Menopause

The average female will begin to experience the symptoms of menopause around the age of 50 however these early symptoms can affect women as young as 40 and as old as 58. Unfortunately, some women undergo an early menopause i.e. at an age younger than 40, and while the reasons behind this are varied, they can be broadly slotted into 4 categories:

• Premature ovarian failure
• The result of surgery
• The results of cancer treatments
• Other causes

Premature Ovarian Failure

This cause of early menopause is often due to an autoimmune disease in which the body's immune system mistakes its own components for foreign bodies and so attacks them. It may be that the body produces antibodies to the tissues that make up the ovaries or alternatively the antibodies may attack the hormone oestrogen. Either way, the ovarian function is disrupted and the symptoms of the menopause set in. Autoimmune diseases include conditions such as diabetes, arthritis, Lupus and thyroid disease.

Premature ovarian failure can also be due to a genetic abnormality which more often than not is hereditary. In order for the ovaries to continue functioning both X chromosomes i.e. the female chromosomes have to be present and in working order. Some women are born with a defect in one chromosome or even worse they have a section of one chromosome missing i.e. Turner's syndrome. Both of these case scenarios can result in an early menopause.

The result of surgery

Occasionally it is necessary to remove a female's ovaries and/or uterus because of disease e.g. to remove cancer or potentially cancerous cysts, and by doing this the individual undergoes spontaneous menopause. This is because the ovaries are responsible for producing the sex hormones and in particular oestrogen, and when they are removed the production of these hormones suddenly ceases. Another surgical cause is sterilisation where the fallopian tubes are tied off. In some cases this can interfere with the blood flow to the ovaries and they slowly die as a result.

The result of cancer treatments

Both radiotherapy and chemotherapy can cause early menopause when used in high dosages. Radiotherapy generally only has an affect when it is used to treat cancer in the region of the pelvis i.e. uterine, cervical, bladder, kidney and even liver cancers, whereas chemotherapy used for more widely spread cancers, such as breast cancer, can also affect ovarian functioning. Radiotherapy can cause permanent ovarian failure, especially when it is used over a period of time ad this then leads to early menopause however in most cases chemotherapy, unless it is being used to treat ovarian cancer, only causes temporary menopause and over time the normal functioning returns to normal.

Other causes

This category includes a family history of early menopause because in many cases a female will go through menopause at roughly the same age as her mother did and so any history of early menopause may well repeat itself. Only around 5% of cases of early menopause have a family history however and so it is not certainty that the trend will carry on with each generation.

Also in this category are viral infections. It may be that a mother picks up a viral infection while pregnant that affects either the development of the ovaries or the number of eggs that are contained within each one. The lower the number of eggs that are contained in the ovaries the earlier that menopause will occur. Alternatively it may be that a woman picks up an infection during life which affects the functioning of her ovaries. It is thought that having severe mumps during childhood may affect ovarian functioning in later life.

As you can see there are a number of reasons why a woman may undergo early menopause however natural early menopause only affects around 15% of women, meaning that the odds are definitely in our favour.