Early Menopause: What is it and why does it happen?

Menopause is a given in most women’s lives at some point. No one expects it to occur before a certain age. It can be alarming when menopause occurs before your mid-thirties. Why does this happen and is there a reason that menopause occurs early for some women?

What is early menopause?

Early menopause occurs when a woman’s period stops before she reaches the age of 45. If your periods are very irregular you should speak to your doctor. This can happen when a woman’s ovaries don’t make normal levels of certain hormones. Some medications and treatments can also cause early menopause.

Some symptoms of early menopause are hot flashes, night sweats, vaginal dryness, difficulty sleeping, and reduced sex drive. If you are experiencing some of these symptoms you should reach out to your doctor. Most general practitioners can make a diagnosis of early menopause. A referral to a specialist may be necessary. [1]

Menopause beginning at an earlier age may not seem like an issue that will impact more than your menstrual cycle, it can actually put you at risk for other conditions. Those who experience early menopause are at an increased risk for osteoporosis and cardiovascular disease. This is another reason to talk to your doctor if you have any symptoms of early menopause, it is always better to be informed about your health. [2]

What causes early menopause?

It is difficult to exactly determine what causes early menopause for many women, but there are certain factors that do contribute to a decline in ovarian function. Some of these factors include:

• Cigarette smoking is one of the strongest risk factors for early menopause. Women who smoke are likely to undergo menopause a year earlier than nonsmokers. Polycyclic hydrocarbons in tobacco smoke may cause estrogen deficiency. 
• Depression is prevalent in women between the ages of 35 and 45. This is a time you would expect a decline in estrogen production, but it is possible there is a link between depression and early menopause.
• Obese women typically have higher concentrations of endogenous estrogens and low levels of sex hormone-binding globulin. This causes rapid follicular exhaustion. [2]

There are many different factors that can lead to early menopause. If you feel like one of these factors may lead to early menopause for you, you should speak to your doctor about your concerns. Early menopause is a bodily response and although there are factors that may contribute to early menopause, it isn’t something you can control. 

Can IVF cause menopause?

Women who don’t respond well to ovarian hyperstimulation during IVF treatment may be at a higher risk for menopause. Women who don’t respond well may have a low number of retrieved oocytes and an impaired ovarian reserve. Researchers have found that there is no evidence that ovarian stimulation will advance the menopausal age for patients who underwent IVF. [3]

Women with a poor response to IVF treatment are more likely to reach menopause in the next decade in comparison to normal responders. IVF doesn’t cause menopause, but the poor response to IVF may be a symptom of early menopause. If you are interested in IVF but have some reason to suspect menopause may be near you should contact a fertility specialist. A fertility specialist will give you an accurate depiction of what you can expect from IVF. It is always best to speak to a doctor about your worries and concerns. [4]

Sources:

[1]https://www.nhs.uk/conditions/early-menopause/#:~:text=Early%20menopause....
[2] Bernard L Harlow, Lisa B Signorello, Factors associated with early menopause, Maturitas, Volume 35, Issue 1,2000, Pages 3-9, ISSN 0378-5122,
https://doi.org/10.1016/S0378-5122(00)00092-X.
[3] Muharam R, Sumapraja K, Pratama G, Azyati M, Prabowo KA. Impact of IVF on the Timing and Symptoms of Menopause. Int J Womens Health. 2021 Sep 22;13:889-893. doi: 10.2147/IJWH.S322718. PMID: 34588821; PMCID: PMC8473711.
[4] Evelien J. de Boer, Isolde den Tonkelaar, Egbert R. te Velde, Curt W. Burger, Flora E. van Leeuwen, on behalf of the OMEGA‐project group*, Increased risk of early menopausal transition and natural menopause after poor response at first IVF treatment, Human Reproduction, Volume 18, Issue 7, 1 July 2003, Pages 1544–1552, https://doi.org/10.1093/humrep/deg278