Early Menopause: What is it and what can cause it to happen?

Menopause is the time in a woman's life that marks the end of her menstrual periods. In most cases, this is a normal body change that completes when you haven't had your period for a year, and almost always happens between the ages of 45 and 55 (51 years on average). It is a natural process and its early appearance is called early menopause (MedlinePlus, 2019).

Symptoms and signs you may experience during early menopause

The main symptom of early menopause is that menstruation becomes infrequent or completely interrupted, for no other reason, before the age of 45. However, every woman experiences menopause differently. They may have symptoms and signs that begin before your period ends and last for several years. These include (NHS, 2021; Brazier, 2021):
  • Hot Flushes caused by a sudden feeling of heat in the upper body. They usually happen in the first year after menstruation ends but may continue up to 14 years later.
  • Vaginal dryness and discomfort during sexual intercourse that generates irritation. It can begin during perimenopause (transition to menopause) and continue until menopause.
  • Sleep disorders that cause sleep problems such as anxiety, night sweats and increased need to urinate.
  • Emotional changes such as low mood, irritability, depression, and anxiety.
  • Reduced sex drive (low libido). This leads to a decrease in sexual interest or changes in sexual response.
  • Low fertility due to lack of estrogen.
  • Memory problems and difficulty concentrating.
  • Physical changes such as weight gain, fat buildup in the abdomen, breast reduction and tenderness, hair and skin changes, and urinary incontinence.

Causes of early menopause

According to the NHS (NHS, 2021), the early menopause occurs when a woman's menstruation stops for a year before the age of 45. It can develop due to several factors:
  • Because the ovaries naturally stop producing normal levels of certain hormones
  • As a side effect of cancer treatment.
  • Surgery to remove the ovaries
  • Primary ovarian failure due to disease, certain infections or hereditary causes
However, factors that may be involved in the development of early menopause are (NHS, 2021; Mayo Clinic, 2021):

Impaired reproductive hormone levels

The early menopause can happen naturally if the ovaries stop producing normal levels of certain hormones, due to genetic causes, an autoimmune disease, or certain infections. Particularly the hormones that regulate menstruation: estrogen and progesterone. This happens when you get close to 40, so fertility decreases. Likewise, your periods undergo changes, making them longer or shorter, more intense or less frequent, until you stop having them.

Cancer treatments

Cancer treatments of radiation therapy and chemotherapy can induce menopause permanently or temporarily. This they cause symptoms such as hot flushes during or shortly after treatment. Chemotherapy can affect the ovaries with interruption of menstruation and fertility, although it is not always permanent after treatment. Whereas radiation therapy only affects ovarian function if it is specifically targeted at these organs. Also, the risk of premature menopause may be increased if you receive radiation therapy around the brain or pelvis.

Surgery to remove the ovaries

Surgical removal of the ovaries will also cause early menopause. With surgery, menstrual periods stop and you'll experience hot flushes and other signs and symptoms that can be severe. This is because hormonal changes happen abruptly rather than progressively over several years.

Primary ovarian failure

Early menopause may be the result of primary ovarian failure. It occurs when the ovaries do not produce normal levels of reproductive hormones due to genetic factors or autoimmune disease before the age of 40. The cause is often unknown, but in some women it may be due to:
  • Chromosomal abnormalities, which are alterations in the structure of the chromosome, such as turner syndrome.
  • Autoimmune disease such as type 1 diabetes or multiple sclerosis where the immune system attacks body tissues.
  • Less often from other infections such as tuberculosis, malaria, and mumps.
  • For hereditary reasons, if any of your relatives went through the early menopause.
The early menopause and the factors involved in it’s development

Treatments to relieve symptoms of early menopause

In some women, many of the symptoms of early menopause disappear over time without treatment. However, there are treatments that focus on relieving them to prevent chronic disorders that can happen with age. The main ones are (FDA, 2019; Mayo Clinic, 2021; McDermott, 2019):

Hormone therapy (HT)

Estrogen hormone therapy is an effective treatment to relieve the symptoms of estrogen. early menopause such as hot flushes, night sweats, vaginal dryness and low mood. If you still have a uterus, it is also combined with progesterone. The recommendation is to use low doses of hormones for a short period of time. This will relieve symptoms and avoid cardiovascular and breast cancer risks from prolonged use. Recommendations for starting hormone therapy during early menopause focus on:
  • Women who have recently entered menopause.
  • Do not use the medicine for longer than necessary. Although some women may need to use estrogen for a long time because of problems with hot flushes.
  • Women with a low risk of stroke, heart disease, blood clots, or breast cancer.

Vaginal estrogen

Giving estrogen directly into the vagina is a treatment that relieves vaginal dryness, sexual discomfort, and urinary incontinence. This is applied with a vaginal cream, patch, or ring, which releases a small amount of estrogen to be absorbed into the vaginal tissues.

Healthy lifestyle

Living a healthy lifestyle can help prevent or reduce the effects of early menopause. For that, eat a balanced diet that provides essential nutrients such as vitamins A, group B, C, D, E and K and minerals such as calcium, magnesium, selenium and zinc. This should include a variety of fruits, vegetables, and whole grains. Limit saturated fats, oils, and sugars. Check with your doctor if you need supplements of these nutrients to help meet your daily needs. Exercise regularly to protect yourself from age-related illnesses. Sleep well and avoid smoking. These healthy habits can help you manage menopausal symptoms. However, you can talk to your doctor about your options and whether more powerful solutions like medications are needed.

Health risks that early menopause can bring

Women who experience early menopause may present health risks similar to their regular occurrence. Among the effects of menopause that stand out most are (OASH, 2018; Brazier, 2021):
  • Increased risk of cardiovascular disease and osteoporosis due to low estrogen levels.
  • Feeling sad and depressed about loss of fertility or change in your body. You may feel less energy and lack of interest in things you once enjoyed.
  • Breast cancer, which may develop more likely after menopause because of the hormonal changes involved.
These risks can be mitigated by living an active and healthy life. It's important that you eat a healthy diet, have good sleep habits, and practice exercise. Also, seek counseling for depression and explore your experience by talking to your friends and family (Brazier, 2021). Early menopause happens when menstrual periods are rare or stop before age 45. It can happen naturally or be induced by various treatments, and its development can bring health risks. Going through this stage of your life can be difficult, but there are treatments to relieve your symptoms, which should be guided by medical prescription. A healthy lifestyle that includes a balanced diet and regular physical exercise will promote change and improve your well-being. References U.S. Food and Drug Administration . (2019, August 22). Menopause. https://www.fda.gov/consumers/womens-health-topics/menopause Brazier, A. (2021, October 3). Signs and symptoms of menopause, and treatments if you are experiencing them. Medical News Today. https://www.medicalnewstoday.com/articles/155651#_noHeaderPrefixedContent Mayo Clinic. (2021, July 29). Menopause. Symptoms and causes. Diagnosis and treatment. https://www.mayoclinic.org/es-es/diseases-conditions/menopause/symptoms-causes/syc-20353397 McDermott, A. (2019, April 22). Can vitamins help relieve menopause symptoms? Healthline. https://www.healthline.com/health/menopause/vitamins-for-menopause#takeaway MedlinePlus. (2019, June 30). Menopause. https://medlineplus.gov/spanish/ency/article/000894.htm Office for Women's Health . (2018, May 22). Early or premature menopause. https://espanol.womenshealth.gov/menopause/early-or-premature-menopause National Health Service in the United Kingdom . (2021, February 2). Early menopause. https://www.nhs.uk/conditions/early-menopause/ Last edited: 9th May 2022

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