Dr Chris Nwan, a general medical practitioner with St Bernadeth Hospital, Ikorodu, Lagos, discusses early menopause with SIMON UTEBOR
What is menopause?
Menopause is the natural decline of reproductive hormone in a woman who is above 40 or 50 years. But averagely, it is 51 years. However, it occurs in some women in their 40s and some in their 50s.
What then is early menopause and when does that occur in a woman?
Early menopause is when menopausal conditions start earlier in a woman. For instance, it starts in a woman in her 30s. Normally, a woman should be expecting her menopause in her 40s or 50s, but in this condition of early menopause, it starts earlier before 40.
What are the causes of early menopause?
It is a natural occurrence. Once a woman is born, at a time in her life, she will meet her menopause.
But what is worrisome is that some women see it much earlier than others.
Don’t you feel there must be a reason why it is so?
History is viewed according to medical statistics that women that face early menopause in life, sometime this condition was predisposed when their mothers were even pregnant for them because when a woman is predisposed to any radioactive element while pregnant, the radioactive elements can damage the ovaries in the bodies of unborn babies. When the baby is born with this kind of nature, it is called congenital abnormality. When such a baby grows, it can face this condition of early menopause. But it was not caused by what she did or what she eat during her early days or may be during her adolescent but this condition was caused to her by her mother when she was in the womb. Again, any woman that exposes herself to any radioactive element of that nature when she is born can also face the condition because the radioactive element is capable of damaging the ovary whether in the womb or outside the womb.
What are the differences between premature ovarian failure and premature menopause?
They have similarities but they are different. The similarity is that they have the same nature of occurrence. If two persons don’t see their menses, different things can cause it. The difference is that premature ovarian follicle arises when the hormone that induces ovulation is not capable of doing that in a woman. Its cause can be genetic, that is, it runs through the lineage. Another thing that can cause it in a woman is when she is addicted to hard drugs, alcohol and smoking etc. Infections can also lead to that. But in the premature menopause, it can be caused only by damage which I have said before. When the damage was done, maybe when the woman was in the womb or after she was born and in her early life, somehow she was exposed to radioactive element that damaged her ovary.
When is it advisable to see a doctor?
It is advisable to see a doctor when a woman experiences any of the underlying symptoms. She does not need to see fellow women who may give her wrong information and advice. It is only the doctor that will explain to the affected woman what is actually happening to her.
What are the risk factors of developing early menopause?
Before a woman goes to any radioactive element for diagnostic purposes, she should do that on the advice of the doctor. Women should not just go to Xray room and say they want to do chest Xray, abdominal Xray, lumber Xray and other Xray just because one can do that. You can see that even those who do the Xray, don’t even allow the radioactive ray to touch their bodies because they know the implication. Another thing is that anything that is wrong in your body that needs medical attention, you should go to hospital; you don’t go to patent medicine practitioners, herbalists or herb sellers. It is in the hospital that you can get proper tests and treatments.
How is it diagnosed?
It is diagnosed when a woman has not seen her menstrual flow for 12 months. There are factors or conditions that can make a woman not to see menses for months, it does not mean that the person has menopause even when she is in her 30s, 40s or 50s. But when it is counted for 12 months and a woman does not see her period, that is the first sign of menopause. Such a woman needs to go to the hospital for medical advice and attention.
What do doctors use to diagnose such condition?
Such a condition can only be diagnosed through clinical presentations because it comes with dryness of vaginal, pains, insomnia and anxiety etc. And the person has to confirm that the menstruation has not occurred in the last 12 months. Based on not seeing menstruation, which is called avonorhea, and it is said that it has been up to 12 months because if it is not up to 12 months, it could be some diseases that have prevented the woman from seeing her menses. If it is not up to 12 months, it cannot be confirmed menopause. That is the medical position. The history has to be taken first to confirm from the last time of menses to the period of investigation.
With the case of early menopause, what advice do you have for ladies who want to stay above 30 before getting married?
Women should have clear information about menopause. Some of them who are planning getting married by 30s or 40s, who are not even concerned, do not have true knowledge of menopause. The information should be clear to them. I think if they have clear knowledge and information of menopause, it would help them greatly. The first thing these women should know about is what is menopause and what time or age it occurs. Only this information can change their decision or what they have embarked on.
Is there technology to correct this condition?
Yes, the technology they use these days is that some women freeze their eggs. Those who have gone to the extent of not wanting to marry early in life or want to finish their studies in school or do one thing or another for themselves and their families, go about freezing their eggs which will make them not to menstruate. When they are ready to marry, they go back and unfreeze their eggs. That is releasing their eggs to indicate they are ready.
Don’t you think there will be medical problems associated with eggs freezing?
Anyway, we are still getting information. We were told that it has side effect which is not yet confirmed. But for now, not every woman can afford that procedure because it is very expensive.
Talking about freezing the eggs, does it mean if a woman freezes her egg at 20, could she unfreeze it at 60 for instance and still have babies?
It is a decision some women take for one month, two months, one year and so on. It is a choice. For instance, it is just like a person decides to lock a room for one week, and after that one week, you reopen the room. Freezing is just like locking egg from coming out in the form of ovulation.
Conception is all about when a woman is able to achieve menstruation and ovulation. But there are other factors and gynaecological organs in the body that play major role in pregnancy. One cannot say one can freeze one’s egg at 20, when one is 60 things will work perfectly. One can unfreeze one’s egg without having the clear idea of other organs involved. When you freeze your egg, fine and good, but when you unfreeze it, what about other organs of the body to carry the baby? What about the strength to carry the baby? Other body organs are growing old. Therefore, when one thinks like that without proper medical advice, it also has side effects as there are people who cannot achieve pregnancy because their womb is weak and the strength of giving birth, pushing and whatever thing one is involved in during pregnancy is no longer there. The idea may turn out to be a disappointment because the egg may be achieved but the pregnancy may not be achieved.
What are treatments available for women having signs of early menopause?
Their treatment is based on clinical presentations. Nature decides when it happens to a woman. Early menopause as I have said is when it occurs before normal natural time – in the 40s and 50s. It is nature that decides. A woman can be born with more eggs and in 30s she will not see her menopause and another woman is born with fewer eggs. The one that has fewer eggs and the one that has multiple eggs, their period of menopause will not be the same. Another factor is that there are people that start seeing their menstrual period early in life, at nine or 10, they start seeing it but another person will start seeing her own at 17 or 18. Their menopausal time will not be the same. So, history has to indicate when a woman starts seeing her period and the advice will be based on such history. If one starts early, one will stop early. She is already predisposed to seeing her menopause early that is why she should see her doctor early.
Does diet also contribute to early menopause?
In these modern days, so many women eat noodles, among others that have effects on hormones induction. You can see a little girl of nine years developing breasts whereas some girls at 12 have yet to develop breasts. It means that their hormonal level is not the same. The one that has to do with all these chemicals have more stimulation on her hormonal follicle and is likely start her menstruation early in life and when it starts early, it is likely that it will stop early.
What are its symptoms?
The symptoms of menopause include dryness of the vagina, rashes in the body, sleepless night which is called insomnia, worries and anxiety, headache and weakness of the general body, and weight addition – these are the clinical presentations of menopause.
What is the cure?
There is no permanent cure for menopause. The cure is majorly based on clinical presentations – signs and symptoms. There should be psychological therapy, which is advice on the clear knowledge of what is happening to her will clear her anxiety before you start taking care of dryness of vagina. Dryness of vagina may cause pains when she wants to meet her husband.
Does exposure to sex early have anything to do with early menopause?
No, it has nothing to do with menopause. It can be suspected but not yet medically confirmed.