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Premature Menopause: Risks and Therapies Explained


A woman's hand holding a clock.
Credit: Miracare (1)

It can be shocking enough to reach menopause on time; now imagine if it hit ahead of schedule. Premature menopause impacts your daily life, coming with a host of unpleasant symptoms, early infertility, and higher risk of mortality. So, let’s delve deeper into what triggers premature menopause, potential therapies to treat it, and why it can help to predict and diagnose it early.


A graph of hormone levels from ages 35 to 75.
Hormone levels throughout life. (3)

Natural menopause and early menopause.

The average age of menopause, a year after a woman's final period, is between ages 45 and 55. Early menopause occurs at the earlier age of 40 and 45. (4)


What is premature menopause?

Premature menopause is an extreme and clinical case of early menopause. Premature menopause occurs before the age of 40 (5).


Causes of Premature Menopause.

Primary ovarian insufficiency is the most common cause of premature menopause.


Primary ovarian insufficiency and symptoms of premature menopause.

One of the main reproductive pathways in women stretches from the brain right down to the ovaries. Your brain sends signals that instruct your ovaries to produce hormones such as estrogen. As we age, our ovaries get less diligent. They start responding less and less to these brain signals and produce less and less estrogen.

Eventually, your ovaries stop responding altogether, resulting in low levels of estrogen and marking the onset of menopause. (Read more about the mechanism behind menopause here!) You may then begin to experience menopausal symptoms such as hot flashes, night sweats, weight gain, vaginal dryness, emotional changes, and decreased bone density.


A graphic showing estrogen levels rising until age 35 and then falling.
Hormone levels as women get older (6)

Premature ovarian insufficiency or POI is when your ovaries stop responding too early. More specifically, they stop responding before the age of 40. This leads to a crash in estrogen levels, which can trigger the onset of menopause, prematurely. POI is often caused by exposure to chemotherapy and radiation therapy, often used in cancer treatments. It can also be caused by metabolic disorders such as type 2 diabetes. (7)


Are premature menopause and POI the same?

It's important to note that POI and premature menopause are not the same! POI can cause premature menopause, but premenopausal women with POI continue to have irregular periods and some can even get pregnant. However, women with premature menopause stop having menstrual periods altogether and cannot conceive. (8)


Associated risks with premature and early menopause.

Individuals who experience menopause at an early age can face the following health conditions and symptoms of menopause:

  • A higher mortality rate.

  • Sexual dysfunction.

  • Greater risk for neurological diseases.

  • Greater risk of cardiovascular disease.

  • Greater risk of osteoporosis. (9)

Fortunately, there are routes around this! Let’s take a look at the most commonly prescribed medication for cases of premature menopause.


Hormone replacement therapies for menopause.

Unfortunately, there aren't any treatments that can reverse premature menopause, or kickstart the ovaries. But, there are therapies that can reduce the majority of the associated health risks and menopause symptoms. The most popular, and arguably effective therapies are hormone replacement therapies or HRTs. (Read more about HRTs here!)

After identifying signs of early or premature menopause, it is highly recommended that you start on HRTs as soon as possible. (10) Taking advantage of menopause prediction tools can assist with POI or premature menopause diagnosis.


Hands holding a pill box.
Credit: Medical News Today (15)

Harnessing stem cell therapy to restore fertility.

There are a few therapies in development to prevent and even reverse the effects of premature menopause. Stem cell therapy research has actually shown potential in reversing premature menopause and restoring female fertility.

Stem cells can multiply and convert into different specialized cells as needed. (11) A research paper on Bone Marrow Mesenchymal Stromal Cells (BMMSCs) derived from young monkeys, successfully reversed ovarian aging in elderly monkeys!

The treatment promoted several indicators of youthful and functional ovaries, including the following.

  • Improved cell regeneration and function.

  • Restored youthful ovarian structure.

  • Suppressed premature cell apoptosis, or cell suicide.

  • Restored secretion of hormones such as estrogen. (12)

Eventually, as these trials progress to humans, we may have a tool to reverse premature menopause and its associated risks!


Cell infusion techniques to address POI.

Platelet-rich plasma (PRP) is cell therapy where your own cells are used to treat or prevent a medical condition. (13) A clinical application of PRP was conducted on perimenopausal and premature menopausal IVF patients. PRP was injected into the ovary and within 1-3 months their ovarian function was restored along with their menstrual cycle! (14)

As we learn more about premature menopause, the associated risks can get overwhelming. But the future is bright folks! We know more than we ever have about the mechanisms behind menopause and a woman’s reproductive system. Eventually, we might be able to predict early or premature menopause in advance and proactively begin treatments to avoid negative side effects.


Key takeaways.

  • Menopause occurs between the ages of 45 and 55.

  • Premature menopause occurs before the age of 40.

  • Early menopause happens between the ages of 40 and 45.

  • POI is the most common conviction of premature or early menopause.

  • Women with POI can still conceive, however, women with premature/early menopause cannot.

  • Hormone therapy is recommended for those experiencing menopause.

  • Stem cell therapy and platelet-rich plasma are both therapies showing huge potential in addressing ovary insufficiency.



Drawing of a woman inside an hourglass.
Credit: Mira (16)

Citations

  1. https://www.miracare.com/blog/what-are-the-34-symptoms-of-menopause/

  2. https://my.clevelandclinic.org/health/diseases/21138-premature-and-early-menopause

  3. https://www.lecturio.com/concepts/menopause/

  4. https://www.nia.nih.gov/health/what-menopause#:~:text=Menopause

  5. https://www.womenshealth.gov/menopause/early-or-premature-menopause#:~:text=Early

  6. https://www.hopkinsmedicine.org/news/newsroom/news-releases/sex-hormone-levels-alter-heart-disease-risk-in-older-women

  7. https://pubmed.ncbi.nlm.nih.gov/23812652/

  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3634232/

  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815011/

  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5137796/

  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8969497/

  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8371769/

  13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7563844/

  14. https://pubmed.ncbi.nlm.nih.gov/30725347/

  15. https://www.medicalnewstoday.com/articles/181726

  16. https://www.miracare.com/blog/primary-ovarian-insufficiency/

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