Early or Premature menopause, when menstrual periods stop permanently before age 45, affects 8-10 percent of women but receives little attention.
One medical causes of premature menopause are known as the premature ovarian failure. Other causes of premature menopause include damage to the ovaries by chemotherapy and/or radiation treatments, or surgical removal of the ovaries.
The symptoms of premature menopause are those of typical menopause. They can include mood swings, vaginal dryness, cognitive changes, hot flashes, a decrease in sex drive, and sleep disturbances. Diagnostic tests can show an elevated level of follicle-stimulating hormone (FSH) and low level of estradiol.
Complications of premature menopause include infertility and an increased risk for osteoporosis.
Hormone replacement therapy (HRT) is recommended for women diagnosed with early menopause in order to replace the hormones the body is missing.
It is recommended to:
Ease menopausal symptoms
Maintain bone density and reduce the risk of osteoporosis
Reduce the risk of early onset of cardiovascular and heart disease
In one in 10 women, pregnancy occurs spontaneously after the diagnosis of POF, and where a woman wants to have this chance of spontaneous pregnancy, the hormone therapy consists of continuous oestrogen with cyclic progestin therapy. Otherwise, a woman can be prescribed the oral contraceptive pill. Both of these therapies will normally give a monthly period. If your period doesn’t occur when a pregnancy test should be performed.
Higher doses of hormones are often prescribed because younger women require more hormones to maintain the quality of life and wellbeing. Testosterone, which is also a female hormone, may be considered.
Long-term risks of hormone therapy
Although there are no long-term studies of HRT in women experiencing an early menopause, it is recommended that HRT should be taken to the expected age of menopause (45-50 years of age). All the studies of long-term use of HRT published in recent years have been in women some years after the expected age of menopause, who have much greater risks of heart disease, stroke, and cancer because of their age. Anticipated serious adverse effects in younger women are very rare.
Long-term follow up is recommended
Monitor your symptoms and therapy
Maintain regular monitoring of heart disease risks and bone density
Continue surveillance to exclude the development of other conditions such as other gland failure, thyroid, adrenal, diabetes