Premature Ovarian Failure – Infertility is often the most significant concern when you start menopause early.
What is premature menopause? The WHO defines natural menopause as the cessation of menses for more than a year in a woman resulting from the loss of ovarian function. Normal menopause occurs between 45 to 55 years of age, with a mean age of 51. However, Menopause is said to be early if it occurs between 40 to 45 years of age, whereas below 40 years is labelled as PREMATURE. Indian studies on women aged 15-49 revealed the incidence of Premature Menopause as 1.5%. Some Indian surveys have also shown that 18% of married women between 30-49 years had reached menopause. According to recent studies, the number of women who experience early menopause related to premature ovarian failure is rising worldwide. The overall incidence of Premature Menopause worldwide is 1%. However, some surveys have reported the incidence as high as 8%.
Dr Pratibha Singhal, Director, Department of Obstetrician and Gynaecology, Cloudnine Group of Hospitals, Noida, shares the causes, symptoms and treatment of premature menopause.
Causes Of Premature Menopause
- Genetic factors: Demographic studies reveal the lowest rate in Kerala (0.2%)and the highest in Odisha (2.4%). A higher incidence has been found in the poorest and lowest in the richest. (7.7%) Female sterilisation at an early age also leads to premature ovarian failure and subsequent Premature Menopause.
- Autoimmune Conditions:Autoimmune conditions like thyroiditis, adrenal insufficiency, and rheumatoid arthritis are commonly associated with POF leading to premature menopause. Above all, several studies have strongly associated Premature Menopause with the rapidly changing dynamics of the Indian family and the increased stress upon women to be financially independent. These pressures are coupled with a lack of proper nutrition and sedentary lifestyles. Smoking in the modern lifestyle makes women more prone to premature menopause.
Hormone Replacement Therapy
This unfortunate condition often hits young women at the heart of their self-esteem; many think they will never feel normal again. Unfortunately, besides hormone replacement therapy (HRT), conventional medicine doesn’t have many answers regarding POF. Therefore, it is impossible to reassure them of regaining the normal function of their ovaries. Still, a complete understanding of the problem and its management makes life easier for the affected woman
Symptoms Of Premature Menopause
- Reduced menstrual flow
- Progressively delayed cycles
- Vaginal dryness
- Trouble sleeping
- Night sweats
In such cases, women must see a doctor immediately.
Premature Ovarian Failure
Premature menopausal women face the devastating concern of infertility if she has had no issue till such a situation has arisen. POF is usually permanent, but ovarian activity can resume in 5-10% of cases leading to the return of menses and sometimes fertility. However, with full menopause use of donor eggs, IVF and adoption are the only means left for becoming parents in cases of Premature Menopause.
Some Other Clinical Features
The other clinical features of concern are the early start of hot flashes, night sweats, mood swings, behavioural changes, lowered sex drive, vaginal dryness, repeated urinary infection, weight gain, sleep disorders etc. Apart from these clinical features, women facing premature menopause are at greater risk of bone weakness or osteoporosis due to a longer span of life left with very low estrogens. Similarly, having lost the protective effect of estrogens for the heart at an early age, these women are more prone to heart disease. Further, premature menopause often leads to depression due to fluctuating hormones in the body coupled with a highly anxious state of mind following the early cessation of menses.
So How Can Pre-Mature Menopause Be Treated?
Medical management of women suffering from premature menopause aims to regain a vibrant perspective of life with specific therapies, lifestyle modifications, and regular exercise schedules.
Dietary changes have an essential role in lowering transfats and refined carbohydrates. Therefore, calcium, multivitamin and vitamin D supplements are advised regularly. Hormone replacement therapy, if advocated, has to be strictly monitored because of the proven increased risk of breast and uterine cancers.
