Premature menopause: what it is, associated risks, and promising therapies.
Updated: Jul 1
Menopause can be shocking enough when it’s on time; now imagine if it hit ahead of schedule. Premature menopause comes with a host of unpleasant symptoms, early infertility, and an increased mortality risk. 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.
Are premature and early menopause the same?
Premature menopause is an extreme and clinical case of early menopause. Menopause that happens between ages 40 and 45 is called early menopause. (4) Menopause before age 40 is premature menopause (5).
What causes premature menopause?
Primary ovarian insufficiency is the most common cause of premature menopause.
Primary ovarian insufficiency
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, marking the onset of menopause. (Read more about the mechanism behind menopause here!)
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. 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. However, women with POI who have not entered menopause, continue to have irregular periods and in some cases, can even get pregnant. On the other hand, women with premature menopause stop having periods altogether and cannot conceive. (8)
Associated risks with premature and early menopause.
Individuals who experience early or premature menopause can face the following:
A higher mortality rate.
Increased risk for neurological diseases.
Increased risk of cardiovascular illness.
Increased 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.
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 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.
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!
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.
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.
(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://medlineplus.gov/primaryovarianinsufficiency.html (8) https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/symptoms-causes/syc-20354683 (9) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815011/ (10) https://www.bodylogicmd.com/blog/when-to-start-hrt-earlier-may-be-better-but-its-never-too-late/ (11) https://journals.sagepub.com/doi/full/10.1177/09636897221083252 (12) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8371769/ (13) https://journals.sagepub.com/doi/10.1177/0963689720926154 (14) https://link.springer.com/article/10.1007/s11033-019-04609-w