Menopause is a natural event in which a woman's reproductive function fades. It is characterized by the cessation of menstrual bleeding and the depletion of the follicular reserve. (In fact, the female body produces a limited number of oocytes, determined from birth.)
Cyclic cessation of ovarian activity usually occurs at about 50 years old on average (plus or minus five years). However, some women enter menopause early, before forty. This natural or induced condition is known as an early (or premature) menopause.
Premature menopause – is always stress that can become emotionally destructive for a woman. A direct consequence of the condition is infertility, caused by a sharp decrease in the production of follicles and a deterioration in their quality. According to statistics, early menopause affects 5% of women of reproductive age.
РEarly menopause is also referred to as the term POF (premature ovarian failure), this term refers to early ovarian failure with amenorrhea, elevated serum gonadotropins (FSH and LH) and hypoestrogenism. In reality, these two conditions are not entirely equivalent. We will deal with this in more detail.
Premature extinction of ovarian function can be considered as a transient phenomenon, since in many cases intermittent spontaneous activity of the ovaries occurs, when menstrual periods alternate with amenorrhea (absence of menstruation for at least three months).
Women with early ovarian failure are still capable of ovulation and may become pregnant. Dysfunctional primary follicles, which are physiologically unpredictable, ovulate in 5 to 10% of cases, in patients with POF (premature ovarian failure) in the ovaries «are sleepping» Patients with stable early menopause, when menstruation is completely stopped, naturally, can not get pregnant.
Causes of premature menopause
The basis of the mechanism for starting early menopause is follicular atresia - a stop of the development of the follicle caused by multiple causes. In 75% of cases, early menopause is idiopathic in nature, when it is impossible to determine a specific cause, and no changes have been detected in the karyotype н(that is, there are no specific gene abnormalities that predispose to early menopause).
Possible causes contributing to early menopause are genetic abnormalities, metabolic defects, autoimmune disorders, viral and bacterial infections. One of the common causes of early menopause is severe stress, as well as a state of constant chronic stress and a high level of anxiety.
Some examples of genetic syndromes that are apparent in karyotype analysis associated with early menopause are Turner Syndrome and Sewer Syndrome.
Metabolic defects include:
- galactosemia (non-converted galactose has a toxic effect on the ovaries);
- congenital adrenal hyperplasia (steroid hormone biosynthesis is impaired);
- mucopolysaccharidosis is a group of systemic metabolic diseases caused by a lack of specific enzymes.
Autoimmune disorders that can coexist with early menopause can be of two types. In the first case, the immune system mistakenly produces antibodies against ovarian tissue. In the second, early ovarian failure is associated with other systemic diseases, especially the thyroid gland.
(hypothyroidism), Crohn's disease, systemic lupus erythematosus, rheumatoid arthritis. The histological picture characterizing patients with early autoimmune ovarian failure is the presence of oophoritis (inflammation of the ovary). Some viral and bacterial infections, such as cytomegalovirus, mumps, and tuberculosis.
contribute to the early onset of menopause. It should be borne in mind that smoking and alcohol abuse can anticipate menopause. Early induced menopause is provoked by medical procedures - pharmacological, radiation, surgical.
Symptoms of premature menopause
Early menopause is usually difficult to interpret and often it is the same ones that accompany the natural menopause. Before you begin to deal with early menopause, you can contact the specialists of the Bogoliuby MC to find out the causes of the condition. The decision on what to do with premature menopause is made jointly with a gynecologist depending on the presence of pathological manifestations.