WHAT IS PREMATURE MENOPAUSE?

Menopause occurring below the age of 40 years is considered to be premature.

APART FROM SURGICAL REMOVAL OF OVARIES, WHAT ARE THE CAUSES OF PREMATURE MENOPAUSE?

Spontaneous 'natural' menopause may occur at any age. It has been associated with genetic and certain autoimmune disorders. An increasing number of women are being rendered menopausal at an early age notably due to radiotherapy and chemotherapy, which have been administered to treat certain cancers.

HOW CAN ONE BE SURE THAT IT IS PREMATURE MENOPAUSE AND NOT SECONDARY AMENORRHOEA?

The presence of typical estrogen deficiency symptoms may suggest diagnosis of ovarian failure. However some women with premature menopause are without symptoms. A diagnosis of premature menopause is usually confirmed by at least two and preferably three sets of hCG and perhaps oestradiol measurements within the menopausal range.

WHY SHOULD WE BE CONCERNED BY PREMATURE MENOPAUSE?

Some women with premature menopause will experience symptoms but others will not. Leaving aside these problems, women undergoing early loss of ovarian function who do not receive HRT are at an increased risk of the early development of arterial disease and osteoporosis.

HOW LONG SHOULD HRT BE CONTINUED AFTER PREMATURE MENOPAUSE?

Therapy should be initiated soon after the early menopause and should continue until the age of 50 years.

CAN YOUNG WOMEN WITH PREMATURE MENOPAUSE BE TREATED WITH THE ORAL CONTRACEPTIVE?

NO. The estrogen dose in the contraceptive is a bone conserver. However it has been shown that long-term administration of the pill as a contraceptive may increase arterial disease risk. Thus, it is possible that HRT and oral contraceptive formulations have different effects upon arterial disease risk.