Premature and Early Menopause

Premature menopause is when you reach menopause prior to the age of 40. Early menopause is when you reach menopause before you reach 45. The average age for menopause is 51 in Western countries. 

Both premature and early menopause can occur naturally or due to medical reasons such as surgery or medications. Surgical menopause where both ovaries are removed carries the most risk. This is because post-menopausal ovaries can still produce hormones. Even the smallest amounts of estrogen and testosterone still produced by the ovaries can be protective and are better than nothing. 

Natural causes can be due to decreased follicle numbers, increased follicle destruction, or a failure of the follicle to respond to stimulation. Looking at natural statistics roughly 1% of women will experience a premature menopause and about 5% will experience an early menopause.

Unfortunately both premature and early menopause carry with them an increased risk of overall mortality, heart disease, osteoporosis, cognitive impairment, mental health challenges, sexual dysfunction, and auto-immune conditions. The younger you are at menopause, the greater your risk. Some of these risks may be mitigated by hormone therapy, however, hormones alone do NOT prevent all of these risk factors. But it's generally a great place to start.

So let's explore what else is going on and what other factors you should be considering if you have experienced a natural menopause at a younger age.

Starting with your follicle. The follicle contains your oocyte or your egg. Oocytes contain more mitochondria and mitochondrial DNA than any other cell in your body.  It is estimated that each individual oocyte contains 100,000-600,000 mitochondria. Mitochondrial dysfunction is a key cause of oocyte failure.

Think of the mitochondria as batteries, they power up your cell. Genetics, environmental pollution, nutrient deficiencies, and age can be associated with mitochondrial DNA damage and this damage impacts the ability of your mitochondria to work and this impacts the health and quality of your oocyte. Protecting your mitochondria is paramount.

Interestingly your heart cells contain the second highest concentration of mitochondria, containing about 5,000 mitochondria per cell. Could this be part of the link between a younger menopause and heart disease? 

Other signs of mitochondria dysfunction include fatigue, muscle weakness, exercise intolerance, hearing and/or vision reduction, blood sugar issues, and more.

When you consider the health of your mitochondria you also need to consider the health of your mitochondrial membrane. Think of the membrane as the brain of the cell, as its controls what happens within the cell, the nutrients it lets in and the toxins it lets out. Click here for more information about Cellular health. Ultimately you won't have healthy mitochondria if you don't have great membranes.

Dietary considerations

* Low consumption of dietary fibre is linked with an increased risk

* Increased consumption of green or yellow fruits and vegetables decreases the risk

* Dairy consumption increases your risk and is associated with a lowers follicle count 

* Low protein consumption increases your risk

Lifestyle consideration

* Insomnia and low melatonin levels are linked with greater mitochondrial and oocyte damage and poorer insulin sensitivity

* Stress levels greatly impair hormonal communication and ovarian function 

* Exercise can help enhance the capacity of your mitochondria and enhances mitochondria DNA replication

* Safe sunshine exposure - low Vitamin D levels are linked to poor follicular development and low oocyte reserves (AMH)

* Cigarette smoking damages your oocytes and promotes earlier menopause.

* Avoid endocrine disrupting chemicals like BPA, phthalates, pesticides, PCBs, DDT, etc as they disrupt follicular development and alter your hormonal response

Testing considerations

* Bone density scan 

* Autoantibodies 

* Glucose and insulin

* Genetics

* Environmental toxicity

* Nutrient levels (including ferritin)

* Methylation factors / homocysteine

Supplement considerations

* COQ10

* Glutathione

* Phospholipids

* Melatonin

* B vitamins

* Vitamin D

* Electrolytes

* Iron

WARNING if you have experienced a younger natural menopause and you address some of the factors we have discussed above it is possible in some cases for your periods to return and your diagnosis to be removed. The return of your periods may or may not excite you, but the health benefits will. Please make sure you investigate any post-menopausal bleeds.