What is Premature Menopause?

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The average age a woman in the US reaches menopause is 52. If a woman reaches earlier than that, it may be considered early menopause or premature menopause. 

Premature Menopause vs Early Menopause

Sometimes the terms early menopause and premature menopause are used interchangeably. They are similar, but they differ based on age guidelines. According to the Office on Women’s Health, menopause that happens before age 40 is called premature menopause. Menopause that happens between 40 and 45 is called early menopause

Women going through premature or early menopause will experience the same symptoms as a woman going through menopause at the average age. These symptoms include:

  • Hot flashes
  • Night sweats
  • Vaginal dryness 
  • Difficulty sleeping
  • Headaches
  • Frequent urination
  • Hair loss or thinning
  • Mood changes
  • Depression or anxiety
  • Decreased sex drive

Causes of Early & Premature Menopause

Early and premature menopause can have the same causes. They may happen on their own and have no clear cause. Or they may be caused by certain health conditions or medical treatments. Potential causes of premature and early menopause include:

  • Bilateral oophorectomy: This surgical procedure removes both of the ovaries. Because the ovaries are no longer present to produce hormones, menopausal symptoms may start right after surgery.  
  • Hysterectomy: This surgical procedure removes the uterus. It is sometimes performed along with bilateral oophorectomy, but some women keep their ovaries which keep making hormones. In these cases, menopause will occur naturally but it may occur a year or two earlier than expected.
  • Chemotherapy or radiation treatment: These treatments can damage the ovaries and/or cause menstruation to stop. Menstruation may be stopped permanently or it may resume once treatment is stopped. 
  • Autoimmune diseases: Conditions like rheumatoid arthritis and thyroid disease may cause the body to attack the ovaries. This can prevent them from making hormones, which triggers premature or early menopause.
  • HIV and AIDS: If an HIV infection is not well controlled, early menopause may occur. 
  • Genetic conditions: If a woman is born without certain chromosomes, she may go through menopause early. This can also occur in women with abnormal or incomplete chromosomes. Disorders like Turner’s syndrome may cause developmental issues with the ovaries, which can affect ovulation, menstruation, and menopause.
  • Smoking: Women who smoke may experience early menopause. According to the Office on Women’s Health, smokers may reach menopause up to 2 years earlier than nonsmokers and their symptoms may be more severe.
  • Family history: If a woman has direct family members who experienced early or premature menopause, she is more likely to reach menopause early as well.

Premature & Early Menopause Management

Because there are health risks associated with premature and early menopause, it is important to seek help from a menopause practitioner to manage symptoms. 

Hormone Replacement Therapy (HRT)

Hormone replacement therapy can help alleviate the symptoms of premature and early menopause. HRT for menopause usually includes forms of the female sex hormones estrogen and progesterone. Treatments come in many forms including injections, oral medications, transdermal patches, creams, gels, and other topical forms. They also may be given with bioidentical pellet therapy.

This treatment is often recommended to younger women experiencing the symptoms of menopause because of the health risks associated with the condition. A qualified menopause practitioner is the best person to consult about whether HRT is the right treatment for you. 

Non-Hormonal Treatment

There are non-hormonal treatment options for premature menopause as well. They may be used in place of HRT for women who are not good candidates for that treatment. These medications may also be used alongside HRT. These medications include:

  • Antidepressants: Antidepressants like Paxil, Prozac, Zoloft, and Effexor are effective in treating the vasomotor symptoms of menopause, including hot flashes. They can also help with mood changes and depression.
  • Gabapentin: A medication that may reduce the frequency and intensity of hot flashes.
  • Brisdelle: A medication that contains a very small dose of the same drug in the antidepressant Paxil. The dose is not high enough to treat depression but it can help with hot flashes and night sweats.
  • Clonidine: A blood pressure medication that can help with hot flashes and night sweats.

See a Menopause Practitioner

As a certified menopause practitioner, Dr. Karen Clark of Chapel Hill Gynecology is experienced in helping patients manage the symptoms of menopause. She can help develop a treatment plan to help you manage the symptoms of conditions like premature menopause and improve your quality of life. To schedule an appointment, call (919) 960-2720. Chapel Hill Gynecology is open for office visits (using recommended protocols for preventing COVID-19 exposure) as well as telemedicine visits. 

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