Premature Menopause: When ‘The Change’ Comes Too Early
Premature menopause made headlines when scientists reported breakthrough news of a successful ovarian tissue graft giving hope to thousands of young women affected by early menopause. This is exciting news, but it's still experimental. Dr. Donnica discusses premature menopause and the treatments available.
What is Premature Menopause?
Many patients prefer to call it “premature ovarian failure” or “POF”. POF is menopause that occurs (for any reason) before the age of 40 as a result of lost ovarian
function. For most women with POF, the cause of their condition is never identified.
Known causes of premature menopause include: autoimmune disorders (most common),
genetic factors, chemotherapy, radiation, surgical removal of the ovaries for
any reason (e.g. endometriosis, trauma, cancer, etc.), or endocrine disorders
(e.g. thyroid or pituitary problems, diabetes). While it may seem disconcerting
that this condition is increasing in frequency, the good news is that the increase
is largely due to the large number of women who are being treated for cancer
and surviving.
The ovarian failure of POF may be temporary or periodic or incomplete. Some
patients may ovulate occasionally so contraception is still necessary
if pregnancy is undesired. Pregnancies have occurred after the diagnosis of
POF in about one in twelve women not using contraception.
Menopause means more than just losing your periods. This is a syndrome with
clinical symptoms as well as long-term consequences. An important distinction
here is that women who have had a hysterectomy (surgical removal of the uterus)
but whose ovaries function normally won’t have periods, but they are not “in
menopause.” They will go into menopause naturally when their ovaries cease
functioning.
POF is estimated to affect 250,000 American women, which represents apr. 3%
of women between 15 and 39. The average age of onset is 27. There is no typical
menstrual history for women with POF. Approximately 10 to 15% of females with
POF have primary amenorrhea, which means they never had a period on their own.
The confusion of the numerous but vague physical and psychological symptoms can be overwhelming, especially when many physicians don’t consider menopause as a diagnostic option in women under 40. 
