Premature menopause: what it is and how to deal with it
What's this
We talk about premature menopause POF (Premature Ovarian Failure), when this arrives earlier than expected, that is when, before the age of 40, the ovarian function of the woman inexplicably ceases. Invasive therapies or surgery, as well as congenital pathologies, can also lead to premature menopause. Regardless of the cause, the result is the loss of fertility and proper hormonal supply at an "earlier age than what would be called" normal. "In addition, the likelihood of shortening the fertile age is increased by having very short cycles. or having undergone treatments for assisted fertilization that exhaust the ovaries, leading them to cease their activity prematurely.
The causes
As we have said, the causes of POF can be different. In cases where it arises spontaneously, we speak of spontaneous MP, a phenomenon that affects about 1% of Italian women. In cases where it is the result of medical treatment or surgery, we speak of iatrogenic menopause, a phenomenon that affects 4-5% of Italian women.
See also
Spontaneous MP: in one third of cases the cause is genetic, with family transmission, so attention must be paid to the age at which the mother, grandmother or any sisters went through menopause. In two thirds of cases it is occasional, that is, when there are no other cases in the family. It can depend on autoimmune causes, when the body produces antibodies that attack the ovary, on chromosomal alterations, genetic syndromes, enzymatic / metabolic problems. In many cases, however, the reasons that lead to POF remain unknown, and then we speak of idiopathic PD.
Iatrogenic menopause: It is a consequence of invasive medical treatments, such as surgery, ovarian cyst enucleations, bilateral ovarian removal, chemotherapy or pelvic radiotherapy. Finally, pelvic radiotherapy, in which irradiations are directed to the pelvis to treat tumors there, or the complete irradiation necessary before a bone marrow transplant can also cause iatrogenic premature menopause.
Symptoms and Diagnosis
The symptoms and clinical signs are manifold and concern various psycho-physical aspects such as: amenorrhea or in any case significant changes in the menstrual cycle, osteoporosis, decreased sexual desire.
To make a correct diagnosis it is however sufficient to measure the levels of gonadotropins and estradiol every week for a few weeks (maximum 4): the first must be high, the second low.
Therapy
The definition that is often associated with this irreversibility condition is often wrong. The guidelines of the International Menopause Society indicate, very clearly, that hormones are indispensable and that it is the doctor's duty to prescribe them to the woman. Premature menopause is an unnatural, non-physiological phenomenon, and if the ovary stops working too soon the woman can face many problems: very fragile bones, much higher cardiovascular risk and a greater danger of neurodegenerative diseases such as disease Alzheimer's.
