From the Guidelines
Early menopause is defined as menopause that occurs before the age of 45, with premature menopause specifically referring to onset before age 40. This condition can happen naturally or be triggered by medical treatments like chemotherapy, radiation, or surgical removal of the ovaries 1. Symptoms of early menopause typically mirror those of natural menopause, including hot flashes, night sweats, vaginal dryness, mood changes, and sleep disturbances.
Health Risks Associated with Early Menopause
Early menopause increases health risks including:
- Osteoporosis
- Heart disease
- Cognitive issues due to the prolonged absence of estrogen For most women experiencing early menopause, hormone replacement therapy (HRT) is recommended until at least the natural age of menopause (around 51) to manage symptoms and protect bone and heart health 1. Standard HRT options include estrogen with progesterone (for women with a uterus) or estrogen alone (for those without).
Lifestyle Modifications
Women with early menopause should also ensure:
- Adequate calcium intake (1000-1200mg daily)
- Vitamin D (600-800 IU daily)
- Engage in regular weight-bearing exercise
- Have bone density screenings to monitor bone health 1.
Considerations for HRT
The decision to use HRT should be made on an individual basis, considering the risks and benefits, and HRT usage should be confined to women younger than the age of the expected natural menopause if at moderate or high risk of breast cancer 1. The impact of the menopause, and the option of HRT should be discussed prior to any surgery that may induce menopause, such as risk-reducing salpingo-oophorectomy (RRSO), and commenced immediately after surgery if appropriate.
From the Research
Definition of Early Menopause
- Early menopause, also known as premature menopause, is defined as menopause occurring before the age of 45 2.
- It is characterized by the permanent cessation of ovarian function, resulting in the end of menstrual bleeding.
- Early menopause can be idiopathic, medically, or surgically induced.
Causes and Symptoms
- The causes of early menopause can vary, but it is often associated with premature deprivation of ovarian hormones, primarily estrogen 2.
- Symptoms of early menopause can include hot flashes, night sweats, vaginal dryness, and sleep disturbances 3.
- These symptoms can be challenging to manage and can negatively impact quality of life.
Management and Treatment
- Hormone replacement therapy (HRT) is a common treatment for early menopause, offering symptom control and prevention of health consequences associated with premature loss of ovarian hormones 2, 4.
- Lifestyle adjustments, talking therapies, and dietary supplements can also be used to manage symptoms 5.
- The decision to use HRT or other treatments should be made jointly by the woman and her healthcare provider, after careful consideration of possible benefits, risks, and personal preferences 4.
Prevalence and Impact
- Early menopause can have a significant impact on a woman's quality of life, with many women experiencing bothersome and disabling symptoms 3.
- The prevalence of early menopause is not well understood, but it is estimated that many women will experience menopause before the age of 45 2.
- Understanding and treating the symptoms of early menopause is essential to reduce the burden associated with this physiological state 5.