Let’s talk about Premature Menopause
Premature Menopause
AKA
Primary Ovarian Insufficiency (POI)
or
Premature Ovarian Failure (POF)
It affects 1% of the population under 40, 0.1% below 30 years and 0.01% below 20 years, but before we dive into what premature menopause is, let’s go through the basics.
What is the Menopause?
Menopause: The last period. The average age of menopause is 51 years. It occurs as a result of the depletion of eggs in the ovaries.
Perimenopause: The duration of time from when the ovaries start to fail until 1 year after the last period. Only about 10% of people don’t experience any symptoms and instead just find their periods stop abruptly.
What is Premature Menopause?
Premature Menopause: often referred to as Primary Ovarian Insufficiency (POI) or Premature Ovarian Failure (POF), premature menopause occurs due to the loss of function of the ovaries before 40 years of age. It happens because the ovaries stop responding but there are still eggs left inside.
Iatrogenic Menopause: Menopause due to medical treatment. This may be due to medications such as chemotherapy, or surgical removal of the ovaries.
How common is Premature Menopause?
1% of the population before 40 years (1:100)
0.1% of the population before 30 (1:1,000)
0.01% of the population before 20 years (1:10,000)
Why does it happen?
In 90% of cases, the cause is unknown. 10% is due to autoimmune or genetic disorders. 30% of people with premature menopause have a family history of premature menopause.
Can I get pregnant?
5-10% of this affected may achieve a spontaneous pregnancy due to fluctuating function of the ovaries. Women with POF often go down the donor egg route using IVF when they want to start their families.
How do I know if I have it?
It is most commonly found it people being investigated for absent (amenorrhoea) or irregular/infrequent periods (oligomenorrhoea). Despite it being one of the most common signs of premature ovarian failure, absent or irregular periods can mean several other things, and is not the most common cause for these cycle changes.
How is the diagnosis confirmed?
Blood tests will be performed to look for other causes which need to be ruled out first. Levels of FSH (follicle stimulating hormone) will be very high. This blood test must be repeated 6 weeks later to confirm the diagnosis.
What are the symptoms?
No periods
Hot flushes
Night sweats
Vaginal dryness
Depression, anxiety, mood swings
Muscle and joint pain
Sleep disturbances
Fatigue
Memory & concentration difficulty
Low libido
Hair loss
What is the treatment?
Hormone Replacement Therapy
This is recommended up to at least the age of the natural menopause to reduce the risk of heart disease, osteoporosis, dementia, and depression associated with premature menopause.
There is no increase in the risk of HRT use until this time. It can be in the same form as some of the HRT used for the contraceptive pill. Your doctor should talk to you through your individual options, risks and benefits.
Psychological Support
This can be often overlooked but very important for both dealing with the diagnosis as well as the symptoms. The Daisy Network is dedicated to providing information and support to women diagnosed with Premature Menopause. Make sure to check their website and resources supporting women with this diagnosis. Their community is awesome.