The menopause, strictly speaking, starts at the time of your last period although the term is usually used to cover a longer time span. The average age at which periods stop is 50 but anything between the ages of 45 and 55 is considered normal. The term ‘premature menopause’ is usually used to describe any menopause that occurs before the age of 45. This may be related to a pattern in your family history, and an enquiry into your immediate female relatives will tell you if this is the case. If it occurs like this in your family, then this would be considered normal for you.
What can cause premature menopause?
Apart from family factors, a premature menopause may result from medical or surgical treatment. Any surgery that involves the removal of the ovaries will obviously do this, but other surgery in the region of the ovaries, such as a hysterectomy, can impair their blood supply and lead to atrophy of the ovaries and thus to premature menopause.
Treatment involving chemotherapy and radiotherapy can cause a premature menopause as can treatment with certain drugs and this condition may be permanent or temporary, depending upon the cause. Other conditions such as autoimmune disease, hormonal imbalances and excessive emotional or physical stress can be also bring about a premature menopause
Temporary Hormone Imbalance
If you are diagnosed as having a premature menopause it is very important to ensure that this diagnosis is correct, and to ensure that it is not just a temporary hormone imbalance that can happen for a number of reasons, stress being among them. It is also seen in women in their late thirties or early forties who, having taken the contraceptive pill for many years, then stop it and find that their periods do not return. Their hormones are out of balance, but this does not necessarily mean that they are in an early menopause. Although if their doctor does a hormone test at this time it will often show a menopausal picture and they will usually be offered Hormone Replacement Therapy (HRT). This can be devastating news especially if you were hoping to become pregnant, but in my experience a misdiagnosis of a premature menopause can easily be made.
The reason the test shows this menopausal result is because the ovary has not yet recovered from the suppression caused by the contraceptive pill, and natural ovulation has not yet recommenced. It is therefore always worth waiting for a few months before accepting a diagnosis of premature menopause.
At this time it is essential to eat a good whole food diet and to take nutrients to help the restoration of a normal hormone balance. The periods will often reappear and all will be well, but if HRT is taken the restoration of a normal hormone balance cannot occur.
Trying to become pregnant
If you have been on the contraceptive pill and come off it in order to become pregnant and your periods do not restart, you should not despair. In a normal menstrual cycle when you ovulate the ovary produces large quantities of progesterone to prepare the body and the lining of the uterus for a pregnancy. If no fertilisation occurs, the ovary stops making the progesterone after about 12 days and the lining of the uterus is shed as the menstrual flow. This drop in progesterone level seems to stimulate the pituitary to start the next cycle and stimulate the ovary to ovulate. If this mechanism has been stopped by the pill, or stress, it can take time for it to get going again
It is sometimes possible to restart this cycle artificially by using progesterone for two weeks and leaving it off for two weeks to fool the pituitary that ovulation is taking place.
Consequences of premature menopause and how to treat them
If there is a true premature menopause, and not a temporary situation, then treatment should be considered. One particular risk that increases is that osteoporosis and other problems that are associated with the normal menopause are often more severe. A good diet and nutritional supplements can help these problems, but if the symptoms are severe HRT may be recommended. If HRT is recommended, this is usually offered in the balance and dosage normally prescribed to older women, who have experienced a natural menopause and is advised for long term usage.
It is far better to consider the use of natural or bio-identical hormones as this ensures that you replace the actual hormones that are missing in the correct dosage for you, rather than chemicals in a standard dose. Whether or not it will be necessary to take these long-term or not varies from person to person.
It is interesting that women who frequently experience a premature menopause, and need hormone supplementation, find that this is no longer necessary once they reach the years when the menopause would have been expected to occur naturally. In fact at that time they often experience problems with the hormone supplements that, up until then, have kept them in balance.
This is due to the usual and normal change in hormone production that occurs with the natural menopause, as the premature menopause was due to a malfunction of the ovary. However, it does not seem as if this in any way affects the mechanism whereby fatty tissue starts to make oestrogen, rather than the ovary, at the time of the natural menopause. As a result the woman who had a premature menopause due to ovarian failure or removal now starts making her own oestrogen again, but from a different source – the fatty tissue of her own body.
It is essential that when this occurs that the dosage of the supplemental hormones is adjusted and often such women find that they no longer need to take additional hormones.
All women who experience a premature menopause should have regular screening to ensure that their hormone balance is correct and that they are not developing osteoporosis.
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