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The menopause
Published in Myra Hunter, Melanie Smith, Managing Hot Flushes and Night Sweats, 2020
Remember that the menopause can occur quite normally during a wide age range – at any time between 40 and 60 years, in fact. Studies have found that in some parts of the world, however, women experience the menopause slightly earlier. For example, in India and Pakistan, menopause age ranges from 44 to 48 years (average 47 years), compared with 50 to 51 in Europe and North America. Earlier menopause can be associated with poverty, poor nutrition and smoking (Freeman and Sherif 2007; Andrikoula and Prevelic 2009). Menopause is considered early, or premature, when it occurs in women aged 40 or younger, and this is estimated to affect approximately 1 per cent of women (Panay and Fenton 2008). The causes of early menopause are often unknown, but early menopause can be caused by certain genetic conditions, as well as some autoimmune disorders. Menopause also happens earlier due to surgery (surgical removal of the ovaries, or oophorectomy); medical treatments, such as chemotherapy and radiotherapy; or some hormone treatments, which interfere with natural hormone production. Medically induced menopause, if not caused by surgery, can be permanent or temporary. This can be the case for women who have had chemotherapy to treat breast cancer. So, if this has happened to you and you are uncertain about your menopausal status or fertility, do discuss this with your doctor.
The minerals
Published in Geoffrey P. Webb, Nutrition, 2019
Many studies have suggested that cigarette smoking is associated with reduced bone density and with increased fracture risk. Smoking is associated with the following: Lower body weight. Reduced physical activity. Early menopause. Reduced blood oestrogen concentration (even in women receiving HRT).
Investigations in infertility
Published in David J Cahill, Practical Patient Management in Reproductive Medicine, 2019
Commentary: Poppy’s results show a raised FSH level, at 22 IU/L. The further blood test was an anti-Mullerian hormone test. The result was 6.7 pmol/L, which is low and in line with the raised FSH level. The ultrasound scan of ovaries looked at the antral follicle count and found very low numbers of follicles. The history of irregular cycles for 2 years, with these test results, indicates the diagnosis of impending early menopause. The low antral follicle count means that the chances of her responding to ovulation stimulation drug injections are poor.
Use of a vaginal CO2 laser for the management of genitourinary syndrome of menopause in gynecological cancer survivors: a systematic review
Published in Climacteric, 2022
J. Mejia-Gomez, J. Bouteaud, E. Philippopoulos, W. Wolfman, C. Brezden-Masley
Early menopause may arise from various forms of cancer treatment, including radiation, chemotherapy and surgery. Anti-estrogen cancer therapy may exacerbate genitourinary syndrome of menopause (GSM) symptoms. External beam radiotherapy and brachytherapy can negatively impact a cancer survivor’s sexual life, causing loss of sexual sensitivity of the skin, premature ovarian insufficiency, fatigue and general discomfort, all which can lead to an overall decreased sexual desire. Radiotherapy on female reproductive organs may cause inflammation of the vaginal mucosa leading to ulceration, necrosis and fibrosis. The vaginal walls become atrophic, inelastic, narrow, short and, lastly, stenotic, which can make sexual intercourse painful or uncomfortable. In cases of complete stenosis this may ultimately prohibit any penetrative sexual activity [1–3]. Chemotherapy is a major determinant of sexual dysfunction, resulting in poor sexual self-concept, including weight changes and alopecia, to name a few. Anti-estrogen treatments have similar effects on sexual function including vaginal dryness, dyspareunia, loss in vaginal wall elasticity and decreased sexual desire [4].
Demographic, clinical and hormonal characteristics of patients with premature ovarian insufficiency and those of early menopause: data from two tertiary premature ovarian insufficiency centers in Greece
Published in Gynecological Endocrinology, 2020
Maria Sotiria Bompoula, Georgios Valsamakis, Spyridoula Neofytou, Pantelis Messaropoulos, Nikolaos Salakos, George Mastorakos, Sophia N. Kalantaridou
Table 1 illustrates the symptoms and clinical characteristics of women with early menopause at the presentation. As in POI patients, the most common symptom in women with early menopause was secondary amenorrhea (100%). The mean age of menarche was approximately 13 years. At the time of diagnosis, the mean FSH levels were 32.4 IU/L. Moreover, 31 women performed a DEXA scan. Seventeen of those had normal bone density, 11 were diagnosed with osteopenia and 3 with osteoporosis. None of the women with early menopause had a pregnancy or a miscarriage/abortion history. At the presentation, 11 women were smokers, 42 nonsmokers and 8 unrecorded. Regarding treatment, 14/61 patients were on treatment and of those (14) reported use of oral (71%) and transdermal (29%) estrogen/progestogen combination. The treatment management after the final diagnosis was initially transdermal estrogen/progesterone combination for each woman.
The global prevalence of primary ovarian insufficiency and early menopause: a meta-analysis
Published in Climacteric, 2019
S. Golezar, F. Ramezani Tehrani, S. Khazaei, A. Ebadi, Z. Keshavarz
The age at which menopause occurs is under the influence of various factors including genetic, hormonal, environmental, and lifestyle-related ones4,5. However, if amenorrhea occurs at an earlier age (i.e., before the age of 40 years) accompanied with a serum follicle stimulating hormone increase to the menopausal level6–8, this is considered to be primary ovarian insufficiency (POI), which is also called premature menopause or premature ovarian failure. Also, there is early menopause (EM) which occurs between the ages of 40 and 45 years4,9.