Menopause is a natural part of life that marks the end of a woman’s ability to have children, usually happening between ages 45 and 55. However, reaching menopause earlier involves an additional set of challenges that are part of a condition called premature menopause.
What is premature menopause?
Premature menopause, also called primary ovarian insufficiency (POI), happens when a woman’s ovaries stop working properly before the age of 40.
The ovaries produce eggs and hormones like estrogen and progesterone, which control a woman’s menstrual cycle. When these hormones decrease or halt, a woman’s periods stop and she may experience menopausal symptoms, like hot flashes, night sweats and vaginal dryness.
For women going through menopause early or prematurely, it may feel unexpected and confusing. Not only does it signal the end of fertility, but it can also bring on various physical and emotional changes that can feel overwhelming.
If you suspect you may be experiencing early menopause, make an appointment with your gynecologist. They can determine the best treatment plan for your symptoms.
What causes premature menopause?
There are several reasons why a woman might begin menopause early, although in some cases, the cause isn’t clear. Here are some of the main reasons
- Genetics: Family history plays a significant role in the timing of menopause. If your mother or sister had early menopause, you might be more likely to experience it as well. Some genetic conditions can also increase the chances of early menopause.
- Medical treatments: Treatments like chemotherapy or radiation for cancer can damage the ovaries and cause premature menopause. The treatment poses a higher risk if it affects the ovaries directly or if doctors administer it at a younger age.
- Surgical removal of the ovaries: If both ovaries are removed in surgery (a procedure called a bilateral oophorectomy), menopause will happen right away, no matter the woman’s age. This can happen if a woman needs surgery for conditions like ovarian cysts or cancer.
- Autoimmune disorders: Some conditions, like rheumatoid arthritis or lupus, can cause the body’s immune system to attack its own organs, including the ovaries, which can lead to early menopause.
- Infections and health conditions: Certain infections and medical conditions may also damage the ovaries. For example, viral infections like mumps or tuberculosis can sometimes affect the ovaries. Chronic conditions like diabetes and thyroid disease can also interfere with hormone levels.
- Lifestyle factors: Smoking and high levels of stress may speed up the onset of menopause. Studies show that smoking can cause the ovaries to decline sooner than they would otherwise.
Symptoms of premature menopause
The symptoms of premature menopause are often similar to those experienced in natural menopause, but they can happen much earlier. Common symptoms include:
- Irregular periods: Changes in your menstrual cycle are often one of the first signs of premature menopause. Periods may become irregular, lighter or heavier, or more frequent or less frequent than usual.
- Hot flashes and night sweats: Hot flashes (feeling suddenly hot, often with sweating) and night sweats (waking up drenched in sweat) are common symptoms of menopause. They can happen during the day or night and disrupt sleep.
- Vaginal dryness: Lower estrogen levels can make the vaginal tissues drier. This can cause discomfort during sex or frequent urinary issues.
- Mood swings and irritability: Hormonal changes can affect your mood, leading to feelings of sadness, anxiety or frustration. Emotional well-being may be hard to manage during this time.
- Fatigue and sleep problems: Many women feel more tired than usual and have trouble sleeping, which can make other symptoms worse.
- Reduced fertility: Since premature menopause causes the ovaries to stop working, women often struggle to get pregnant naturally.
Long-term health risks
While the symptoms of premature menopause can be difficult, the condition can also lead to longer-term health risks. Because estrogen is important for keeping bones and the heart healthy, women who go through menopause early are at a higher risk for:
- Osteoporosis: Lower estrogen levels can lead to weaker bones, making them more likely to break. Women with premature menopause may need to take steps to protect their bone health.
- Heart disease: Estrogen helps protect the heart and blood vessels. Women who experience early menopause may have a higher risk of heart disease, stroke and other cardiovascular diseases.
- Cognitive decline: Some research suggests that women who go through menopause early may have an increased risk of memory loss or conditions like Alzheimer’s disease. However, this requires more research.
Treatment options
While there is no cure for premature menopause, there are ways to manage symptoms and reduce health risks. At first glance, treatment options can be split up into two categories: prescription and over-the-counter. From there, you can narrow your options down based on the symptoms you’re seeking to treat, says Coral Spicer, MD, an OB-GYN in our Springfield market.
One of the most commonly known treatments for premature menopause is hormone replacement therapy, or HRT. Ths involves taking hormones to replace the ones your ovaries no longer produce. This can help reduce hot flashes, vaginal dryness and other symptoms. However, HRT isn’t for everyone and it’s important to talk to your doctor about the risks.
However, that there are treatment options aside from hormone replacement therapy, and several that do not include the risks associated with HRT, Dr. Spicer says.
Some prescription treatment options include:
- Anti-depressants: Low-doses of anti-depressant medications can reduce the severity and frequency of hot flashes. They can also address mood swings and help with anxiety.
- Non-hormonal medication: Hot flashes can also be treated with a non-hormonal medication that is newer to the market. However, your provider will need to do blood work prior to starting this treatment with you as well as monitoring it with continued blood work, Dr. Spicer says.
- Vaginal dryness medication: There are several treatment options that are targeted to the vaginal tissue. These increase the blood flow to the vagina and increase natural lubrication. Because they change tissue, it takes eight weeks of consistent use before they reach full efficacy. They do not have the same risks as systemic hormones because they act locally. These medications can come in many forms, including vaginal estrogen creams, vaginal inserts and an oral pill.
Other options you can get over the counter or don’t require a prescription include:
- Estroven, black cohosh and ashwagandha root: These supplements can help some women find relief from hot flashes and other menopausal symptoms.
- Vaginal lubricants and moisturizers: Used to treat vaginal dryness, there are many varieties of lubricants and moisturizers on the market that you can choose from. Most are gels and creams, but some come in a pill-like form that is absorbed by the skin in the vagina.
- Bone health: Your doctor might recommend taking calcium and vitamin D supplements to protect your bones. Weight-bearing exercises (like walking or strength training) can also keep bones strong. In some cases, your doctor may prescribe medications to help prevent bone loss.
- Emotional support: The emotional toll of premature menopause is real. Talking to a counselor or joining a support group can help you deal with the emotional challenges of this condition and connect with others going through the same thing.
How we can help
Premature menopause is a condition that can change many aspects of a woman’s life. It may happen unexpectedly, but understanding the causes, symptoms and treatment options can help women make informed choices and feel more in control of their health.
If you think you might be experiencing premature menopause, make an appointment with your gynecologist. They can help you understand your options, offer treatments to manage symptoms and guide you in protecting your long-term health.
Learn about the women’s health and gynecology services we offer at Mercy Health.
