Early Menopause, Premature Ovarian Failure Rising

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The number of women who experience early menopause related to premature ovarian failure is rising, says a new study in The Obstetrician & Gynaecologist. This increase is partly due to better cure rates among young female cancer patients who were treated with radiation and chemotherapy.

Early menopause affects fertility

Approximately 1 to 4 percent of women have premature ovarian failure (POF), according to the International Premature Ovarian Failure Association, which results in abnormally early menopause due to the loss of function of the ovaries. Early menopause usually occurs in women younger than 40, and it can happen as early as the teen years. Premature ovarian failure is also sometimes called ovarian insufficiency.

The new review study reports that one reason for the rise in early menopause is actually good news in one way, because it means more young women are surviving cancer. However, these cancer survivors frequently have undergone radiotherapy and chemotherapy treatments, which have been linked to premature ovarian failure. Previous research shows that 30 to 40 percent of women who received both radiotherapy and alkylating agents experience POF.

Premature ovarian failure can also be caused by a variety of other factors. Some of these include thyroid dysfunction, adrenal insufficiency, rheumatoid arthritis, Turner syndrome, lupus, and viral infections.

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According to Puneet Arora, co-author of the review and Registrar in Obstetrics and Gynaecology at Hope Hospital in Salford, “Premature ovarian failure is usually permanent but ovarian activity can resume in some cases.” Studies indicate that 5 to 10 percent of women with POF have experienced a return of ovarian activity and fertility.

Symptoms of POF include an irregular menstrual cycle, hot flashes, night sweats, and loss of sexual desire, which are related to an estrogen deficiency. Women who are experiencing these symptoms years before conventional menopause (around age 50) should seek medical help and a diagnosis.

Women who are diagnosed with early menopause and who wish to have a baby have several options, including egg or embryo donation or adoption. Because infertility is typically a result of POF, women often need counseling and psychological support along with medical support.

In all cases, women with POF should consult their healthcare providers about what steps they should take for health issues related to POF, including their increased risk of coronary heart disease, osteoporosis, cardiovascular events, and depression. Some treatment options for women who have POF include supplementation with vitamin D, following a calcium-rich diet, regular physical exercise, avoiding alcohol and smoking, and consideration of hormone replacement therapy.

Jason Waugh, editor-in-chief of The Obstetrician & Gynaecologist, noted that “premature ovarian failure can be very distressing however there is some hope for women who wish to go on to have a baby.” Women who are diagnosed with early menopause need medical and emotional support, and this latest review “raises awareness of this condition which is on the increase.”

SOURCE:
Arora P, Polson DW. The Obstetrician & Gynaecologist 2011; 13:67-72

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