Premature Menopause

What it is

Premature menopause, or premature ovarian insufficiency, is diagnosed when the ovaries stop functioning before age 40. Symptoms are similar to those of menopause — periods that become spaced out and stop, hot flashes, night sweats, vaginal dryness, and changes in sleep and mood — but they occur at a stage of life when a woman is often still planning to have children. Causes include genetic factors, autoimmune diseases, chemotherapy, radiotherapy and ovarian surgery; in many cases, no cause is identified. Diagnosis is confirmed with repeated hormone level tests. Because early estrogen deficiency increases the risk of osteoporosis and cardiovascular disease, hormone therapy is generally recommended until the usual age of menopause, barring contraindications. The consultation also addresses fertility, with guidance on the available options, and emotional support.

Most common symptoms

• Periods that become spaced out or stop before age 40
• Hot flashes and night sweats
• Vaginal dryness and pain during intercourse
• Changes in sleep and mood
• Decreased libido
• Difficulty getting pregnant

Causes and risk factors

• Genetic conditions, such as Turner syndrome and the fragile X premutation
• Autoimmune diseases, such as those of the thyroid and adrenal glands
• Chemotherapy, radiotherapy and ovarian surgery
• Family history of premature menopause
• Infections or unidentified causes, which account for many cases

How it is diagnosed

Suspicion arises when periods become spaced out or stop for more than four months before age 40, with or without symptoms of estrogen deficiency. During the consultation, your gynecologist reviews the menstrual history, previous treatments, family history and desire for pregnancy. Confirmation comes with repeated hormone level tests, a few weeks apart, and ruling out other causes, such as thyroid and prolactin changes. Depending on the case, genetic and autoimmune tests and a bone density scan are requested.

How we treat it at Femi Saúde

Barring contraindications, hormone therapy is recommended until the usual age of menopause, to relieve symptoms and protect the bones, heart and intimate health, with the route and dose chosen individually. The gynecology team at Femi Saúde monitors bone and cardiovascular health, provides guidance on diet, physical activity, calcium and vitamin D, and treats vaginal dryness with local estrogen or technologies such as intimate laser, when indicated. The desire to have children is discussed with care: fertility is reduced, but options exist, and the couple is counseled and referred for assisted reproduction when appropriate. Emotional support is part of the care.

What we offer