Early Menopause: What It Is and Advice from Gynecologists on How to Face It

“It is a physiological and spontaneous change in a woman’s life that results in the definitive cessation of menstruation, with the loss of egg production and, consequently, the definitive loss of fertility. This typically happens around 50 years of age, but the range can vary from 40 to 59 years old.

Undoubtedly, the average life expectancy has increased, and today menopause represents a third of a woman's life. Therefore, it is important to prevent and treat all symptoms,” says Dr. Mignini Renzini.

"Premature menopause occurs before the age of 45 and affects 10% of the female population. Early menopause affects women under 40 years old and affects 1% of the population,” specifies the expert.

“There can be many reasons why menopause occurs prematurely or early in a woman's life, and they are all related to an early depletion of the ovarian reserve, which is the number of eggs a woman has throughout her life and the ability of the ovaries to produce gametes that can be fertilized and lead to pregnancy,” continues Dr. Mignini Renzini.

Depletion of the ovarian reserve can be linked to:

• Genetic factors
• Surgical interventions on the ovaries for benign conditions, such as endometriosis
• Ovarian removal surgeries
• Chemotherapy for cancer treatment, which can damage the ovarian follicular reserve
• Other factors, such as the consumption of toxic substances: for example, smokers tend to enter menopause several years earlier.

The typical symptoms of menopause include irregular periods, with cycles shortening from 30 to 22 days, which can occur up to 7 or 8 years before menopause. Subsequently, the cycles become more spaced out, with longer periods between them or even absent altogether. Other symptoms include:

• Hot flashes
• Sleep problems (insomnia)
• Mood swings
• Vaginal dryness, which can cause urinary issues and/or discomfort during sexual intercourse.

“There are no tests that can tell us exactly when menopause will occur. In young women presenting symptoms compatible with menopause, we can carry out specific tests to understand the ovarian reserve status and the reasons for this condition,” emphasizes Dr. Mignini Renzini.

Additionally, it is important to consider the woman's overall health and well-being to evaluate the appropriateness of proper prevention for other conditions, either pre-existing or occurring alongside menopause, and to consider the potential need for therapy to prevent menopausal symptoms.

“Unfortunately, there is little attention given to the issue of fertility preservation: today, many women start trying to have children after the age of 35, or even 40, and may face difficulties conceiving, as the ovarian reserve decreases. If early or premature menopause is suspected, it is possible to propose egg retrieval and cryopreservation to preserve the woman's fertility,” highlights the specialist.

This technique is normally proposed to oncological patients before they undergo the necessary treatments.

“Prevention of early menopause symptoms is done through pharmacological, phytotherapeutic, and homeopathic therapies. For example, a woman diagnosed with early menopause will be directed toward hormone replacement therapy (HRT) to address the risks associated with early hormonal deficiency, such as bone fragility and cardiovascular problems.

However, every therapy must be personalized based on the conditions and needs of each woman. Today, we have several solutions available, each with different advantages and disadvantages. Therefore, the therapy must be tailored to the patient,” says Dr. Di Pace.

There are also lifestyle recommendations, under medical supervision, that can help alleviate symptoms. Here are some of them:

• Use natural remedies based on phytoestrogens and phytoprogestins, such as soy, passionflower, sage, flaxseeds, and red clover.
• To prevent osteoporosis, take supplements containing vitamin D and calcium.
• To alleviate anxiety and fatigue, magnesium is recommended.
• Take omega-3 fatty acids to help lower triglycerides.
• Follow a balanced diet, avoiding foods high in saturated fats, and prioritize consuming fruits and vegetables.
• Eliminate alcohol and smoking.
• Engage in regular physical activity.