Premature menopause
The average age American women go through menopause is age 51. If menopause (hormonal changes at the end of the female reproductive years) occurs before age 40, it is considered premature menopause. Possible causes include autoimmune problems and common cancer treatments.
About half of all women will go through menopause before age 51 and the restwill go through it after. Most women will finish menopause between the ages of 42 and 58. A small number of women will find that their periods stop prematurely, before age 40.
There are many possible causes of premature menopause. Women who have premature menopause often have autoimmune disorders like thyroid disease or diabetesmellitus. In these diseases, the body produces antibodies to one or more ofits own organs. These antibodies interfere with the normal function of the organ. Just as antibodies might attack the thyroid or the pancreas (causing thyroid disease or diabetes), antibodies may attack the ovaries and stop the production of female hormones.
Cancer treatments like chemotherapy or radiation can cause premature menopause. The risk depends on the type and length of treatment and the age of the woman when she first begins radiation or chemotherapy. If the ovaries are surgically removed (during a hysterectomy, for example) menopause will occur within a few days, no matter how old the woman is.
The symptoms of premature menopause are similar to those of menopause at anytime. Menstrual periods stop and women may notice hot flashes, vaginal dryness, mood swings, and sleep problems. Sometimes the first symptom of prematuremenopause is infertility. A woman may find that she cannot become pregnant because she is not ovulating (producing eggs) anymore.
When menopause occurs after the ovaries are surgically removed, the symptomsbegin within several days after surgery and tend to be more severe. This happens because the drop in the level of estrogen is dramatic, unlike the gradualdrop that usually occurs.
Premature menopause can be confirmed by blood tests to measure the levels offollicle stimulating hormone (FSH) and luteinizing hormone (LH). The levels of these hormones will be higher if menopause has occurred.
Because premature menopause is often associated with other hormonal problems,women who have premature menopause should be screened for diabetes, thyroiddisease, and similar diseases.
There is no treatment to reverse premature menopause. Hormone replacement therapy (HRT) can prevent the common symptoms of menopause and lower the long-term risk of osteoporosis. Women who have premature menopause should take HRT.Estrogen relieves the unpleasant symptoms of menopause, including the hot flashes and the vaginal dryness. Estrogen is especially important for women whogo through premature menopause. The long-term health risks of menopause (osteoporosis and increased risk of heart disease) are even more likely to occur after premature menopause. However, women who have certain medical conditions(like liver disease, uterine cancer, or breast cancer) may not be candidatesfor estrogen.
If a woman still has her uterus after premature menopause, she will need to take progesterone along with the estrogen. If her uterus has been removed, estrogen alone will be enough.
Women who wish to become pregnant after premature menopause now have the option of fertility treatments using donor eggs. This is similar to in vitro fertilization, but the eggs come from a donor instead of the woman who is tryingto become pregnant. Premature menopause cannot be prevented.
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