For women, it's been termed "the change of life"- the time when they experience a number of physiological and emotional responses as their reproductive cycle ends. Generally, menopause triggers hot flashes and the end of menstrual periods for women ages 45 to 55. But for one in ten American women, this change occurs a bit early.
Throughout a women's reproductive life, a hormone in the pituitary gland stimulates the growth of millions of ovarian follicles, fluid-filled cavities from which one egg develops each month. These follicles progressively decrease in number during the years before ceasing activity at about a woman's 50th year. Besides producing eggs, ovaries also generate the sex hormones estrogen and progesterone that stimulate growth of the endometrium lining the uterus and regulate ovulation and menstruation. In some women, however, the process comes to a premature halt and sparks common symptoms of menopause.
"If a woman stops menstruating before age 40, the condition is called premature menopauseor premature ovarian failure (POF)," said M. Denice Leonard, D.O., Department of Obstetrics and Gynecology at Allegheny General. "Like older women approaching menopause, these women may start noticing night sweats, irregular periods and hot flashes. But why menopause occurs prematurely is largely unknown."
An answer may lie in a woman's genetic makeup; she may house abnormal chromosomes that make her susceptible to early menopause. In women younger than 35 with ovarian follicles that appear normal, premature ovarian failure may be associated with an autoimmune disorder such as thyroid disease. Autoimmune disorders occur when the body's immune system attacks its own organs or tissues.
"In this case, a woman may be producing antibodies that attack the ovarian follicles," Dr. Leonard added. A thorough patient history and comprehensive tests may help pinpoint the cause of early menopause.
Premature ovarian failure can be devastating, particularly in young women who wish to conceive. For these women, advanced assisted reproductive techniques such as in vitro fertilization may offer hope for pregnancy.
"For all women with premature ovarian failure, estrogen replacement therapy is recommended to reduce the risk of osteoporosis," Dr. Leonard said. In addition, estrogen replacement-usually given as pills, a skin patch or vaginal cream-helps minimize hot flashes and relieve vaginal dryness and discomfort.
Last Updated: September 28, 2009