Premature Menopause

Apart from the natural menopause transition (perimenopause to postmenopause) which most women will experience, some may face one of the following challenges:

Premature Ovarian Failure (POF)

Surgical Menopause

Medical Menopause

PREMATURE OVARIAN FAILURE

The average age for women to reach natural menopause, the cessation of periods, is about 50. Some women, however, go through menopause in their 40s and some, as early as their 20s and 30s. For most women, the diagnosis of Premature Menopause (also known as Premature Ovarian Failure) is a shattering experience. Many younger women who are diagnosed with POF have not had the chance to make a decision about having children and find that opportunity denied to them.

SURGICAL MENOPAUSE

Menopause happens most dramatically as the result of surgical intervention, namely a hysterectomy and bilateral oophorectomy where both ovaries are removed. Sometimes this is called TAH/BSO, or total abdominal hysterectomy with bilateral salpingo-oophorectomy. Salpingo refers to the fallopian tubes which connect the ovaries to the uterus. In the case of a hysterectomy, where only the uterus is removed and the ovaries maintained, there will be some confusion about when menopause occurs because of the absence of a period.

When the uterus is removed (hysterectomy) and the ovaries remain, menstrual periods stop but other menopausal symptoms (if any) usually occur at the same age that they would naturally. However, some women who have a hysterectomy may experience menopausal symptoms at a younger age.

There are many decisions to make when faced with surgical menopause. You can never have enough information about the process. You can't just take your doctor's word! Become proactive…this is your body. Listed below are a few points of information that should help your transition into this process:

• The younger the woman going through surgical menopause, the more problems she will likely encounter.

• It is crucial that every young woman scheduled for a hysterectomy have a complete hormonal blood work-up. That way there is a baseline to go by when determining hormonal needs. You can look back at those tests and see what the levels were when you felt normal and try to achieve those levels again with the right hormones.

• Plan on your care after the hysterectomy. As a young woman it is important to find a "specialist " in hormonal therapy; someone who is up to date and keeps up to date with the newest medicine and side effects from surgical menopause. This doctor has to be someone you can trust, who provides good information and is open minded and will see you as a partner in your healthcare.

• Research, research, and more research! The long-term affects of surgical menopause at a younger age has not really been determined. We are just now finding out how it relates to heart disease, osteoporosis and general health.

SYMPTOMS

Not every woman will experience these symptoms, but it is a proven fact that if you are in surgical menopause, then you will experience most of these symptoms in a more severe fashion than women going through menopause naturally.

FOR ADDITIONAL INFORMATION:

HERS FOUNDATION (Hysterectomy Educational Resources & Services)
422 Bryn Mawr Avenue
Bala Cynwyd, PA 19004
Email: info@hersfoundation.com

To request a free information packet: Tel (610) 667-7757
To arrange a telephone appointment with a counselor: FAX (610) 667-8096

Sans Uteri Hysterectomy Forum, communication between hysterectomized women and women considering surgery. This site has many segments including a private mailing list of women who have had hysterectomies. Other features of the site are described in their FAQ.

Alternatives to Hysterectomy is designed for women who have been told they need a hysterectomy and are searching for alternative treatment. This site is under the direction of Michael E. Toaff, M.D.

Alternatives in Gynecology is the site of Paul D. Indman, M.D., FACOG. Topics explored at this site are common gynecological problems and procedures that should be considered when contemplating hysterectomy.

A Woman's Guide to Overcoming Endometriosis from IVF.com - complete and thorough resource about endometriosis

EarlyMenopause.com offers information and support for women who are experiencing early menopause—whether it's happened naturally or due to premature ovarian failure; surgery (hysterectomy and oophorectomy), cancer treatments (such as chemotherapy or radiation), autoimmune disorders, and more.

Hystersisters, a woman-to-woman support website for hysterectomy recovery. This group offers resources and kindness so that visitors can discover options and make decisions for themselves.

MEDICAL MENOPAUSE

Intervention can occur which produces a medical menopause. Often women who are treated for cancer with chemotherapy go into temporary or permanent menopause.

Anticancer drugs can damage the ovaries and reduce the amount of hormones they produce. As a result, some women find that their menstrual periods become irregular or stop completely while they are having chemotherapy. The hormonal effects of treatment may cause menopause-like symptoms such as hot flashes and itching, and burning or dryness of vaginal tissues.

Damage to the ovaries may result in infertility, the inability to become pregnant. In some cases, the infertility is a temporary condition; in other cases, it may be permanent. Whether infertility occurs, and how long it lasts, depends on many factors, including the type of drug, the dosage given, and the woman's age.

The above information is summarized from The National Cancer Institute web site. It has been extracted from a segment entitled "Coping With Side Effects".

Cancer Care. This is a national non-profit organization whose mission is to provide free professional help to people with all cancers through counseling, education, information and referral and direct financial assistance. This page covers breast cancer.

It is not the intention of Project AWARE to offer in-depth information on cancer treatment, but only to provide direction to information as it relates to cancer and its effect on women's reproductive health.

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Updated 08/07/2004