Premature Menopause

Gynaecologist and Obstetrician, Premature Menopause, Dr JFA Potgieter

Premature menopause is a fairly rare condition which occurs when women under the age of 40 experience menopause. Menopause typically takes place from the age of around 45 years of age, but some women start experiencing menopause symptoms from as young as their teens, which can be traumatic for young women.

Though the exact reason for premature menopause is not yet known, there are factors which are believed to contribute towards the condition. These include:

  • A family history of early menopause
  • The surgical removal of the ovaries or a hysterectomy
  • Medical treatments such as radiotherapy and chemotherapy, even when the ovaries are not removed.
  • A history of tuberculosis, mumps, malaria, shingles or chickenpox (very rare cases)
  • Medical conditions such as enzyme deficiencies, Down’s syndrome, Turner’s syndrome, Addison’s disease and hypothyroidism

Most women experience menopause later in life - when the production of eggs in the ovaries slows and eventually stops. If the function of the ovaries is hindered, egg production could be halted much earlier than expected and premature menopause may begin. Not all women have menopause symptoms, however the most common are the following:

  • Hot flashes
  • Early morning awakening
  • Irritability
  • Difficulty with short-term memory
  • Difficulty with concentration

As with symptoms of the menopause, symptoms of premature menopause are often put down to stress, life events or other factors. The misdiagnosis of premature menopause by doctors is widespread as there is a belief that menopausal symptoms only manifest themselves as we reach late 40s and early 50s. This can lead to frustrating delays in diagnosis.

Women going through premature menopause will produce lower levels of oestrogen in their ovaries. This can lead to reduced numbers of eggs being released and, as a result, intermittent periods. It does not mean that no eggs are produced and some women may still be able to conceive. However, infertility is common and can be a devastating consequence of premature menopause for those who wish to have children.

The reduced production of the hormone oestrogen during premature menopause can affect a women's overall health as oestrogen has an impact on almost all the tissues in the body. Most affected are the bones, the cardiovascular systems and the brain. Bone thinning may occur and this can cause osteoporosis. It is therefore very important to follow exercise and nutrition guidelines for osteoporosis. In order to boost low levels of oestrogen it is common for women in early menopause to undergo hormone replacement treatment (HRT).

Premature ovarian failure (POF):
There is a lot of confusion out there surrounding POF. The first thing is that Premature Ovarian Failure and Premature Menopause are not separate conditions but terms used for when the ovaries stop functioning properly before the age of 40. It it a different process to the natural menopause, but brings about the same symptoms (often more severe) than than normal menopause. It is also known as Primary Ovarian Insufficiency, which is a more accurate description as it can come about due to a dysfunction of the eggs. The term 'early menopause' applies to women with the same condition between 40 and 45.

Premature Ovarian Failure (POF) is also known as Premature Ovarian Insufficiency. It may be the diagnosis for some women who have FSH levels above the level of 40. It's a rare condition that affects 1-4% of women in the world.