When menopause comes too soon

Proven content

A hundred years ago, it was associated with a disease that required surgical intervention. A decade ago – with a declining phase of life. Today, when two-thirds of European women have the opportunity to celebrate their 80th birthday, menopause is just another stage of maturity. It usually shows up around the age of fifty and we are getting better at dealing with it. But it’s bad when it affects us early. Way too soon.

From a medical point of view, menopause is the time between reproductive age and the aging stage. It is associated with permanent disruption of the ovaries. In women living in the circle of Western culture, it is usually observed between 45 and 55 years of age. It has even been calculated that a statistical Polish woman goes through the menopause at the age of 49. What is happening in her body then? – Hormones start to lack, mainly estrogen and progesterone, and menstrual problems appear – the cycles become irregular, often plentiful, clotting, there are spotting between bleeding, and sometimes the menstruation stops altogether – explains gynecologist Jacek Tulimowski. – Estrogen is a hormone that acts on the mucous membranes of the vagina, cervix, bladder or urethra, so when there is less of it, there are atrophic changes in the mucosa of these organs. It becomes thinner and thus the protective layer is reduced. Thus, menopausal women complain of vaginal dryness, painful intercourse, frequent vaginal and vulvar infections, recurrent cervical and bladder infections, and the onset of urinary incontinence. There are also hot flashes, night sweats, irritability, crying attacks, palpitations, headaches – concludes Dr. Tulimowski.

In short, menopause is not pleasant, although doctors assure you that it can be tamed. It’s only worse when it shows up too early.

Adequate supplementation can positively affect the well-being and condition of the body during menopause. At Medonet Market you can buy a dietary supplement from Nature’s Sunshine with a complex of vitamins and minerals that alleviate the symptoms of the menopause and strengthen the body.

Lubricants such as SKYN Natural Harmony intimate gel with hyaluronic acid or SKYN All Night Long premium moisturizing intimate gel are a way to facilitate intercourse and increase hydration.

Even before forty

We talk about premature menopause when the function of the ovaries stops at least before the age of 40. and includes secondary amenorrhea. By this, doctors understand the cessation of bleeding in a healthy woman who has had normal menstruation, because the primary amenorrhea is if the bleeding never occurs. Premature menopause, however, may affect younger women – even before the age of 20. – These are rare cases, because the incidence of premature menopause in women from 15 to 29 years of age it is estimated at 10 cases out of 100. From 30 to 39 years of age this is about 76 cases out of 100. Before the age of 40 until recently, there were 4–18% of cases of premature menopause, and now it is diagnosed in one in 100 women – explains Dr. Tulimowski.

Does this mean that we should be worried the first time we miss a period? No, menstruation may not appear due to a change in the climate, time zone or, for example, after intense exercise. And while premature menopause begins suddenly, it is only diagnosed after there is no bleeding for the next four months. A visit to the gynecologist is then essential.

To determine whether the discomforts that have arisen in your body may be related to menopause, perform the Premature Menopause genetic test, available on Medonet Market. You take the blood sample for testing yourself and then send it to the Medgen laboratory. After 2-4 weeks, results are available.

Up to two times a piece

Before a specialist gynecologist or gynecologist-endocrinologist can make a diagnosis, he must perform several tests. It will definitely be ultrasound and cytology, and then blood tests. They will allow you to check the level of hormones produced by the ovaries (estrogens, progesterone) and the pituitary gland (FSH – follicle stimulating hormone). The FSH value allows the doctor to assess whether the follicles are maturing normally and the production of estrogen is normal. You can now do the FSH level test yourself before visiting the doctor, and go to the appointment with the result ready. Menopause Urine FSH Plate Test and Menopause Urine FSH Stream Test are available from Medonet Market. The tests may also include the control of the level of prolactin (PRL) and thyroid hormones (T3 – triiodothyronine, and T4 – thyroxine) and TSH secreted by the pituitary (thyrotropin). If it turns out that T3, T4, TSH and prolactin are normal, while the FSH level is twice as high above 40 IU / l, and estrogen is definitely too low, we will get a referral for further tests. If a patient has secondary amenorrhea, the determination of FSH levels must be repeated at least twice. When the FSH reaches 80 IU / L twice, this is called a premature menopause.

Why me?

Although premature menopause is becoming more common in women, its causes are still largely unknown. However, doctors include autoimmune diseases among the possible causative factors. It has been observed that in women with autoimmune diseases, when the immune system acts against nature and destroys the body’s own tissues, the function of the ovaries, which are attacked by antibodies as the endocrine gland, may stop working. This type of disease includes, among others rheumatoid arthritis, lupus, myasthenia gravis, thyroid disease. Other causes of premature puberty include viral infections that interfere with the immune system, such as mumps, rubella, and smallpox in adulthood. The list of causes also includes genetic factors (an abnormality of the X chromosomes), so the medical history that the gynecologist conducts usually asks about the women’s menstrual cycle in the family. So, if our mother started menopause early, it might be the same for us.

