Consultant Endocrinologist, Dr Michael Olamoyegun Explains 6 Factors That Could Trigger Early Menopause In Women

A few years ago, London’s Imperial College released a report that shows that women, arguably, now seem to reach menopause earlier than it used to be in the past. The average age for menopause used to be about 60, unlike now that it seems to be about 45 years or even below.

The discussion about menopause, which signals the end of a woman’s menstrual cycle, seems to have assumed a more diverse and interesting dimension in recent years following the recent cases of women who, in their 60s and 70s, have been delivered of babies.

Even though most of such cases were more often than not a product of in-vitro fertilisation technique, popularly known as IVF. This process involves fertilisation of eggs outside the womb in a laboratory dish or a test tube before the embryo is transferred into the woman’s uterus for development.

For example, just few weeks ago, a 66-year-old woman, Mrs. Ajibola Otubusin, was reportedly delivered of her first child, a baby boy, after 40 years of marriage.

Given her age and several attempts to conceive, she said that she initially didn’t believe it was true. But, as it turned out, she had her bundle of joy.

Earlier in the year also, a 63-year-old woman, Margaret Davou, in Plateau State was reportedly delivered of a baby girl; her first in her 38 years of marriage to her husband, 67-year-old Francis.

The issue of having delay in childbirth is no doubt a global challenge. A 72-year-old Indian, Daljinder Kaur, was in 2016 reportedly delivered of a baby boy after 46 years of marriage.

Perhaps, the age of the women would justify why they had to resort to IVF, given that menopause occurs in women when they are about 50 years old, even though it also varies among individuals.

But, on the other hand, there have been instances where younger women slide into menopause, a phenomenon that is known as premature menopause.

However, given that several factors could be responsible for delay in getting pregnant, premature menopause may not be detected early. And such was the case of Janet, a 39-year-old mid-level marketer, who had been married for about 10 years.

She revealed that initially when she didn’t conceive, despite the frequent and timely sexual intercourse with her husband, doctors told her it was stress, as she spends hours in traffic and she is oftentimes out of the office for fieldwork.

But even after quitting her job and settling for a less-paying and less-taxing one, nothing changed, which according to her prompted her to go for more comprehensive medical tests. But the results broke her heart beyond what she could comprehend. She said,

“I noticed that my period was irregular and sometimes I missed it. As you can imagine, I thought it was a good signal, but it was far from it. Anytime I had a period, it was either lighter or heavier than normal.

“After some time, I started having lower sex drive and of course, vagina dryness came with it and I needed to lubricate myself anytime we were to have sex, because as much as I was losing interest in sex, I knew we had to do it to stand a chance. My husband also told me I had mood swings.

“At the end, I was told that I was producing less oestrogen and that I had suffered premature menopause. It was like the world ended that minute – having menopause at my age. My thoughts ran wild and I was losing it.”

After several counselling sessions and encouragement from her husband, she said she went for IVF and now has two children. She said:

“I wasn’t happy until the IVF was successful and I could see my own children.”

The foregoing underscores the fact that there are women who suffer from premature menopause. A seasoned consultant endocrinologist, Dr Michael Olamoyegun, explained that for most people, menopause age usually ranges from 50, plus or minus five years, which means it’s from 45 to 55 and some people could reach menopause at age 57.

“So, it could vary, but if it occurs before 45, that is premature menopause,” he added.

Thus, apart from age, which is primary and the most relatable, it would seem helpful to identify the factors that could make women reach menopause prematurely, some of which include:

Genetics:

This is one of the factors that experts have identified as one of the causes of premature menopause. Olamoyegun explained that even though it is a potent factor, it does not mean that every woman (daughter) in a family would experience it because the mother reached menopause early.

He said there was only a higher likelihood that they could follow the same pattern. According to him:

“It tends to run in families and that is why we said it is genetic. However, it is not a certainty that the daughter would reach menopause at the same age the mother did, but there is a higher likelihood that the daughter would experience the same thing.

However, if the daughters are prone to other medical conditions like obesity, it could increase their chance of experiencing it.”

Surgery:

This is perhaps one of the most critical causes of premature menopause as it could impact directly on the hormones responsible for the menstrual cycle.

Olamoyegun explained that if a woman undergoes surgical procedures that remove the ovary, which is the female reproductive organ where eggs are produced, the woman, regardless of the age, tends to invariably slide into menopause because the hormone that controls menstrual cycle comes from the ovary.

Thus, once the ovary is removed, the source of the hormone responsible for menstrual cycle has been removed and so the woman is unable to menstruate or produce eggs, which is tantamount to menopause. He said,

“The hormones that control menstrual cycle come from the ovary and once you remove the ovary, for whatever reason, you have removed the source of those hormones and so the woman cannot produce eggs because what happens in menopause is that the ovary is not releasing eggs, which is why somebody that has attained menopause cannot give birth to children, except through IVF.”

He explained further,

“Let’s say somebody has cancer of the uterus, she can decide to remove the uterus (hysterectomy), and sometimes they remove the ovary as well because if you have removed the uterus, the ovary is of no use again.

Also, if somebody has fibroid, instead of doing myomectomy, which is the removal of the fibroid, some women remove the uterus and ovary as well if they have completed childbirth. In such cases, they have reached menopause.”

He added that in some instances, women could be placed on hormone replacement therapy so as to reduce the manifestation of the lost hormones.

Cancer chemotherapy:

This is the use of certain drugs to treat cancer, and according to Olamoyegun, there are instances where this could affect the ovary. He added that once the ovary is destroyed, such a woman may stop producing eggs or menstruating. He stated:

“Chemotherapy may affect the ability to produce hormones required for menstruation. When somebody has cancer of the ovary, abdomen or of any area around that region, and the person does chemotherapy, as it destroys the cancer it’s also destroying the ovary and the ovary won’t be able to produce the hormones required for menstruation again.”

It was learnt that the type of chemotherapy used would determine whether the person would go into menopause or not.

Radiation:

While this may seem unpopular, it is another factor that causes premature menopause. Experts have said that pelvic radiation therapy for reproductive system cancers could cause ovarian damage. He said,

“You know radiation is also used for treating cancer, so when someone is exposed to radiation, it can affect the ovary and the person might have premature menopause, depending on other things like the extent of the exposure to the radiation.”

Autoimmune factor:

Researchers have said that there are times the immune system in the body fights itself, and that if it attacks itself in the region of the reproductive organs, it could affect the ovary which makes it impossible for it to produce hormones that are needed for menstruation. Olamoyegun said,

“This is when the body produces chemicals that destroy itself, so there can be immune diseases that destroy the ovary and it can start anytime. And once the ovary is destroyed, the person would not be able to produce hormones needed for menstruation and the person would face premature menopause.”

Meanwhile, WebMD, a website where experts provide valuable health information, pointed out that thyroid disease and rheumatoid arthritis are two diseases in which this can happen.

Lifestyle:

This seems to be one factor that impacts people’s well-being in all aspects of their lives, and it appears reproductive health is not spared in this regard. Olamoyegun explains that even though there is no established link between things like obesity, smoking and premature menopause, they may possibly be risk factors. He said,

“Things like obesity, smoking and inhaling certain chemicals and alcoholic drinks cause many problems such as hypertension, diabetes, high cholesterol and other things and even though lifestyle has not been shown scientifically to cause premature menopause, it is not impossible. But, like I said, it has not been established.”

The endocrinologist advised that it was important for people to pay attention to the factors identified, noting that “once you enter menopause, medically, the only solution in terms of childbirth is IVF, so people should exercise care with their system.”

Source: PUNCH