Menopause and premature ovarian insufficiency (POI) are topics that don't get enough attention. Menopause is defined as the point when a woman has gone 12 months without a period. The phase leading up to this is known as perimenopause, during which the egg count declines, and the brain increases the production of LH and FSH to stimulate the ovaries to produce oestrogen. This can cause significant fluctuations in oestrogen levels, sometimes even higher than normal, leading to symptoms like hot flushes and mood changes. Understanding perimenopause is crucial for diagnosis, often more so than blood test results.
The average age for menopause is 51, but for 1% of women, it occurs before the age of 40, a condition known as premature ovarian insufficiency (POI). Early menopause, occurring between ages 40-45, affects about 5% of women. Additionally, around 5% of women experience induced menopause due to surgery, chemotherapy, or other treatments that damage the ovaries. Unlike natural menopause, diagnosing POI or early menopause often requires blood tests.
The cause of POI in 1% of women is often unknown or idiopathic. Known causes include autoimmune diseases like thyroid disease, coeliac disease, and Addison’s disease, as well as genetic conditions such as Fragile-X or Turner’s syndrome.
Oestrogen is a vital hormone, and its deficiency in POI is associated with a 2-3 times higher risk of osteoporosis and a 50% increased risk of cardiovascular disease. There may also be an increased risk of conditions like dementia or Parkinson’s disease. Unless there is a strong contraindication, such as breast cancer, women with POI and early menopause should be offered hormone replacement therapy (HRT) to potentially reduce these risks.
If you experienced menopause before age 45, it's important to discuss with your doctor whether HRT is right for you. 😊
For young women experiencing troublesome symptoms and changes in their menstrual cycle, it might be worth considering whether POI needs to be checked. 💛
If you have any questions or need further information, feel free to ask!