When talking about the causes of premature menopause, one must not forget about the surgical treatment, such as hysterectomy, removal of cysts from the ovaries, removal of the ovary, and oncological treatment: chemotherapy or radiotherapy. The latter, however, must apply to the area of ​​the small pelvis. It is a myth that all radiation therapy contributes to sterilization. It is also worth knowing that not all patients after pelvic radiotherapy, i.e. cancer of the cervix, uterus, ovaries or colon, will cease to function of the ovaries. It is not about the procedure itself, but the radiation dose – it must exceed 40 Gy / g. However, even then, it does not have to be XNUMX% sterilized, because the ovaries will not be completely damaged. Unfortunately, it is different in the case of chemotherapy, because each of its forms largely destroys the function of the ovaries. However, there have been cases of patients who had normal periods and even gave birth to children after the treatment. Fortunately, there are more and more such women. It all depends on the individual’s reactivity to the administered drugs, so we cannot say that every woman after chemotherapy will experience a premature menopause.

Treatment methods

If the doctor diagnosed us with premature menopause, we should think together about what to do next. Of course, a lot depends on our age, willingness to have a child and indications for hormone replacement therapy. If we have, for example, hot flashes, drenching sweats, concentration disorders, insomnia or headaches, and all this interferes with our daily functioning, it is worth considering HRT. Currently, as a result of the decision of the European Federation for Menopause and Andropause, very restrictive rules for the administration of hormones have been introduced. The general rule is – the gynecologist gives the patient hormones only when it is indicated. It is the woman who decides on the therapy and chooses its form, e.g. injections, patches, tablets, gels, sprays. After three months, he undergoes the first check-up, then another one each year. During the observation, all tests are performed – from cytology to mammography. Before starting the therapy, the gynecologist still has to collect a detailed interview, finding out, for example, whether the patient’s family has had cancer or venous thrombosis.

In the case of premature menopause, low doses of hormones (estrogen and progesterone) are usually administered, thus stopping the decline of the ovarian function and the return of ovulation and menstruation. When the ovaries start producing estrogen again, the hormone dose is gradually reduced. For many women, they can even be weaned off. But what happens when there are no indications for HRT, because premature menopause does not cause any disturbing symptoms? – According to the indications of the European Federation for Menopause and Andropause, HRT should not be used, but in each case it should be carefully considered. Premature menopause due to a deficiency of hormones in a woman’s body carries a risk of cardiovascular disease and osteoporosis. If a woman is 40 years old and for the next decade, i.e. by the time when she should be biologically menopausal, she does not have an adequate level of estrogen, the risk of not only osteoporosis, but also a stroke or a heart attack may increase – warns Dr. Tulimowski.

And what about the patients who are still planning motherhood? When a woman is in her thirties or forties and wants to give birth to a child, stimulation with gonadotropins is used so that not only menstruation occurs, but also ovulation, GnRh analogues or anti-estrogens occur. Treatment usually takes several months and is often successful.

During menopause, it is also worth reaching for the botanical complex that soothes unpleasant symptoms of the menopause and supports the proper functioning of the body.

Guilty civilization

Doctor Jacek Tulimowski admits that his office is increasingly visited by women with menstrual disorders or with premature menopause. Usually, there are genetic or immunological factors, and thyroid disease is the most common among them. The so-called civilization causes: chronic stress, smoking, drinking alcohol, improper diet. They trigger a cascade of processes in the body that contribute to hormonal disorders, e.g. excess prolactin, which manifests itself functionally and in the immune system. Chronic vasoconstriction, release of stress hormones, increased blood pressure, then atherosclerosis, diabetes, and diseases of the digestive system have a negative effect on the body. In my opinion, we will have to deal with premature menopause more and more often – warns the gynecologist and appeals to his patients to think carefully before they consciously decide on late motherhood. From a biological point of view, a woman should give birth to children up to 35 years of age. Then, if only because of the hormonal fluctuations, it will get harder and harder.

FOR THE INTERESTING

Twice the risk of a heart attack

Dr. Melissa Wellons of the University of Alabama, Birmingham, has shown that women who go through the menopause before the age of 46 may be more than twice as likely to suffer from heart attacks, strokes and other cardiovascular events later in life. Together with a team of scientists, Dr. Wellons studied over 2,5 thousand. women who were between 45 and 84 years of age at the time of study initiation. Approximately 28% of them underwent earlier menopause, and 10% of it was caused by the removal of the ovaries. Before 55 years of age none of the women had a heart attack, stroke, bypass surgery, or symptoms of ischemic heart disease. After several years of observation, it turned out that among patients over 55 years of age there were cardiovascular events in 6% of women who were menopausal earlier and 2,6% of women who had not yet gone through menopause or after 47 years of age.

Text: Anna Niewiadomska, consultation: Jacek Tulimowski, gynecologist and obstetrician

Source: Let’s live longer