Early Menopause
An early menopause can occur naturally or it can be induced by medication, radiotherapy or surgery. Around 10 percent of women have their menopause before the age of 45. Of these, less than two percent will have a true premature menopause, which means their periods will have stopped by the age of 40.
Most experiences of true early menopause will have been induced and are the result of surgical or medical intervention. Induced menopause can take place at any age, but the younger the woman, the more traumatic and difficult it will be for her to come to tern-is with it.
Surgical Menopause
A surgical early menopause occurs when both ovaries are removed completely, and its effects start to be felt the day the ovaries are removed. The sudden drop in hormone levels, both estrogen and androgens, means a rapid adjustment is necessary by the whole body, and severe and distressing symptoms can occur. Most premature or early menopause is the result of this type of surgery, and it may be performed for a number of reasons.
For example, tumors and cysts can destroy the ovaries, and whether these are cancerous or non-cancerous, they may need to be removed. Likewise, in cases of severe or chronic pelvic inflammatory disease, the ovaries may have been destroyed by infection and will have to be removed. In very severe cases of endometriosis, removal of the ovaries is sometimes an option, but symptoms may recur when hormone treatment is given afterwards.
Hysterectomy
Not long ago many gynecological surgeons used to recommend removing the ovaries when performing a hysterectomy. They justified this by saying that the ovaries were unnecessary if there was no longer a uterus to support a pregnancy, and that the ovaries should be removed to reduce the risk of future ovarian disease, ovarian cancer in particular. The majority of surgeons now feel that there is no point removing a healthy organ - which does have a very important function in continuing to produce essential hormones until a natural menopause occurs.
If you are having a hysterectomy, make sure you know whether the surgeon is planning to remove the ovaries and, if so, that the reasons for this decision are clearly explained. After a hysterectomy, women tend to experience early menopause around five years earlier than they otherwise would. This is thought to be the result of surgery reducing the blood supply to the ovaries, but the reason is not yet fully understood.
Problems from Induced or Natural Early Menopause
The symptoms surrounding menopause, such as hot flushes and reduced libido, are usually felt more intensely when early menopause is induced.
Loss of fertility, particularly in women who have not yet had children, can be traumatic and may leave them prone to depression and concerned over their sexuality.
The earlier menopause is experienced the greater a woman’s risk of osteoporosis or thinning of the bones. When the protective effect of estrogen on the cardiovascular system is lost early, cardiovascular problems, including heart disease and stroke, become more likely.
