Premature Menopause: When 'The Change' Comes Too Early
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What Are the Symptoms of Premature Menopause? 

Just as with menopause, many women have no symptoms other than that their periods occur less and less frequently, or, in some cases, "irregularly irregular" until they stop altogether.  Many women have the typical symptoms of menopause: hot flashes, night sweats, irritability, moodiness, sleep disturbances, vaginal dryness, decreased libido, and hair coarseness/loss.

Premature menopause, as explained above, is when a woman enters menopause before age 40, for whatever reason.  Perimenopause, on the other hand, is the transitional phase a woman goes into for the 2 to 10 years preceding her natural menopause.  During this time she may have normal or irregular periods and one or many of the symptoms of menopause such as hot flashes, night sweats, mood changes, irritability or sleep disturbances.

The most common misperception is that POF just isn't a big deal.  Upon hearing of this condition, many who are not affected react with nonchalance saying, "I wish I could get out of having my periods 10 years earlier!"  This condition is about much more than losing your periods, however.  To begin with, this may cause infertility, which can be devastating not only for the woman but her family as well.  Even for women who have already had children, this can represent a strong sense of loss.  Many women with POF struggle with the emotional burden of feeling "old" before their time.  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.  Some women report that when they asked their doctors if their symptoms could be related to menopause, they are told "Oh-you're too young.  Come back and see me in 10 years."  Patients fear that they are stigmatized; they fear telling others and fear that no one will understand.

The most dangerous myth is that POF doesn't have any serious consequences other than infertility.  This simply is not true.  Women with POF go through the same loss of estrogen as menopausal women in their 50's, but usually faster or suddenly, as for women who have surgery to remove their ovaries.  In many cases, this estrogen loss is even before these women have had the full benefits of estrogen in their lives, such as building maximal bone mass.  Losing estrogen puts women at increased risk for osteoporosis, heart disease, colon cancer, Alzheimer's disease, tooth loss, impaired vision, Parkinson's disease and diabetes.  The longer women are without the protection of their own estrogen, the greater their risk for serious health consequences of these conditions.

Many women in their 20's and 30's whose periods stop for 23 months take a home pregnancy test and, if it's negative, assume that their period stopped because of "stress".  While this may in fact be true, there are many other potential causes; this is worth discussing with a physician.

Just because premature ovarian failure is common doesn't mean that it's normal.  But just because POF is abnormal doesn't mean the patient is abnormal!  POF is a real, legitimate, biologic syndrome that can be treated, and managed.  At this point it cannot generally be prevented or cured.  The good news is that with prompt intervention and proper management, many of the long-term consequences can be prevented or delayed.