Health For Women - Early Menopause

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Early Menopause

What is early menopause?

Menopause before the age of 40 is termed ‘early menopause’. It may:

Occur spontaneously because of early failure of the ovaries to produce their normal hormones such as oestrogen
Be caused surgically when a woman has her ovaries removed
Be caused chemically by chemotherapy for cancer treatment

Symptoms of early menopause are essentially the same as for natural menopause; however they can be more severe in younger women.

Due to long-term effects of lack of oestrogen however, the risks of developing osteoporosis or heart disease are higher than for women reaching menopause at the expected age (45-50 years of age). For this reason, it is important that advice is sought from your doctor. Treatment is usually long-term hormone replacement therapy, with the risks, including breast cancer, not expected to increase until after the age of expected normal menopause.

Symptoms

The most common symptom is hot flushes, however women may experience one or more of the following symptoms:

Hot flushes and night sweats
Aches and pains
Crawling or itching sensations under the skin
Headaches
Vaginal dryness
Reduced sex drive (libido)
Urinary frequency
Tiredness
Irritability
Depression
Sleeping difficulty
Lack of self esteem
Forgetfulness

Menopause symptoms experienced are unique to each woman and may vary from very mild to severe symptoms that interfere with the quality of a woman’s life.

Premature loss of female hormones after menopause may lead to:

Thinning of the bones (osteoporosis) leading to increased risk of fractures (see ‘Bone Health – Preventing Osteoporosis fact sheet).
An increase in the risk of heart attack/heart disease.

Managing early menopause

Lifestyle factors

Often, by improving your lifestyle habits, as outlined below, symptoms of early menopause can be reduced.

1. Eat a healthy diet

Choose a wide variety of foods:

Plenty of fresh vegetables, fruits, cereals and whole grains
Plenty of fluids (6-8 glasses daily)
Decrease caffeine intake (coffee, tea, cola, chocolate)
Limit alcohol, 1-2 standard glasses or less, per day
Low fat dairy foods with high calcium content
Small portions of lean meat, fish or chicken several times a week:

The iron in meat is more readily absorbed into the body than iron from other foods
Vegetarians sometimes find it difficult to maintain adequate iron levels

Phytoestrogens (plant oestrogens)

Regularly include a variety of foods containing phytoestrogens
These weak plant oestrogens replace some of the natural oestrogen lost during menopause, and may reduce mild symptoms
The best sources of phytoestrogens are soy and linseed bread, soy beans, tofu, whole grains and legumes

Avoid spicy foods

2. Regular physical activity

At least 30 minutes of moderate intensity physical activity on all or most days of the week.

Advantages of regular physical activity include:

Maintains heart health as well as general health
As you age there is a decrease in metabolic rate and therefore exercise is important to stop weight gain
Weight bearing exercise (e.g. walking briskly, dancing) helps to keep bones healthy and reduce bone loss
Provides a feeling of relaxation and wellbeing
Helps us to cope better with stress in our everyday lives

3. Avoid smoking

Quitting smoking reduces many health risks. Need help to quit? Call the Quitline on 131 848 or visit www.quit.org.au

4. Think positive

Lifestyle changes and controlling physical symptoms will often improve general wellbeing.

Lifestyle modifications

Cooler environment

Have fans throughout the house and always carry a little hand fan
Air conditioning in your home to cool your environment
Use a water facial spray when experiencing a hot flush
Have cool drinks available when flushing

Wear layers of clothing, so you can take off as much as you need when hot
Flushes can be reduced by paced respiration (a controlled breathing technique)
Referral to a psychologist to teach you biofeedback techniques or behavioural therapy techniques may also help to reduce the intensity and frequency of flushes.
Regular Pap test and breast checks

Two yearly Pap tests (see your doctor or women’s health nurse) or according to your doctor’s recommendations.
Have regular breast checks by your doctor.
Have a mammogram every two years if you are over 50 years of age (a free services from BreastScreen – phone 132 050). Women in their 40s are also able to access this free service but will not receive any notification.

Hormone replacement therapy

Hormone replacement therapy will reduce many of the symptoms of menopause. Discuss the advantages and disadvantages of hormone replacement with your doctor. Following premature menopause moderate to higher doses of oestrogen are usually needed. Testosterone therapy may be considered, especially after a surgical menopause. Therapy should be individual depending on your symptoms and medical history.

Non-hormonal therapies

In women who have developed menopause following chemotherapy for breast cancer or following surgery for a hormone dependent cancer, such as uterine cancer, hormone replacement therapy is not recommended. There are a number of different non-hormonal medicines which are suitable such as Clonidine, the SSRIs groups of antidepressants which can also reduce hot flushes, and gabapentin. Discuss these with your doctor.

Natural therapies

Because of the long-term risks of osteoporosis and early onset of heart disease, Hormone Replacement Therapy is often recommended as the treatment of choice. However, some women may choose natural therapies. It is important to remember that ‘natural’ herb and plant should be treated as medicines; therefore if considering natural therapy for long-term guidance and balance throughout the menopausal years, it is important to see a qualified naturopath with an interest in women’s health.

Natural therapies can often be taken in conjunction with hormone replacement therapy, for example; a woman might take hormone therapy to address some symptoms and natural therapies for others. It is essential to let both your doctor and naturopath know exactly what each has prescribed.

In women with a history of breast cancer or hormone-dependent cancers, the safety of some herbal therapies is not known. It is advisable to seek the advice of a naturopath to discuss safe options, and you should always consult your cancer specialists before taking any natural remedies.