Premature Menopause Symptoms

Premature Menopause Symptoms

Menopause is a natural occurrence in a woman’s life when she no longer is able to become pregnant. This usually occurs between the ages of 47 and 55. In some instances, however, premature menopause occurs in women before they reach the age of 40. This is known as premature ovarian failure or POF, and is sometimes called premature ovarian insufficiency.

Because POF can occur during normal (and desired) childbearing years, having proper diagnosis and subsequent treatment options available may preserve a woman’s overall level of health. As menopause is uncommon in women younger than 40 years of age, premature menopause symptoms may be attributed to other conditions.

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First Signs of Menopause: Diagnosing POF

Premature menopause symptoms, because they occur at such an uncommon time in a woman’s life, may be misinterpreted as symptomatic of other conditions. For women younger than 40 who have stopped having periods or begun having noticeably irregular periods, a doctor should be consulted.

Initial diagnosis at the first signs of menopause may involve determining any family history of early menopause or other reproductive endocrinology issues. Additionally, blood tests are usually done to check estrogen and progesterone levels, as well as follicle stimulating hormone and sometimes luteinizing hormone. These tests will indicate whether the ovaries are functioning properly.

If it is determined that the ovaries are showing signs of failure or impending menopause, further tests may be performed. In about two thirds of women with premature ovarian failure, a cause can be found. Sometimes an autoimmune process is present, and sometimes a genetic cause is present. Making a diagnosis is helpful because there may be a need to conduct follow up testing to protect a woman’s health.

Symptoms of Hormone Imbalance: Treatment Options

For women going through POF, there are treatment options. The most popular menopause treatment option for women of all ages is hormone therapy. As the body’s levels of estrogen fall, they can be supplemented to ease premature menopause symptoms and reduce related risks of developing osteoporosis. There are, however, certain factors that need to be taken into consideration.

First, estrogen, if taken by itself, can increase a woman’s risk of developing uterine cancer. That’s why hormone therapy consists of taking estrogen with progestin, which is a form of progesterone. This helps to protect the lining of the uterus. For women who have had their uterus removed surgically, this is not a concern estrogen therapy alone is the preferred option.

Moreover, estrogen therapy and hormone therapy is often contraindicated for women who have:

• A family history of breast cancer
• Had breast cancer themselves
• Uterine cancer
• Liver disease
• Heart disease
• A history of blood clots
• Any unusual vaginal bleeding

For women who are not experiencing or have not experienced the items in this list, hormone therapy may be a very effective way to treat the premature menopause symptoms of hormone imbalance. For women with premature menopause, it is believed that symptoms are more severe than when menopause occurs between ages 47-54. In most cases, hormone therapy can be continued until the normal age of natural menopause is reached.

Fertility after a diagnosis of premature ovarian failure is rare but not impossible. The ovary is more likely to recover in younger women. It is estimated that 5-10% of women with premature ovarian failure will conceive on their own. There are no proven effective treatments for inducing fertility in women with POF. However, women with POF are capable of carrying a pregnancy to term and giving birth using a donated oocyte. Assisted Reproductive Technology (ART) centers provide these treatments.

Alternatives to Hormone Therapy

For women who fall into the above category, or those who simply wish to pursue treatment options that are not hormone-based, there are a number of viable non-hormone options that can begin at the first signs of menopause. These options to address premature menopause symptoms include:

• SSRI and SNRI drugs - Known as Selective-Serotonin Reuptake Inhibitor and Serotonin Norephinephrine Reuptake Inhibitor by their medical names respectively, these drugs have proven useful in treatment for hot flashes and depression.
• Medroxyprogesterone acetate and megestrol acetate - These drugs are similar to progesterone and can be used to treat hot flashes.
• Clonidine - Primarily prescribed as an agent to lower blood pressure, Clonidine can be effective in reducing both the severity and frequency of hot flashes.
• Gabapentin - For hot flashes that occur primarily during the night and disrupt normal sleeping patterns, Gabapentin can be effective.
• Lubricants and Moisturizers - To address common premature menopause symptoms such as vaginal dryness and irritation, there are a variety of vaginal moisturizers and lubricants available over-the-counter.
• Low-dose vaginal estrogen - Estrogen delivered in low enough does to remedy vaginal dryness and irritation limits the amount of estrogen in the blood stream and may be safe for some women who cannot take estrogen by mouth.
• Communication and counseling -- Women with POF often experience loss and reactive depression due tot their unexpected inability to conceive. Emotional issues associated with mood swings as well as changes to libido may also be present. ,Women who are experiencing unusually severe symptoms, persistent sadness or suspect they may be depressed should seek professional help. .

To know which hormone therapy alternative are most suited to your needs, consult your doctor. To learn more about hormone treatment options and more, please visit our premature menopause symptoms resource page.

Living with Premature Menopause Symptoms

As the body changes, leading a healthy lifestyle is even more important. A body that is in better condition is better prepared to handle not only the physical symptoms of menopause, but the emotional ones as well. The most important lifestyle changes a woman are as follows:

• Quit smoking. Even smoking less is beneficial.
• Alcohol should be consumed in moderation, if at all.
• Practice physical exercise a for a minimum of 30 minutes per session, 3 times per week.
• Do you best to avoid situations you know will induce stress.
• Get mammograms as prescribed by your doctor and annual clinical breast exams

For more information regarding other conditions and diseases associated with premature menopause symptoms, please see our menopause lifestyle and prevention page.

Editors:

Richard Santen, MD

Nannette Santoro, MD

March 2008

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The Hormone Health Network is the public education affiliate of The Endocrine Society. As such, our aim is to provide resource for citizens and professionals regarding not only premature menopause symptoms, but all conditions related to hormonal changes or abnormalities.

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