Premature menopause and how it’s related to female infertility
Today at our fertility clinic in Spain we want to talk to you about menopause and, more specifically, premature menopause. About how it affects women and infertility, and what assisted reproduction treatments exist in these cases.
As you already know, a female’s ovaries have reproductive and hormonal functions. They are responsible for ovulation and are the main producers of the reproductive hormones oestrogen and progesterone.
Women are born with a set number of eggs in their ovaries, called their ovarian reserve. This reserve decreases as a woman ages. When a woman’s ovarian reserve runs out she will stop ovulating, hormone production will sharply decrease and, finally, her menstrual cycles will stop. This period of time is known as menopause and generally happens, on average, at the age of 51 in the Western world.
What is premature menopause?
We’ve already talked about menopause. What you need to know is that when this situation presents itself before the age of 40 it is known as premature menopause. It is also called premature ovarian failure or premature ovarian insufficiency.
This situation affects 1% of women and 1 in a thousand women under the age of 30.
Diagnosis of premature menopause
Diagnosis is based on the absence of menstrual cycles and elevated levels of the hormone FSH in a blood sample, generally around 40 IU/L on at least two separate occasions about 4 to 6 weeks apart.
Diagnosis can also include levels of anti-Mullerian and inhibin B hormones which are much lower than normal values.
Symptoms of premature menopause
Women with premature ovarian failure, in addition to an absence of menstrual cycles, may mention climacteric symptoms such as hot flashes, vaginal dryness, changes in their skin, hair loss and mood disorders.
There are also certain long-term effects such as osteoporosis and cardiovascular issues, to name a few.
Causes of premature menopause
The causes may be genetic, such as with Turner Syndrome, Fragile X Syndrome, genetic polyendocrine syndromes, etc.
There are also certain autoimmune-related causes which produce anti-ovarian antibodies, Hashimoto’s thyroiditis, Addison’s disease, Type-1 Diabetes, Celiac disease, Albinism, rheumatoid arthritis, lupus and Myasthenia gravis.
Finally, other causes include iatrogenic effects such as chemo and radiotherapy, as well as environmental factors such as tobacco use in susceptible women.
Treatment for premature menopause
Treatment focuses on infertility caused by lack of ovulation and oestrogen deficiency.
In cases in which the problem is an immune issue, treating the cause oftentimes restores ovarian function in terms of ovulation and hormones. One example would be with Celiac disease: cases have been described in which, by removing gluten from the diet, ovarian functioning was restored.
For oestrogen deficiency, which is responsible for the majority of symptoms (such as hot flashes), using controlled hormone replacement therapy with oestrogen and progesterone is one hundred percent effective. Infertility due to an absence of oocytes is dealt with by employing in vitro fertilisation with donor eggs.
For women who will be receiving radio and/or chemotherapy, it is possible to preserve their fertility by freezing eggs before undergoing cancer treatment.
Do you have premature menopause and would you like to receive more information about your options for becoming a mother? Contact us. At URE Centro Gutenberg we’ll explain everything to you in detail, evaluate your situation and talk to you about the best solutions.