Premature Menopause

Premature menopause has many causes:

If the cause is a disorder that confers a Y chromosome, the risk of cancer of the ovaries is increased.

Some women may have no symptoms, except that menstrual periods become lighter or irregular, or stop (amenorrhea Absence of Menstrual Periods Having no menstrual periods is called amenorrhea. Amenorrhea is normal in the following circumstances: Before puberty During pregnancy While breastfeeding read more ). Other women have infertility Overview of Infertility Infertility is usually defined as the inability to achieve a pregnancy after 1 year of regular sexual intercourse without birth control. Frequent intercourse without birth control usually results... read more or develop the same symptoms that are associated with normal menopause (which occurs at about age 51), such as hot flashes, night sweats, or mood swings.

Women may have symptoms of the disorder that caused premature menopause. For example, if Turner syndrome Turner Syndrome Turner syndrome is a sex chromosome abnormality in which girls are born with one of their two X chromosomes partially or completely missing. Turner syndrome is caused by the deletion of part... read more is the cause, they may have physical or cognitive abnormalities.

If premature menopause is caused by an autoimmune process, women may also have other autoimmune disorders. such as thyroiditis Hashimoto Thyroiditis Hashimoto thyroiditis is chronic, autoimmune inflammation of the thyroid gland. Hashimoto thyroiditis results when antibodies in the body attacks the cells of the thyroid gland—an autoimmune... read more , vitiligo Vitiligo Vitiligo is a loss of melanocytes that causes patches of skin to turn white. Patches of whitened skin are present on various parts of the body. Doctors usually base the diagnosis on the appearance... read more , myasthenia gravis Myasthenia Gravis Myasthenia gravis is an autoimmune disorder that impairs communication between nerves and muscles, resulting in episodes of muscle weakness. Myasthenia gravis results from malfunction of the... read more , and Addison disease (adrenal insufficiency Adrenal Insufficiency In adrenal insufficiency, the adrenal glands do not produce enough adrenal hormones. Adrenal insufficiency may be caused by a disorder of the adrenal glands, a disorder of the pituitary gland... read more ). Addison disease can be life threatening.

The lack of estrogen may lead to decreased bone density (osteoporosis Osteoporosis Osteoporosis is a condition in which a decrease in the density of bones weakens the bones, making breaks (fractures) likely. Aging, estrogen deficiency, low vitamin D or calcium intake, and... read more ) and thinning and drying of the lining of the vagina (vaginal atrophy). The risk of other conditions (such as depression Depression Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to interfere with functioning. It may follow a recent... read more , anxiety Overview of Anxiety Disorders Anxiety is a feeling of nervousness, worry, or unease that is a normal human experience. It is also present in a wide range of mental health conditions, including generalized anxiety disorder... read more , Parkinson disease Parkinson Disease (PD) Parkinson disease is a slowly progressive degenerative disorder of specific areas of the brain. It is characterized by tremor when muscles are at rest (resting tremor), increased muscle tone... read more , dementia Dementia Dementia is a slow, progressive decline in mental function including memory, thinking, judgment, and the ability to learn. Typically, symptoms include memory loss, problems using language and... read more , and coronary artery disease) Overview of Coronary Artery Disease (CAD) Coronary artery disease is a condition in which the blood supply to the heart muscle is partially or completely blocked. The heart muscle needs a constant supply of oxygen-rich blood. The coronary... read more , may be increased.

Doctors suspect premature menopause when a woman younger than 40 has menopausal symptoms, or few or no periods, or cannot become pregnant.

A pregnancy test is done to make sure that pregnancy is not the reason for periods stopping. Then, levels of estrogen and follicle-stimulating hormone (which stimulates the ovaries to produce estrogen and progesterone) are measured. These measurements may need to be repeated weekly for several weeks to confirm the diagnosis of premature menopause.

Additional tests may be done to help doctors identify the cause of premature menopause or associated disorders and thus evaluate a woman’s health risks and recommend treatment. For example, if doctors suspect a woman also has thyroiditis Hashimoto Thyroiditis Hashimoto thyroiditis is chronic, autoimmune inflammation of the thyroid gland. Hashimoto thyroiditis results when antibodies in the body attacks the cells of the thyroid gland—an autoimmune... read more (an autoimmune disorder), they measure thyroid hormone levels in the blood.

Genetic counseling and testing are done if women have cognitive disability, tremor, or loss of balance (ataxia) or have a close relative with premature menopause or if they are younger than 35.

A blood test for antimüllerian hormone (which is produced in the ovaries) can be done to evaluate how well the ovaries are functioning and to estimate the chances that a woman will be able to become pregnant after treatment with fertility medications.

Bone density may be measured to check for osteoporosis.

If a woman with premature menopause does not wish to become pregnant, she is given one of the following:

These treatments are typically taken until about age 51 (the average age for menopause). Then, doctors decide whether to continue the treatments based on a woman's individual circumstances.

Estrogen therapy helps relieve symptoms and helps prevent other effects of menopause (such as vaginal dryness, and mood swings). It also helps maintain bone density (to prevent osteoporosis). Because taking estrogen alone increases the risk of cancer of the uterine lining (endometrial cancer), most women should also take a progestin or progesterone with the estrogen to help protect against this cancer. Women who have had a hysterectomy (removal of the uterus) do not need to take a progestin or progesterone.

If a woman with premature menopause wishes to become pregnant, doctors may recommend in vitro (test tube) fertilization Assisted Reproductive Technologies Assisted reproductive technologies involve working with sperm and eggs or embryos in a laboratory (in vitro) with the goal of producing a pregnancy. (See also Overview of Infertility.) If treatment... read more using another woman’s eggs (donor eggs). These eggs are implanted in the uterus after they have been fertilized in the laboratory. This technique gives women with premature menopause about a 50% chance (sometimes even higher) of becoming pregnant. Otherwise the chance of becoming pregnant is about 5 to 10%.