What Are The Causes Of Menopause?
The onset of premature menopause can be caused by a number of different conditions and treatments.
Autoimmune Disorder
In two-thirds of women there is an autoimmune process responsible – here the body’s immune system mistakenly damages the ovary, perhaps as a side effect of trying to fight an infection. What are autoimmune disorders? Some common ones are: diabetes, thyroid disease and rheumatoid arthritis. If you have a family history of such disorders, this may be the cause of your premature menopause. For further information look at Dr Conway’s Website .
Infection
Infections, such as mumps or tuberculosis, may result in premature ovarian failure. However, this is extremely rare.
Surgery
Some of the reasons for gynaecological surgery are: endometriosis, cysts (many different varieties), fibroids and ovarian cancer.
If both a woman’s ovaries are surgically removed, she will undergo a ‘surgical’ menopause. This procedure is called a bilateral oophorectomy.
Depending on the medical problem, a hysterectomy may also be necessary. If you are reading this before surgical treatment, do your research, ask your consultant lots of questions and make sure you know what is going to be removed and why. Ask about retrieving and freezing your eggs for fertility treatment in the future.
This type of surgery is a major operation. It leaves you weak both physically and mentally and it is this point that the menopausal symptoms may kick in with a vengeance.
HRT may or may not be prescribed straightaway depending on the reason for your surgery. Finding the right HRT may take time but it is worth persevering. With so many preparations available, there will be one that suits you.
If your womb remains, you may still be able to carry a child following IVF with donated eggs (unless you were able to have your own eggs frozen). If you no longer have a womb, then surrogacy or adoption are the only remaining options if you wish to have children.
Cancer Treatment
Early menopause can result from radiotherapy to the ovaries or from chemotherapy given to treat a cancer which may or may not be located in the reproductive organs. The loss of ability to bear a child will also occur if the womb is removed due to a malignancy or for other medical reasons, with or without the simultaneous removal of the ovaries.
Chemotherapy drugs are systemic, that is they affect the entire body. They are given intravenously to reach all parts of the body to treat, and hopefully cure, or to reduce the likelihood that the cancer will spread or return later. Because cancer cells divide rapidly, chemotherapy drugs are aimed at damaging such cells but, unfortunately, in so doing they also damage healthy cells, particularly those which divide rapidly in the hair follicles, digestive system and ovaries. The drugs aim to kill the cancer cells, whilst any healthy cells damaged at the same time should repair themselves.
In some women, the ovaries do not recover when the treatment ends and periods do not return, resulting in an early menopause. The chances of menopause occurring depend upon the drug regime given, the nature of the illness and the patient’s age. For some women, periods return following treatment but they may return only briefly before menopause occurs.
It is advisable to discuss whether or not your fertility will be affected with your surgeon, oncologist or specialist nurse. Although it is their job to make the treatment of your illness their first priority, good medical staff should also recognise the importance of regarding early menopause as an issue which affects your general physical and emotional well-being. If you have an oestrogen receptor positive cancer, you may not be a suitable candidate for HRT and may want to consider herbal remedies with your doctor’s knowledge.
Unknown
In the majority of cases no obvious cause can be identified. Just because you do not have a logical reason, doesn’t take away the impact that a premature menopause can have and in some cases it can make it harder to come to terms with.
Family History
Recent research has also confirmed a hereditary genetic cause for about five percent of women with this condition. You may wish, if possible, to ask older female family members when they went through the menopause.
Chromosomal
Any defect of the X chromosome (the female sex chromosome) may cause premature menopause.
Turner’s Syndrome
Women with Turner’s syndrome have one X chromosome missing and, as a result, may be born without ovaries or with ‘streak’ ovaries or with ovaries that lack egg follicles. See Turners Syndrome Support Society.
Galactosaemia
A condition where there is a difficulty in utilising the sugar galactase which accumulates in the blood.
Fragile X
Premature menopause is associated only with the permutation status – often in the generation before fragile X syndrome appears in families.
Androgen Insensitivity Syndrome (AIS)
An intersex condition, one of a number of conditions in which there are no ovaries and in which there is a failure to menstruate at puberty. For further information contact AIS Support Group (AISSG) - a support group for Androgen Insensitivity Syndrome.
MRKH (Mayer-Rokitansky-Kuster-Hauser Syndrome)
Women with this condition are born without vaginas but have XX chromosomes and ovaries. They may go through a premature menopause.