The average age of menopause in Brazil is between 50 and 51 years. However, due to genetic factors, pre-existing diseases, surgical procedures, or most often for unknown reasons, some women stop menstruating completely before the age of 40. This is a condition called premature ovarian failure (POI).
In medical terms, menopause occurs on the date of a woman’s last menstrual period. It is a natural event that marks the end of a human’s reproductive life.
When the ovaries stop working, the body is without the functioning of estrogen, the main female hormone, and a person is more likely to develop bone and cardiovascular problems, as well as lose fertility.
He says Gynecologist Christina Laguna, Chairman of the National Committee for Gynecological Endocrinology in Vibrasgo.
What is the difference between premature menopause and premature ovarian failure?
According to the Vibrasgo gynecologist, early menopause is the one that occurs between the ages of 40 and 50. If the bleeding stops earlier than that, this is a sign of IOP.
Some doctors call premature ovarian failure premature menopause, but we don’t like that comparison. Menopause has a connotation associated with a degree of normal aging. He says that it is not physiological for the ovaries to stop working before the age of forty.
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Recent studies show that IOP affects 3.7% of women, says the doctor, who is also a professor in the Department of Obstetrics and Gynecology at Unicamp’s Faculty of Medical Sciences.
In the past, there was talk of a 1% spread. However, as the publicity around the problem increases, more people are seeking care and receiving a diagnosis. In addition, cancer treatments have improved. Many young patients who have undergone chemotherapy and radiotherapy have gone on to have IOP,” she explains.
What are the causes of early menopause and premature ovarian failure?
The reasons are the same in both scenarios. Basically, anything that damages the ovaries or prevents the body from producing estrogen can lead to menopause. According to Christina Laguna, the main triggers are:
– heredity: if a person has a family member who stops menstruating early, the risk of him having the same problem increases;
Autoimmune diseases: Individuals with these conditions may also have autoimmune diseases against the ovaries.
– Iatrogenic factors: operations to remove the uterus and ovaries, as well as radiotherapy and chemotherapy, can cause IOP.
Exposure to physical and infectious agents: It is known that viral infections, excessive smoking and pesticides, for example, can act as endocrine disruptors. However, a cause-and-effect relationship cannot be established.
However, in 60% of cases, we don’t know why the ovaries stop working. People are born with less follicular reserve or have prematurely spent their follicles,” notes the gynecologist.
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How is early menopause and premature ovarian failure treated?
The treatment in either case is similar to menopause: hormone replacement therapy. However, in IOP, the doses administered are higher and adapted to the characteristics of the young woman.
Treatment aims to restore adequate levels of hormones, particularly estrogen. This hormone plays an important role in the development of the reproductive organs during puberty, such as the development of the breasts and uterus. In addition, it is associated with increased bone mass, which helps prevent osteoporosis.
According to Professor Unicamp, studies show that estrogen deficiency is also associated with mood swings, depression, anxiety, decreased cognitive ability, sleep disorders and a greater tendency to dementia.
“Estrogen is the main hormone in the female organism, not only for reproduction, but for all these functions that it performs. The earlier the loss of ovarian function, the greater the risk to a woman’s health,” says the gynecologist.
Progesterone is replaced in women who have a uterus to protect against endometrial cancer. In those with a history of endometriosis, it prevents the disease from reappearing.
Treatment also includes guidance about healthy habits, such as quitting smoking, eating a balanced diet, avoiding being overweight, and being physically active. Psychological follow-up is essential for a person to deal with the emotional challenges associated with a diagnosis.
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