early menopause It is the occurrence of menopause before the age of 40. This condition can be observed in 1% of women. Since there are many health problems and even shortening of life, these women must be given treatment until at least the normal menopause age.hormone support therapy should be implemented.
The lifespan of the ovaries is determined by the number of egg cells in them. While the girl is still in her mother's womb and in the 20th week of pregnancy, there are approximately 2-3 million eggs in each ovary. This is the highest number of egg cells a woman has in her entire life. When a baby girl is born, this number drops to 1 million in each ovary and to 300,000 during adolescence. Therefore, for the ovaries “organ that ages before birth” The term is used.
This number drops to 10,000 when the woman turns 40. While some of these eggs disappear every month during the reproductive age, only one of them matures and ovulation occurs. During a woman's entire reproductive age, that is, between the ages of 13 and 48, only around 400-500 eggs mature enough to potentially result in pregnancy. After the age of forty, a significant acceleration in the loss of eggs is observed. Running out of eggs is now not producing hormones and amenorrhea so menopause It is defined as .
Diagnosis of menopause While it can be made clinically, the most definitive diagnosis is blood secretion from the brain. FSH, LH and E2 hormones secreted from the ovaries are placed with their levels.
In the case of "hidden ovarian failure", although the patient is menstruating, her blood FSH level is above the average for that age group, and ultrasound shows that there is a decrease in the number of structures in the ovary called follicles, which indicate the egg production reserve. This may be one of the reasons why some women cannot have children.
Causes of Early Menopause
Genetic Causes:
Genetic causes are seen in 40% of patients with premature ovarian failure. The type of genetic transmission can be dominant or recessive, depending on the X chromosome or other chromosomes. However, no definitive data has been revealed about how the genetic transition occurs. People who have women in their families who went through early menopause should be more careful in this regard and Not delaying having children There is benefit.
Among the known genetic causes Turner Syndrome, minor defects in the X-chromosome, some enzyme deficiencies such as 17-Hydroxylase and Aromatase, receptor disorders of hormones There are diseases such as.
Infections of the Ovaries Due to Viruses:
Infection in the ovaries is also observed in 2-8% of women with mumps infection. It is suggested that this infection may cause ovarian damage, leading to early menopause. In addition, although it has been suggested that there is a relationship between cytomegalovirus, malaria, chickenpox and dysentery and early menopause, no definitive evidence has been provided for this opinion.
In addition, treatments such as Chemotherapy and Radiotherapy applied for cancer treatment, disorders of the immune system It can also cause early menopause.
In a small portion of patients with premature ovarian failure, antibodies against the ovaries are synthesized and cause destruction of the ovarian tissue. In this group of patients, the likelihood of developing diseases characterized by the production of antibodies against the patient's own tissues increases. autoimmune diseases This group of diseases can occur as thyroid, parathyroid and adrenal gland disorders, some rheumatic diseases, some blood diseases and diabetes.
How is Early Menopause Diagnosed?
The diagnosis of premature ovarian failure is made by looking at the levels of FSH, LH and E2 hormones in the blood. For a definitive diagnosis, blood samples must be taken 4 times at 1-week intervals. After diagnosis, considering that some of these patients have an increased risk of autoimmune disease, the following tests should be performed:
Calcium, phosphorus, fasting blood sugar, fasting cortisol level, free thyroid hormones, TSH, thyroid antibodies, blood count, sedimentation rate, total protein/globulin, rheumatoid factor, ANA.
Additionally, if the patient is under 35 years of age chromosome analysis must also be done.
Treatment of Early Menopause
First of all, it is necessary to consider that spontaneous reversal may occur in 10-15% of these patients and to check hormone levels at regular intervals (for example, every 6 months). If the person wants to have a child, FSH and LH levels in the blood should be checked, and if the FSH/LH ratio is less than 1, ovarian stimulant medications should be tried.
Other patients should begin hormone therapy to prevent osteoporosis and other menopausal symptoms. It should not be forgotten that 10-20% of patients may spontaneously go through menopause during hormone therapy, and therefore a small portion of patients may become pregnant spontaneously. Hormone treatment does not prevent pregnancy and there is no serious potential for anomaly in the resulting pregnancy.
In patients who have chromosomal disorders and have never had a menstrual period from the beginning hormone supplement There is nothing that can be done other than that. The only way to have children in these patients is egg donation.
It depends on the genetic structure, but in cases where the patient enters menopause after puberty, hormone support until a certain age and children are desired. egg donation Other than that there isn't much that can be done.
Hormone supplements can be administered with separate estrogen and progesterone pills or birth control pills.
Early Menopause can occur at any age under the age of 40. In other words, even a woman aged 18 or 22 may go through menopause, she will no longer menstruate and her fertility will be lost.
As a final word, these women who enter early menopause are prone to osteoporosis, heart disease, and ultimately shortening life expectancyEarly menopause, a disease that can even cause definitely Treatment with appropriate medications is required.