Monday, June 27, 2011

Main Causes of Early (or Premature) Menopause

Early menopause and premature menopause are terms that are often used interchangeably. Both terms may cover a wide range of the different medical situations and conditions, like premature ovarian failure, surgical menopause, or menopause caused by chemotherapy or radiation.

The link between all these conditions is woman’s age, when the menopause symptoms are observed. As stated, early or premature menopause is typically used to mean menopause that comes well before the average age of normal menopause when you're still in your 20s, 30s, or early 40s. 

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More technically, as used by many doctors and medical journals:  
  • Early menopause refers to menopause before the age of 45. 
  • Premature menopause is menopause that occurs before age 40.  

Medical treatments that may cause early menopause include:
  • Chemotherapy or pelvic radiation treatments for cancer. These treatments can damage the ovaries and cause your periods to stop. Effects like having trouble getting pregnant can happen right away or several months later. The chances of going into menopause depend on the type and amount of chemotherapy that was used. Also, the younger a woman is, the lower the chances that she will experience menopause.
  • Surgery to remove the ovaries. Surgical removal of both ovaries, also called a bilateral oophorectomy (OH-uh-fuh-REK-tuh-mee), causes menopause right away. A woman’s periods will stop after this surgery, and her hormones drop quickly. She may immediately have strong menopausal symptoms, like hot flashes and diminished sexual desire.
  • Surgery to remove the uterus. Some women who have a hysterectomy (his-tur-EK-tuh-mee), which removes the uterus, are able to keep their ovaries. They will not enter menopause right away because their ovaries will continue to make hormones. But, because their uterus is removed, they no longer have their periods and cannot get pregnant. They might have hot flashes because the surgery can sometimes affect the blood supply to the ovaries. Later on, they might have natural menopause a year or two earlier than expected.
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  • Surgery to remove fallopian tubes.  Fallopian tubes removal causes early menopause. Hormone and egg production is dramatically interrupted, leading to the onset of early or premature menopause.
  • Tubal Ligation. Often women that have undergone a tubal ligation procedure enter menopause at an earlier age.
  • Tamoxifen. Tamoxifen used to be prescribed after you were diagnosed for breast cancer -- and, as with other forms of chemo, you would run a risk for premature menopause as a side effect. But recently doctors have begun prescribing Tamoxifen as a preventative to women with a high risk for breast cancer, since it cuts breast cancer rates by about 45 percent.  While the media has focused on the positive aspects of this drug (and there are many), there is an important potential side effect to Tamoxifen that hasn't been played up a great deal: it can send you into premature menopause. 

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Sometimes, menopause occures early on its own. Some possible causes include:
  • Chromosome defects. Problems in the chromosomes can cause premature menopause. For example, women with Turner's syndrome are born without all or part of one X chromosome. The ovaries don't form normally, and early menopause results.
  • Genetics. Women with a family history of early menopause are more likely to have early menopause themselves.
  • Autoimmune diseases. The body's immune system, which normally fights off diseases, may mistakenly attack the ovaries and prevent them from making hormones. Thyroid disease and rheumatoid arthritis are two diseases that can cause this to happen.
  • Infection. Infection is also linked with premature menopause. Infections such as the mumps and tuberculosis can infect the ovaries, affecting your hormonal balance. This is extremely rare, however.
  • Stress. Although stress cannot cause early menopause by itself, it does play an important role in the severity and frequency of symptoms.

When menopause comes early on its own, it sometimes has been called “premature menopause” or “premature ovarian failure.” But a better term is “primary ovarian insufficiency,” which describes the decreased activity in the ovaries. In some cases, women have ovaries that still make hormones from time to time, and their menstrual periods return. Some women can even become pregnant after the diagnosis.

This is yet another instance where you're often still getting fairly regular periods -- and your hormone levels aren't testing at post-menopausal levels, but you're getting symptoms. When this occurs before the age of 40, it's often viewed as a precursor to premature ovarian failure and is referred to as diminished ovarian reserve

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