperience.

    Where to get help

    Menopause-prematureandearlymenopause Page2of3

  • Yourdoctor Gynaecologist JeanHailesforWomen'sHealthTel.1800JEANHAILES(532642)

    Things to remember

    Prematuremenopauseismenopausethatoccursbeforetheageof40years. Earlymenopausecanbeinducedbysomemedicaltreatmentssuchassurgeryor

    chemotherapy. Womenwhoexperienceearlyorprematuremenopausemayneedhormonetherapyto

    reducetheriskofdiseasessuchasosteoporosis.

    This page has been produced in consultation with, and approved by:JeanHailesforWomen'sHealth

    Contentonthiswebsiteisprovidedforeducationandinformationpurposesonly.Informationaboutatherapy,service,productortreatmentdoesnotimplyendorsementandisnotintendedtoreplaceadvicefromyourdoctororotherregisteredhealthprofessional.ContenthasbeenpreparedforVictorianresidentsandwiderAustralianaudiences,andwasaccurateatthetimeofpublication.Readersshouldnotethat,overtime,currencyandcompletenessoftheinformationmaychange.Allusersareurgedtoalwaysseekadvicefromaregisteredhealthcareprofessionalfordiagnosisandanswerstotheirmedicalquestions.

    Forthelatestupdatesandmoreinformation,visitwww.betterhealth.vic.gov.au

    Copyight 1999/2015StateofVictoria.ReproducedfromtheBetterHealthChannel(www.betterhealth.vic.gov.au)atnocostwithpermissionoftheVictorianMinisterforHealth.Unauthorisedreproductionandotherusescomprisedinthecopyrightareprohibitedwithoutpermission.

    Menopause-prematureandearlymenopause Page3of3

    Menopause - premature and early menopauseSymptoms of premature and early menopauseCauses of early or premature menopauseInduced menopauseDiagnosis of premature or early menopauseTreatment for early or premature menopauseEmotional impact of early or premature menopause Where to get helpThings to remember


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