Factors affect the early onset of menopause in women recently

Menopause marks the end of a female's reproductive years, but usually it occurs at an age range from 45 to 55. However some women experience early menopause during their lifetime before, that is before the age of 40. This appears to be distressing since it brings a lot of physical, emotional, and lifestyle changes earlier than it has been anticipated. Knowing the causes of early menopause helps in preventing and managing it. Here are the key factors that influence the early onset of menopause:

1. Genetics: Genetics determine when a woman will experience menopause. A woman is likely to be an early menopause patient if her mother or her near female relatives experienced the condition much earlier. Family history would be one of the biggest predictors of early menopause. This can be due to the fact that the age at which menopause begins could be inherited.

2. Smoking: Smoking has been linked with the early occurrence of menopause. It is well documented that cigarettes contain chemicals such as nicotine that alter the structure of the ovaries, thus inhibiting estrogen synthesis. Hence smokers are likely to experience menopause earlier than non-smokers. Furthermore, the amount smoked and duration accelerates or causes early menopause.

3. Autoimmune Disorders: Some autoimmune diseases, such as rheumatoid arthritis, lupus, and thyroid disorders, may cause a female body's immune system to attack the ovaries, leading to a woman experiencing an early failure of her ovaries. These diseases are known to affect hormone levels in the body and also disrupt the proper functioning of the ovaries, hence usually manifesting early menopause in a woman.

4. Chemotherapy and Radiation: Women who undergo chemotherapy or radiation therapy - especially when cancers are close to the reproductive organs - usually suffer early menopause. Chemotherapy and radiation therapy often damage ovaries, interfering with their eggs and hormones. The extent of this damage often depends on the dosage and duration of the treatment along with age at the time.

5. Surgical Removal of Ovaries: Oophorectomy, or the removal of one or both ovaries, is a surgical procedure that directly leads to menopause. Women who undergo this surgery will go into immediate menopause due to the body's inability to generate any more eggs or the hormone that causes menstruation to occur. Partial removal of the ovaries can cause early menopause since the remaining tissue might not function correctly.

6. Chronic Health Conditions: Some chronic diseases, like diabetes or epilepsy, have been associated with an earlier onset of menopause. For example, women with Type 1 diabetes experience menopause earlier than disease-free women, possibly because the way blood sugar is controlled affects the ovaries. Similarly, some studies correlated epilepsy with hormonal imbalance that would accelerate ovarian aging.

7. Low Body Mass Index (BMI): Body weight also influences the age at which a woman experiences menopause. A woman with a low BMI, less than 18.5, is bound to experience menopause earlier because body fat has estrogen as one of its origins. The estrogen stores in a woman will deplete faster when her body fat level reduces, hence predisposing her to menopause. Women with a higher BMI experience their menopause slightly later .

Onset of menopause is multifactorial, following a genetic, lifestyle, and medical predisposition. Although some cannot control the onset based on hereditary factors or due to an absolute necessity of medication for another disease condition, lifestyle choices to avoid smoking and be of healthy body weight can delay the transition. These factors help women have better information in making choices regarding health, thus preparing them to face early changes at the physical and emotional levels during such a critical transition.
( Author: Dr Deepika Aggarwal, Director - Obs and gynae at CK Birla Hospital)