What is premature menopause?

Premature menopause, also known as premature ovarian insufficiency (POI) or premature ovarian failure (POF), is a medical condition in which a woman's ovaries cease to function before the typical age of natural menopause, which is typically between 45 and 55 years old. In premature menopause, this process occurs before the age of 40. This condition can have significant implications for a woman's overall health and well-being, as it disrupts the normal hormonal balance in the body.

Gynaecologists, genitourinary specialists and endocrinologists all treat premature menopause.

Symptoms of premature menopause

The symptoms of premature menopause are generally the same as with normal menopause; the key difference is that the symptoms begin to manifest before the age of 40. The principal symptom is that the woman’speriods stop. Preceding the menopause is the perimenopause, in which the periods become less frequent. Other symptoms include:

• Vaginal dryness
• Hot flushes
• Night sweats
• Memory or concentration issues
• Weight gain
• Vaginal pain during intercourse
• Loss of libido
• Anxiety or low mood

Some women who experience premature menopause may be at higher risk of heart disease and osteoporosis, as they will have to live without oestrogen for longer.

Not being able to have children is another effect of menopause. This and/or the changes happening in the patient’s body can lead to psychological effects such as depression. If you have been experiencing extreme low moods, disinterest in things you once enjoyed, and other symptoms of depression for more than a few weeks, you should see your doctor or a specialist.
 

What are the causes of premature menopause?

Sometimes, there is no clear reason why a patient undergoes premature menopause, but often it can be attributed to certain factors:

• Genetics – women with a family history are more likely to experience premature menopause.
• Smoking
• Chemotherapy or pelvic radiation treatments for cancer
• Surgery to remove the ovaries
• Hysterectomy (removal of the uterus)
• Autoimmune diseases
• HIV/AIDS
• Chronic fatigue syndrome
• Missing chromosomes

Treatments for premature menopause

Hormone replacement therapy (HRT): Hormone replacement therapy is a common treatment for managing the symptoms of premature menopause. HRT involves taking medications that contain oestrogen and, in some cases, progestin (synthetic progesterone). These hormones help to replace the declining levels of oestrogen in the body, alleviating symptoms such as hot flashes, vaginal dryness, and mood swings. HRT can be administered in various forms, including pills, patches, creams, and vaginal rings. However, not all women with premature menopause are suitable candidates for HRT.

Suitability: HRT may not be recommended for women who have a history of certain medical conditions, such as breast cancer, blood clots, or heart disease, as oestrogen replacement can increase the risk of these conditions. It's essential for women considering HRT to discuss their medical history and individual risk factors with their healthcare provider.

Combined contraceptive pill: For some women with premature menopause who are not at risk of pregnancy, the combined contraceptive pill may be prescribed. This pill contains both oestrogen and progestin, which can help regulate menstrual cycles and alleviate menopausal symptoms. It's worth noting that this treatment is primarily used to manage symptoms rather than as a contraceptive method.

Non-Hormonal therapies: In cases where HRT or hormonal contraceptives are not suitable, or if a woman prefers non-hormonal options, there are other approaches to managing symptoms:

Lifestyle changes: Adopting a healthy lifestyle can have a significant impact on symptom management. This includes maintaining a balanced diet, engaging in regular exercise, managing stress, and avoiding triggers that worsen symptoms like caffeine, alcohol, and spicy foods.

Vaginal moisturisers and lubricants: For vaginal dryness and discomfort, over-the-counter vaginal moisturisers and lubricants can provide relief. These products can improve comfort during sexual activity and reduce irritation.

Medications for specific symptoms: Some symptoms, like mood swings or sleep disturbances, may be managed with medications other than hormones. Antidepressants or sleep aids, prescribed under a doctor's guidance, can be considered.

Fertility preservation: Women who wish to preserve their fertility despite premature menopause may explore options such as egg freezing or embryo preservation before their ovarian function declines significantly. These methods allow for the preservation of eggs or embryos for potential future use.