What is early and premature menopause?

Early menopause is when menopausal symptoms start before the age of 45. Premature menopause is when symptoms start before the age of 40 affecting about 1% of women. Early or premature menopause 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 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 possible 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 (see heart disease fact sheet for more information)

Managing early and premature menopause

Lifestyle factors

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

1.  Eat a healthy diet

(See healthy eating fact sheet for information)

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 experiencing flushes

• Wear layers of clothing, so you can take off as much as you need when hot
• Referral to a psychologist may help to teach techniques such a paced breathing, to reduce the intensity and frequency of flushes.

Hormone replacement therapy

Hormone replacement therapy (HRT) will reduce most of the symptoms of menopause.  Discuss the advantages and disadvantages of HRT 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, when low sex drive or unexplained fatigue may be particular problems.  HRT should be individualised depending on your symptoms and medical history.

Complementary therapies

Because of the long-term risks of osteoporosis and early onset of heart disease, HRT is normally recommended as the treatment of choice.  However, some women may choose complementary therapies.  It is important to remember that ‘natural’ herb and plant medications should be treated as medicines; therefore if considering complementary 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.

Complementary therapies can often be taken in conjunction with HRT, for example; a woman might take HRT to address some symptoms and complementary 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.

Non-hormonal therapies

In women who have developed menopause following chemotherapy for cancer or following surgery for a hormone dependent cancer, such as uterine cancer, HRT is not usually recommended.  There are a number of different non-hormonal medicines which are suitable.  It is important to discuss these with your doctor.

Where can I find more information?

www.jeanhailes.org.au

www.earlymenopause.org.au

Further Resources

 Early Menopause (103.15 KB)

 Early Menopause and Emotional Wellbeing (71.36 KB)

Australian Menopause Society (AMS)

Content updated July 2009