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Mood swings, hot flashes, vaginal dryness, loss of libido, thinning hair, dry skin, weight gain, insomnia, night sweats — not a set of symptoms anyone is likely to look forward to, right? If you're female, it will inevitably catch up with you at some point though, that menopause. (On the upside, the severity of symptoms varies from woman to woman and you may just get off lightly, plus, well, menstruation will be a thing of the past. That's a good thing, unless of course you want to get pregnant.)
"Premature menopause" is popularly defined as "entering the menopause before age 40". However, reality is slightly more complex — what these women experience isn't simply the same menopause other women typically experience later on in life, but earlier.
Though premature ovarian insufficiency typically halts periods and leads to severely altered hormonal patterns, some ovarian functionality can absolutely be retained, and women who have primary ovarian insufficiency do indeed get pregnant sometimes. Ovarian insufficiency is, in fact, not a single condition but an umbrella of different conditions, the most severe of which is premature ovarian failure, which does cause permanent infertility along with a permanent cessation of periods.
Women under the age of 40 who are experiencing the full range of typical perimenopause symptoms (as mentioned above) should consult their healthcare providers to begin finding out what is going on — but so should those who are noticing a more limited symptomatic spectrum, including irregular periods and not infertility in those trying to conceive.
So, what causes a premature menopause? As it turns out, a rather wide range of things. We can differentiate between induced and spontaneous causes, and these causes include:
- Undergoing a bilateral oophorectomy, an operation to remove both of the ovaries, will cause a state of menopause overnight. Such surgeries are sometimes necessary because of the confirmed presence of disease, but some women who carry the BRCA1 and BRCA2 genes, including famously Angelina Jolie, also opt for an elective double oophorectomy to reduce their risk of reproductive cancers. These women will stop having periods, their estrogen and estradiol levels go down rapidly, and they are very likely to begin experiencing such menopause symptoms as hot flashes and vaginal dryness rather quickly
- Pelvic radiation therapy and chemotherapy can lead to premature ovarian failure, as a result of damage to the ovaries, as well. In these cases, the process may be either gradual or more immediate.
- A premature menopause can also be the result of chromosomal abnormalities, diseases such as Polycystic Ovary Syndrome, and autoimmune diseases.
- Then, there is a strong genetic component: if your female relatives entered the menopause before age 40, you are more likely to encounter premature menopause yourself.
- Transmen who have spent a considerable time on testosterone and then cease to take it may also enter a state akin to the menopause, in which they will not have periods and experience menopause symptoms.