Why some women go through early menopause

Menopause varies from one individual to another in terms of age and timing, also bearing in mind that the period for its occurrence is gradual and not spontaneous.  
Dr Efrem Mrema, a gynaecologist with the Muhimbili National Hospital explains to Your Health that menopause actually means your last menstrual period. ‘Meno’ refers to your menstrual cycle and ‘pause’ literally means stop.
“The menopause occurs when your ovaries stop producing eggs and as a result the levels of your hormones called oestrogen and progesterone hormone fall,” says Dr Mrema.  These hormones work together to regulate your menstrual cycle and also the production of eggs.
So why do we use the term pre-menopause? According to Dr Mrema, the term pre menopause is often used as this is the time in which one experiences menopausal symptoms but are still having periods. These periods are often more irregular and scanty than they used to be.
“During your pre-menopause, the levels of these hormones fluctuat greatly and it is often the imbalance of these hormones which leads to symptoms of the menopause occurring.
For some women these symptoms only occur for a few months and then their periods completely stop. However, other women experience symptoms for many months or even many years before their periods stop.”
Oestrogen protects a number of different systems in your body; your brain, skin bones, heart and vagina, hence low levels can affect all these parts of your body.

When can it occur
Dr Mrema tells Your Health that the average age of the menopause is 51 years as it varies from 45 to 55 years. Some may have premature menopause even at the age of 38 years. If the menopause occurs before the age of 40 it is classed as Premature Ovarian Failure.
“If the menopause occurs when you are under 45 years of age then it is called an early menopause,” adds the specialist.
Although the menopause is a normal event in a woman, certain conditions can bring about an early menopause.
These include if you have had your ovaries removed during an operation. If you have radiotherapy to your pelvic area as a treatment for cancer or if you have received certain types of chemotherapy drugs that treat cancer. Then this might lead to have an early menopause.

Changes
Dr Mrema said when women experience period around menopause, there are some changes she will see including irregular menses, mood changes (depression), hot flushes, sleep disturbance and others. Bleeding and clots can also occur during this period. This is due to hormonal changes during that period.

Diagnosing menopause
Some women bleed profusely, from which they may end up with life threatening haemorrhage case causing death if immediate action is not taken. Consulting with a specialist on this matter is the wisest thing to do, advises Dr Mrema.
If you are over 45 years of age and have irregular periods with symptoms of the menopause, then you do not need to have any tests to diagnose the menopause. If you are taking contraception or have a coil, then it may be difficult to know what your periods are like.
However, if you are younger than 45 years of age then you may need to have tests. The most common test is a blood test measuring the level of a hormone called follicle stimulating hormone.

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