CHENNAI: Shirley Anne was in for a rude shock when she was diagnosed with premature ovarian failure. The 40-year-old assistant professor consulted a gynaecologist when her periods became irregular. The flow was either scanty or she was missing her periods. “Despite taking medication, the condition persisted. I used to have irregular periods since childhood because of the polycystic ovarian syndrome. I got it checked regularly and kept it under control. I was also told that that wasn’t the reason for my condition. After almost a year of cessation, my doctor confirmed that I had a premature ovarian failure,” said Shirley.
How early is too early?
Premature ovarian failure is an off-shoot of premature or early menopause. If the menstrual period ceases for more than 12 months then the woman has attained menopause. It either occurs naturally with time or can occur as a side effect of surgery, chemotherapy or radiation. Menopause typically begins between the ages of 45 and 55. Early menopause usually refers to the onset before 45 years. Premature ovarian failure refers to the onset even before 40 years.
Dr Sabeeha TS, consultant obstetrician and gynecologist, Kauvery Hospital, walks us through the symptoms, causes and control measures of this condition. “The average age for menopause is 51. However, the pattern is changing with lifestyle disorders, age of marriage and conception. Some of the causes for early menopause are malnutrition, low weight at birth, body mass index, inheritance from the paternal or maternal side, incessant smoking, surgeries or radiation therapies,” said the doctor.
The causes for a premature ovarian failure can also include infections, autoimmune disorders such as arthritis or chromosomal defects such as Turner Syndrome. “The symptoms include acute onset of hot flashes, estrogen deficiency, night sweats, anxiety, irregular periods, mood swings, scanty periods, decreased libido and a dry vagina. Long-term consequences can lead to cardiovascular and cerebrovascular problems, hypertension, and osteoporosis.
It’s a myth to associate depression or psychological disorders with mood swings that are natural when there’s fluctuation in the hormone levels. Likewise, the age of menarche has got nothing to do with menopause,” shared the doctor. Shirley wasn’t aware of the fine line between the two conditions. “The symptoms are more or less the same. I was worried that it could be a serious issue. I got married at the age of 30 and had a son when I was 32. It was a mutual decision to have the baby late after we settled down in our lives. There was so much pressure from the family to have another baby. We kept trying but I couldn’t conceive. My family did not agree to IVF or hormone replacement therapy; so, we had to give up the idea,” shared Shirley.
Pros and cons
A fertility specialist may also suggest procedures that can help you have children. Talk to your doctor about the options available to you for becoming a mother. Its risks and successes can be affected by many factors, including your age and overall health. “Early menopause, menopause and premature ovarian failure — all lead to infertility. It’s because of an increase in follicle-stimulating and luteinizing hormone, and decrease in estrogen. Earlier, an ovarian biopsy would have been recommended but not anymore. We also screen for autoimmune disorders in premature ovarian failure. The condition leads to a reduced ovarian reserve which cannot be restored but preservation is gaining momentum. Studies are conducted on ovarian transplantation and ovum donation for women who are planning for a pregnancy post 40 years.
Hormone therapy depends on the individual and I normally do not recommend it,” said the doctor.
Unlike Shirley, for Vanitha Shiva, early menopause was common in the paternal side of the family. But, she wasn’t cautioned before marriage. “There was no pattern or symptom. I stopped menstruating when I turned 41. I’ve heard stories from my aunts and grandmothers regarding the same. Although menopause has its pros and cons, this was quite early. It wasn’t common so I couldn’t discuss with my friends either. I had insomnia and terrible mood swings. I checked with a psychiatrist too. They too attributed it to the drastic drop in my hormones.
I’m well-informed about the diseases I’m prone to — like arthritis and cardiovascular diseases — because of my low estrogen levels. I’m maintaining a healthy lifestyle to protect my body and working out regularly,” said Vanitha. Overall, a healthy lifestyle involving regular exercise, diet, exposure to vitamin D, and increasing calcium intake can manage the symptoms of menopause or conditions related to it. Early menopause can’t usually be reversed, but treatment can help delay or reduce the symptoms of menopause.