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HindustanTimes Tue,21 Oct 2014

Gyrating hormones causing some women to hit menopause before 40

Rhythma Kaul and Antara Sengupta, Hindustan Times   July 13, 2013
First Published: 22:29 IST(13/7/2013) | Last Updated: 08:59 IST(14/7/2013)

When Archana Monga’s menstrual cycle stopped abruptly at the age of 30, her doctors investigated her for everything other than signs of menopause, which normally occurs when women are around 51.


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Ultrasounds and MRI scans showed that her uterus wall was thicker than usual, which prompted further investigations showing high levels of sex steroid hormone (SSH, which play a crucial role in functioning of reproductive tissue) and Luteinising Hormone (LH, which plays a role in sexual development).

Monga was stunned when she was told hers was a case early menopause, and the condition could not be reversed with treatment. Tests revealed a tiny mass in her uterus that was cancerous.  Fortunately for her, it was detected at a very early stage, and she is cancer-free. 

“I used to have irregular periods but I never thought I would get menopause at 30. It was a big blow as my parents then, were looking for a match for me and I also dreamt of getting married and have kids,” says Monga, 34, who works for a private bank in Delhi. “Doctors attributed my condition to me being overweight and leading a sedentary lifestyle,” she adds.

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Gynaecologists say it is possible to identify women who may develop ovarian failure early in life.

“Those having irregular periods, or those who miss periods for months  and then get them suddenly one day, those with longer or shorter menstrual days, those suffering from polycystic ovarian syndrome (PCOS) or other hormonal condition such as thyroid etc, are all high risk cases,” said Dr Sadhna Singhal, senior consultant, department of gynaecology and obstetrics at Delhi’s Sri Balaji Action Medical Institute.

Blaming it on lifestyle is an over-simplification, but the fact is there is an increase in the number of women under 40 being diagnosed with early menopause.

“We have started getting women with ovarian functions on a wane in their 30s and they are on the verge of hitting menopause,” said Dr Madhu Ahuja, senior consultant, department of gynaecology and obstetrics, Max, Patpar Ganj.

Many physicians believe factors such as undernutrition, junk  consumption, stress, alcohol, smoking, pollution, lack of exercise and delay in having the first child increase your risk of early menopause.

“Sometimes chronic and prolonged stress may lead to early menopause or premature ovarian failure. The major causes include chemotherapy, removal of both ovaries, chromosomal defects, a genetic history of early menopause, autoimmune diseases like thyroid imbalances and overenthusiastic doctors who keep surgically removing cysts from ovaries,” says fertility expert Anjali Malpani.  

When Deepa Gowda, 37, a Pune-based housewife who had no idea she has PCOS until she and her husband decided to have a child and she had difficulty conceiving. After eight months of fertility medication, she conceived. Six months after the birth, her menstrual cycles turned erratic, falling into a rhythm only with medication.

Her tests revealed a bulky uterus and dysfunctional ovaries. She has now been diagnosed with premature ovarian failure, a sign of premature menopause. “If the levels of the two hormones — SSH and LH — are under 40, it is a salvageable condition and treatment can be started. However, if the hormone levels are very high and menopause has already set in, it cannot be treated,” said Dr Singhal.

Early menopause also indicates a high risk for heart diseases, bone loss, mood disorders, diabetes and cancer of the uterus. Treatment usually involves hormone replacement therapy, for which women are prescribed daily one or two tablets of the hormones estrogen and progesterone.

“Treatment is given to induce artificial bleeding, using hormones. Progesterone is a safer hormone and we prefer it over estrogen that has its side-effects such as high risk of developing cancers of the breast or the uterus,” said Ahuja.

Doctors recommend daily intake of calcium and multi-vitamins, exercise and a healthy balanced diet to cut down the risk of hitting menopause early.


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