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Dealing with early menopause: Causes and cures

Free Press Journal 2018-01-13 12:10:00

 Menopause hits women between their mid-40s and 50s. But four in every 100 women between 29-34 years have started been experiencing early menopause. Shillpi A Singh finds more on the same 

When Manjari Desphpande, 34, started having night sweats, hot flashes, mood swings, and sleeplessness, off and on, she casually went to see a physician, who instead referred her to a gynaecologist. The subtle symptoms were hinting at something serious – early onset of menopause, and a couple of blood tests and scans later, hers and doctor’s worst fears came true. Both were caught unawares with the hormonal change that led to ovarian failure (when the normal functions of ovaries are disrupted); she was initially put on herbal medication to control symptoms of menopause that had upset her body and behaviour all of a sudden.

In between, Deshpande’s hormonal levels kept on playing truant with her system, and she started experiencing more obvious symptoms – vaginal dryness, change in the pattern of periods and a reduced sex drive. At 40, she was left with no choice but opt for Hormone Replacement Therapy. But all through she kept on wondering how she could suffer from menopause at 35.

What is it?

Deshpande is one among 8% of women between 35 and 39 years, who start showing signs of premature menopause, here in India. An Institute for Social and Economic Change (ISEC) survey had earlier highlighted that, on an average, nearly 4% of women are menopausal between the ages of 29-34 years. The numbers are shocking because normal menopause starts between 45 and 55 years of age, with a mean age of around 51 years across the world.

The most popular option used as an early menopause treatment is hormone replacement therapy

Elucidating the condition that has become quite common among urban women, Dr Richa Gupta, attending consultant, obstetrics and gynaecology, Aakash Healthcare, says, “Premature menopause refers to menopause that occurs before 40 years of age. Early menopause refers to menopause that occurs at or before 45 years of age, both ranges being well below the median age of natural menopause.” Both these conditions – premature menopause or early menopause – can either be spontaneous or induced.

What causes it?

Early or premature menopause occurs due to ovarian failure or anything that damages ovaries following which they stop producing estrogen, the hormone that controls the reproductive cycle. However, because of genetic illness or medical procedures, some women go through menopause before the desired age. “Lifestyle choices impact a lot in early menopause like smoking, drinking. Thyroid or auto-immune diseases, exposure to chemotherapy or pelvic radiation treatments for cancer, and poor nutrition can also cause premature menopause. Along with this, genital tuberculosis can also lead ovaries to fail. Such conditions are causes of induced menopause,” says Dr Archana Dhawan Bajaj, gynaecologist, obstetrician and IVF expert, The Nurture IVF Clinic.

The spontaneous premature ovarian failure is a syndrome of amenorrhea, low sex steroid levels, and elevated gonadotropin levels among women younger than age 40 years and may occur for unexplained reasons. “In some cases, it may also be due to autoimmune disorders, genetic causes, infections or inflammatory conditions, enzyme deficiencies, or metabolic syndromes,” says Dr Gupta. On the other hand, induced menopause may result from cancer treatments including chemotherapy and radiation. Premature menopause from these causes has increased over time because of the improved success in the treatment of cancer in children, adolescents, and reproductive-age women.

What’s the cure?

Women are encouraged to begin with the safest approach to treating early menopause symptoms – lifestyle adjustments – which includes stress management through meditation, yoga and aromatherapy. “Another important factor that is of immense help is emotional support from friends and family, regular exercises to improve muscle elasticity, weight management, reducing smoking and alcohol intake, a balanced diet with increased calcium intake,” suggests Dr Gupta.

For many women like Deshpande, who experience early menopause, lifestyle changes combined with alternative natural treatments are highly effective for symptom management. Deshpande who initially opted for natural alternative medicine to keep symptoms of early menopause under check, says, “Natural alternative treatments are quite effective and low-risk to manage hormonal fluctuations.” The medicines include phytoestrogenic and hormone regulating herbs.

Risks involved  

The most popular pharmaceutical option used as an early menopause treatment is hormone replacement therapy (HRT). While HRT has been a popular treatment option for many years, there are certain side effects associated with its use, including increased risk of stroke and heart disease. “Women who enter early menopause due to hysterectomy are usually prescribed synthetic estrogen, even though estrogen can increase the risk of breast cancer,” says Dr Gupta.

Professional organisations including the North American Menopause Society, the British Menopause Society, and the International Menopause Society recommend estrogen replacement therapy for women with premature menopause or premature ovarian failure. “Women considering this option should consult a trusted medical professional to understand better the benefits and risks involved,” she warns.

The way out

As in some cases, when menopause hits early than expected, especially for the woman undergoing cancer treatments including chemotherapy and radiation, Dr Bajaj advises freezing one’s egg before starting chemo sessions. “Once the woman is fit and keen to start a family, these eggs that she chose to freeze before undergoing cancer treatment will come in handy to help her plan pregnancy. But if she has failed to do so, she can still conceive using donor’s eggs,” she adds.

While menopause is inevitable, the related disorders can be coped up with some simple home remedies and natural cures. When trying to balance hormones and reduce menopause symptoms, one’s diet should include plenty of essential minerals and healthy fats, organic fruits and vegetables. “Along with regular exercise, it is also advisable to use oil which can help in managing menopause symptoms. For example, Clary Sage oil is the most effective essential oils for balancing hormones,” quips Dr Bajaj.